Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom.
Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
Ann Am Thorac Soc. 2024 Dec;21(12):1742-1750. doi: 10.1513/AnnalsATS.202406-581OC.
Findings from individual trials of physical rehabilitation interventions in critically ill adults have limited potential for meta-analysis and informing clinical decision-making because of the heterogeneity in selection and reporting of outcomes used for evaluation. The objective of this study was to determine a core outcome set (COS) for use in all future trials evaluating physical rehabilitation interventions delivered across the critical illness continuum of recovery. An international, two-round, online, modified Delphi consensus process, following recommended standards, was conducted. Participants ( = 329) comprised three stakeholder groups-researchers, = 58 (18%); clinicians, = 247 (75%); and patients and caregivers, = 24 (7%)-and represented 26 countries and nine healthcare professions. Participants rated the importance of a range of relevant outcomes. Outcomes included in the COS were those prioritized of "critical importance" by all three stakeholder groups. Survey response rates were 88% (Round 1) and 91% (Round 2). From a total of 32 initial outcomes, the following outcomes reached consensus for inclusion in the COS: physical function, activities of daily living, survival, health-related quality of life, exercise capacity, cognitive function, emotional and mental well-being, and frailty. This study developed a consensus-generated COS for future clinical research evaluating physical rehabilitation interventions in critically ill adults across the continuum of recovery. Ascertaining recommended measurement instruments for these core outcomes is now required to facilitate implementation of the COS.
在危重病成年人中进行的物理康复干预的个体试验的结果由于用于评估的结局选择和报告的异质性，对荟萃分析和为临床决策提供信息的潜力有限。本研究的目的是确定一个核心结局集（COS），用于评估在整个危重病康复连续体中提供的物理康复干预的所有未来试验。采用国际、两轮、在线、改良 Delphi 共识过程，并遵循建议的标准进行。参与者（ = 329）由三个利益相关者群体组成-研究人员， = 58（18%）；临床医生， = 247（75%）；以及患者和护理人员， = 24（7%）-代表 26 个国家和 9 个医疗保健专业。参与者对一系列相关结局的重要性进行了评分。COS 中包含的结局是所有三个利益相关者群体都认为“至关重要”的结局。第一轮调查的回复率为 88%，第二轮为 91%。从总共 32 个初始结局中，以下结局达成共识，被纳入 COS：身体功能、日常生活活动、生存、健康相关生活质量、运动能力、认知功能、情绪和心理健康以及虚弱。本研究为评估危重病成年人康复连续体中物理康复干预的未来临床研究制定了一个共识生成的 COS。现在需要确定这些核心结局的推荐测量工具，以促进 COS 的实施。
