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神经外科的核心结局:坐骨神经损伤和神经病变评估核心结局集的制定。

Core outcomes in nerve surgery: development of a core outcome set for sciatic injury and neuropathy evaluation.

作者信息

Wilson Thomas J, Ali Zarina S, Davis Gavin A, Dengler Nora F, Desai Ketan, Garozzo Debora, Guedes Fernando, Jacques Line G, Kretschmer Thomas, Mahan Mark A, Midha Rajiv, Puffer Ross C, Rasulic Lukas, Ray Wilson Z, Rizk Elias, Rodriguez-Aceves Carlos A, Shapira Yuval, 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. 2025 Mar 28;143(2):568-577. doi: 10.3171/2024.12.JNS242467. Print 2025 Aug 1.

Abstract

OBJECTIVE

Core outcome sets (COSs) are needed to promote data consistency across studies as well as data synthesis and comparability. The goal of the current study was to utilize a modified Delphi process to develop a COS-sciatic injury and neuropathy evaluation (COS-SINE).

METHODS

A five-stage approach was utilized to develop the COS-SINE: stage 1, consortium development; stage 2, literature review to identify potential outcome measures; stage 3, Delphi survey to develop consensus on outcomes for inclusion; stage 4, Delphi survey to develop definitions; and stage 5, consensus meeting to finalize the COS and definitions. The study followed the Core Outcome Set-STAndards for Development recommendations.

RESULTS

The Core Outcomes in Nerve Surgery (COINS) Consortium comprised 23 participants, all neurological surgeons, representing 13 countries. Three participants were excluded on the basis of agreed upon participation rules. The final COS-SINE consisted of 36 data points/outcomes covering the domains of demographics, diagnostics, patient-reported outcomes, motor and sensory outcomes, and complications. Appropriate instruments, methods of testing, and definitions were set. The consensus minimum duration of follow-up was 24 months, with consensus optimal time points for assessment identified as preoperatively and 3, 6, 12, 24, and 36 months postoperatively.

CONCLUSIONS

The COINS Consortium developed a consensus COS and provided definitions, methods of implementation, and time points for assessment. The COS-SINE should serve as a minimum set of data that should be collected in all future neurosurgical studies on sciatic nerve injury and neuropathy. Incorporation of this COS should help improve consistency in reporting and data synthesis and comparability and should minimize outcome-reporting bias.

摘要

目的

需要核心结局集(COSs)来促进各项研究之间的数据一致性以及数据综合和可比性。本研究的目的是利用改良的德尔菲法来制定一个坐骨神经损伤和神经病变评估的核心结局集(COS-SINE)。

方法

采用五阶段方法来制定COS-SINE:第1阶段,联盟组建;第2阶段,文献综述以确定潜在的结局指标;第3阶段,德尔菲调查以就纳入的结局达成共识;第4阶段,德尔菲调查以制定定义;第5阶段,共识会议以最终确定COS和定义。本研究遵循核心结局集-开发标准建议。

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。根据商定的参与规则,排除了3名参与者。最终的COS-SINE由36个数据点/结局组成,涵盖人口统计学、诊断、患者报告结局、运动和感觉结局以及并发症等领域。设定了适当的工具、测试方法和定义。随访的共识最短持续时间为24个月,确定的共识最佳评估时间点为术前以及术后3、6、12、24和36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-SINE应作为所有未来关于坐骨神经损伤和神经病变的神经外科研究中应收集的最小数据集。纳入这个COS应有助于提高报告和数据综合的一致性以及可比性,并应尽量减少结局报告偏倚。

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