Development of a core outcome set for open lower limb fracture: what core outcomes should be measured?

Bone & Joint Research

article

Alexander L. Aquilina¹  Henry Claireaux¹  Christian O. Aquilina²  Elizabeth Tutton¹  Ray Fitzpatrick³  Matthew L. Costa¹  Xavier L. Griffin⁴ 

[1] Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford;The Royal Free Hospital NHS Foundation Trust;Nuffield Department of Population Health, University of Oxford;Barts Health NHS Trust

关键词: Open fracture;    Open lower limb fracture;    Core outcome set;    Outcome;    open lower limb fractures;    Healthcare professionals;    morbidity;    lower limb fracture;    Deep infection;    Orthopaedic Trauma;    infection;    consultant surgeons;    standard deviations;   

DOI  :  10.1302/2046-3758.124.BJR-2022-0164.R2

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsOpen lower limb fracture is life-changing, resulting in substantial morbidity and resource demand, while inconsistent outcome-reporting hampers systematic review and meta-analysis. A core outcome set establishes consensus among key stakeholders for the recommendation of a minimum set of outcomes. This study aims to define a core outcome set for adult open lower limb fracture.MethodsCandidate outcomes were identified from a previously published systematic review and a secondary thematic analysis of 25 patient interviews exploring the lived experience of recovery from open lower limb fracture. Outcomes were categorized and sequentially refined using healthcare professional and patient structured discussion groups. Consensus methods included a multi-stakeholder two-round online Delphi survey and a consensus meeting attended by a purposive sample of stakeholders, facilitated discussion, and voting using a nominal group technique.ResultsThematic analysis and systematic review identified 121 unique outcomes, reduced to 68 outcomes following structured discussion groups. Outcomes were presented to 136 participants who completed a two-round online Delphi survey. The Delphi survey resulted in 11 outcomes identified as consensus ‘in’ only. All outcomes were discussed at a consensus meeting attended by 15 patients, 14 healthcare professionals, 11 researchers, and one patient-carer. Consensus was achieved for a four-core outcome set: ‘Walking, gait and mobility’, ‘Being able to return to life roles’, ‘Pain or discomfort’, and ‘Quality of life’.ConclusionThis study used robust consensus methods to establish a core outcome set that should be measured in all future research studies and audits of clinical practice without precluding the measurement of additional outcomes.

【 授权许可】

CC BY-NC