O'Malley Nicola, Coote Susan, Clifford Amanda M
School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
HRB Open Res. 2022 May 6;4:123. doi: 10.12688/hrbopenres.13459.2. eCollection 2021.
Given the high incidence of falls and their associated negative effects, the development of effective falls prevention interventions for people with Multiple Sclerosis (MS), Parkinson's Disease (PD) and stroke is a priority. Currently the implementation of condition-specific falls prevention interventions is challenging in the community due to lack of participants and resources. Given the similarities in falls risk factors across stroke, PD and MS, the design of mixed-diagnosis interventions for groups comprising of people with these three neurological conditions may solve these implementation challenges. Having a core outcome set (COS) for evaluating these interventions would enable the comparison and combination of data, thereby facilitating progress in this research area. Therefore, the aim of this research study is to develop a COS for evaluating mixed-diagnosis falls prevention interventions for people with MS, PD and stroke. This will be a mixed-methods, international, multi-perspective Delphi consensus study with five stages. Stage one will involve the identification of potential outcomes through a systematic literature search, patient focus groups, and consultation with our stakeholder group. The second stage will be the development of the Delphi survey using the outcomes elicited from stage one. Stage three will be the prioritisation of outcomes using a two-round online Delphi survey involving patients, clinicians, researchers and policy-makers/service-planners. The fourth stage will be to identify and recommend outcome measures and definitions. The final stage will be a consensus meeting with representatives from each stakeholder group to agree upon the final COS. Adoption of this COS in future trials investigating the effectiveness of mixed-diagnosis falls prevention interventions for people with MS, PD and stroke will facilitate the comparison and combination of research findings. This should translate into improved decision-making by service-planners/policy-makers and clinicians regarding the implementation of evidence-based falls prevention interventions into practice.
鉴于跌倒的高发生率及其相关的负面影响，为多发性硬化症（MS）、帕金森病（PD）和中风患者制定有效的跌倒预防干预措施是当务之急。目前，由于缺乏参与者和资源，在社区中实施针对特定疾病的跌倒预防干预措施具有挑战性。鉴于中风、PD和MS的跌倒风险因素相似，为包含这三种神经系统疾病患者的群体设计混合诊断干预措施可能会解决这些实施难题。拥有一个核心结局集（COS）来评估这些干预措施将能够对数据进行比较和整合，从而推动该研究领域的进展。因此，本研究的目的是开发一个COS，用于评估针对MS、PD和中风患者的混合诊断跌倒预防干预措施。这将是一项采用混合方法、具有国际性、多视角的德尔菲共识研究，共分为五个阶段。第一阶段将通过系统的文献检索、患者焦点小组以及与我们的利益相关者群体进行磋商，来确定潜在的结局。第二阶段将利用第一阶段得出的结局来开发德尔菲调查问卷。第三阶段将通过两轮在线德尔菲调查对结局进行优先级排序，参与调查的人员包括患者、临床医生、研究人员以及政策制定者/服务规划者。第四阶段将确定并推荐结局测量指标和定义。最后阶段将与每个利益相关者群体的代表召开一次共识会议，以商定最终的COS。在未来调查针对MS、PD和中风患者的混合诊断跌倒预防干预措施有效性的试验中采用这个COS，将有助于对研究结果进行比较和整合。这应该会促使服务规划者/政策制定者和临床医生在将基于证据的跌倒预防干预措施应用于实践方面做出更好的决策。
