神经外科的核心结局：腓总神经病变核心结局集的制定
Core outcomes in nerve surgery: development of a core outcome set for common peroneal (fibular) neuropathy.
作者信息
Wilson Thomas J, Ali Zarina S, Davis Gavin A, Dengler Nora F, Desai Ketan, Garozzo Debora, Guedes Fernando, Jack Megan M, Jacques Line G, Kretschmer Thomas, Mahan Mark A, Midha Rajiv, Pondaag Willem, Puffer Ross C, Rasulic Lukas, Ray Wilson Z, Rizk Elias, Rodriguez-Aceves Carlos A, Shapira Yuval, Smith Brandon W, Socolovsky Mariano, Spinner Robert J, Zager Eric L
机构信息
1Department of Neurosurgery, Stanford University, Stanford, California.
2Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
出版信息
J Neurosurg. 2024 Aug 16;142(2):538-546. doi: 10.3171/2024.5.JNS24614. Print 2025 Feb 1.
OBJECTIVE
Common peroneal (fibular) neuropathy is the most common mononeuropathy of the lower extremity. Despite this, there are surprisingly few studies on the topic, and a knowledge gap remains in the literature. As one attempts to address this knowledge gap, a core outcome set (COS) is needed to guide the planning phases of future studies to allow synthesis and comparability of these studies. The objective of this study was to develop the COS-common peroneal neuropathy (CoPe) using a modified Delphi approach.
METHODS
A 5-stage approach was used to develop the COS-CoPe: 1) stage 1, consortium development; 2) stage 2, a literature review to identify potential outcome measures; 3) stage 3, a Delphi survey to develop consensus on outcomes for inclusion; 4) stage 4, a Delphi survey to develop definitions; and 5) stage 5, a consensus meeting to finalize COS and definitions. The study followed the COS-STAndards for Development (COS-STAD) recommendations.
RESULTS
The Core Outcomes in Nerve Surgery (COINS) Consortium comprised 23 participants, all neurological surgeons, representing 13 countries. The final COS-CoPe consisted of 31 data points/outcomes covering domains of demographics, diagnostics, patient-reported outcomes, motor/sensory outcomes, and complications. Appropriate instruments, methods of testing, and definitions were set. The consensus minimum duration of follow-up was 12 months. The consensus optimal time points for assessment were preoperatively and 3, 6, 12, and 24 months postoperatively.
CONCLUSIONS
The COINS Consortium developed a consensus COS and provided definitions, methods of implementation, and time points for assessment. The COS-CoPe should serve as a minimum set of data that should be collected in all future neurosurgical studies on common peroneal neuropathy. Incorporation of this COS should help improve consistency in reporting, data synthesis, and comparability, and should minimize outcome reporting bias.
目的
腓总神经病变是下肢最常见的单神经病变。尽管如此，关于该主题的研究却出奇地少，文献中仍存在知识空白。在试图填补这一知识空白时，需要一个核心结局集（COS）来指导未来研究的规划阶段，以便这些研究能够进行综合和比较。本研究的目的是采用改良的德尔菲法制定COS-腓总神经病变（CoPe）。
方法
采用五阶段方法制定COS-CoPe：1）第一阶段，组建联盟；2）第二阶段，进行文献综述以确定潜在的结局指标；3）第三阶段，进行德尔菲调查以就纳入的结局达成共识；4）第四阶段，进行德尔菲调查以制定定义；5）第五阶段，召开共识会议以最终确定COS和定义。该研究遵循了COS-发展标准（COS-STAD）的建议。
结果
神经外科核心结局（COINS）联盟由23名参与者组成，均为神经外科医生，代表13个国家。最终的COS-CoPe由31个数据点/结局组成，涵盖人口统计学、诊断、患者报告结局、运动/感觉结局和并发症等领域。设定了合适的工具、测试方法和定义。随访的共识最短持续时间为12个月。评估的共识最佳时间点为术前以及术后3、6、12和24个月。
结论
COINS联盟制定了一个共识性的COS，并提供了定义、实施方法和评估时间点。COS-CoPe应作为所有未来关于腓总神经病变的神经外科研究中应收集的最低数据集。纳入该COS应有助于提高报告的一致性、数据综合和可比性，并应尽量减少结局报告偏倚。
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