Schwendicke Falk, Lamont Thomas, Innes Nicola
Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
Dundee Dental School, University of Dundee, Park Place, Dundee, Tayside, UK.
Trials. 2015 Sep 7;16:397. doi: 10.1186/s13063-015-0927-3.
Clinical trials on caries lesion management use an abundance of outcomes, hampering comparison or combination of different study results and their efficient translation into clinical practice. Core outcome sets are an agreed standardized collection of outcomes which should be measured and reported in all trials for a specific clinical area. We aim to develop a core outcome set for trials investigating management of caries lesions in primary or permanent teeth conducted in primary or secondary care encompassing all stages of disease.
To identify existing outcomes, trials on prevention and trials on management of caries lesions will be screened systematically in four databases. Screening, extraction and deduplication will be performed by two researchers until consensus is reached. The definition of the core outcome set will by based on an e-Delhi consensus process involving key stakeholders namely patients, dentists, clinical researchers, health economists, statisticians, policy-makers and industry representatives. For the first stage of the Delphi process, a patient panel and a separate panel consisting of researchers, clinicians, teachers, industry affiliated researchers, policy-makers, and other interested parties will be held. An inclusive approach will be taken to involve panelists from a wide variety of socio-economic and geographic backgrounds. Results from the first round will be summarized and fed back to individuals for the second round, where panels will be combined and allowed to modify their scoring in light of the full panel's opinion. Necessity for a third round will be dependent on the outcome of the first two. Agreement will be measured via defined consensus rules; up to a maximum of seven outcomes. If resources allow, we will investigate features that influence decision making for different groups.
By using an explicit, transparent and inclusive multi-step consensus process, the planned core outcome set should be justifiable, relevant and comprehensive. The dissemination and application of this core outcome set should improve clinical trials on managing caries lesions and allow comparison, synthesis and implementation of scientific data.
Registered 12 April 2015 at COMET ( http://www.comet-initiative.org).
关于龋损管理的临床试验采用了大量的结局指标,这阻碍了不同研究结果的比较、合并以及它们有效地转化为临床实践。核心结局集是一组达成共识的标准化结局指标,在针对特定临床领域的所有试验中均应进行测量和报告。我们旨在为在初级或二级医疗保健机构中开展的、涵盖疾病各个阶段的、针对乳牙或恒牙龋损管理的试验制定一个核心结局集。
为了确定现有的结局指标,将在四个数据库中系统筛选关于龋病预防和龋损管理的试验。由两名研究人员进行筛选、提取和重复数据删除,直至达成共识。核心结局集的定义将基于电子德尔菲共识程序,该程序涉及关键利益相关者,即患者、牙医、临床研究人员、卫生经济学家、统计学家、政策制定者和行业代表。在德尔菲程序的第一阶段,将分别召开患者小组会议以及由研究人员、临床医生、教师、行业附属研究人员、政策制定者和其他相关方组成的单独小组会议。将采用包容性方法,让来自广泛社会经济和地理背景的小组成员参与进来。第一轮的结果将进行总结,并反馈给个人以进行第二轮会议,届时两个小组将合并,并允许根据全体小组成员的意见修改他们的评分。是否需要进行第三轮将取决于前两轮的结果。将通过既定的共识规则来衡量一致性;最多确定七个结局指标。如果资源允许,我们将调查影响不同群体决策的因素。
通过使用明确、透明和包容性强的多步骤共识程序,计划制定的核心结局集应该是合理、相关且全面的。该核心结局集的传播和应用应能改善龋损管理的临床试验,并有助于科学数据的比较、综合和实施。
于2015年4月12日在COMET(http://www.comet-initiative.org)注册。