Smith Paul, Cooper Natalie, Dhillon-Smith Rima, O'Toole Emily, Clark T Justin, Coomarasamy Arri
Academic Department, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham Women's Hospital, Birmingham, West Midlands, UK.
Women's Health Research Unit, Barts and The London School of Medicine, Queen Mary University of London, London and Barts Health NHS Trust, London, UK.
BMJ Open. 2017 Nov 16;7(11):e018535. doi: 10.1136/bmjopen-2017-018535.
'Core outcome sets' are an agreed, standardised set of outcomes based on what key stakeholders (clinicians, patients, their partners, researchers, service developers, funding organisations and so on) consider the important outcomes in the management or prevention of a condition. This paper describes the rationale and design for the development of Core Outcome Sets for Miscarriage Trials.
Systematic reviews, interviews and focus groups with patients and their partners will be conducted to identify potential core outcomes that will be introduced into a modified Delphi survey. To ensure all key stakeholders are included, patients, partners, clinicians, charities and researchers will be invited to take part in the modified Delphi survey. There will be three rounds of scoring and rescoring during the Delphi survey to reach consensus regarding outcomes to be included in the core set, which will be subsequently refined through face-to-face consensus discussions.
The use of core outcome sets allows results from different studies to be compared and combined, thereby reducing inconsistency and aiding interpretation of study findings. It also means research is more likely to report relevant outcomes and so can reduce reporting bias. Understanding which outcomes are important to patients has the potential to act as a driver to improve both the quality and cost-effectiveness of miscarriage services.
“核心结局集”是一组基于关键利益相关者(临床医生、患者、其伴侣、研究人员、服务开发者、资助机构等)认为在某种疾病的管理或预防中重要结局而达成一致的标准化结局。本文描述了流产试验核心结局集制定的基本原理和设计。
将进行系统评价、与患者及其伴侣的访谈和焦点小组讨论,以确定潜在的核心结局,这些结局将被纳入改良的德尔菲调查。为确保纳入所有关键利益相关者,将邀请患者、伴侣、临床医生、慈善机构和研究人员参与改良的德尔菲调查。在德尔菲调查期间将进行三轮评分和重新评分,以就纳入核心集的结局达成共识,随后通过面对面的共识讨论进行完善。
使用核心结局集可使不同研究的结果进行比较和合并,从而减少不一致性并有助于解释研究结果。这也意味着研究更有可能报告相关结局,因此可减少报告偏倚。了解哪些结局对患者重要有可能推动流产服务质量和成本效益的提高。