Hudson George, Osborne-Grinter Maia, Staniszewska Aleksandra, McNally Eleanor, Black Stephen, Avgerinos Efthymios, Baccellieri Domenico, Hartung Olivier, Hunt Beverley J, Jalaie Houman, van Rijn Marie Josee, Mezes Peter, O'Sullivan Gerry, Ortega Marta Ramírez, Prandoni Paolo, Hinchliffe Robert, Ozdemir Baris A
Department of Vascular Surgery, North Bristol NHS Foundation Trust, Bristol, UK.
Department of Vascular Surgery, North Bristol NHS Foundation Trust, Bristol, UK; Department of Vascular Surgery, Bristol Medical School, University of Bristol, Bristol, UK.
Eur J Vasc Endovasc Surg. 2025 Aug;70(2):258-267. doi: 10.1016/j.ejvs.2025.04.005. Epub 2025 Apr 4.
Chronic venous disease (CVD) is a debilitating disease that results in significant morbidity and costs. A lack of standardised outcome reporting has made it difficult to evaluate the impact of interventions for CVD involving the deep veins. This study aimed to develop a core outcome set (COS) for studies evaluating interventions for this subset of CVD.
The COS was developed using the Core Outcome Measures in Effectiveness Trials (COMET) methodology. A systematic review and interviews with 19 patients experiencing post-thrombotic syndrome after deep vein thrombosis generated a longlist of outcomes, which was then refined by a steering group. Each outcome was rated on importance by patients and healthcare practitioners using a 9 point Likert scale within a Delphi survey. Outcomes not meeting consensus criteria in the first round were re-prioritised in a second round. Outcomes meeting the criteria for being critically important were discussed in a final meeting between patients and international experts to develop the COS.
The review and interviews generated 80 outcomes, which entered the Delphi process. In total, 233 stakeholders responded in the first round and 143 in the second round. Consensus was reached on 29 outcomes deemed critically important. These outcomes were discussed in the final meeting to yield seven general outcomes and six procedure specific outcomes, since some outcomes were not relevant to all patients with CVD. The general outcomes were death, lower limb ulceration, venous thromboembolism, bleeding, quality of life, limb pain, and oedema or limb swelling. The procedure specific outcomes were device migration, device mechanical failure, patency, technical and/or procedural success, re-intervention, and vascular complications.
A COS was developed for studies evaluating interventions for CVD involving the deep veins, comprising seven general outcomes and six procedure specific outcomes. Reporting these outcomes will promote comparison of interventions for CVD involving the deep veins.
慢性静脉疾病(CVD)是一种使人衰弱的疾病,会导致严重的发病率和成本。由于缺乏标准化的结果报告,难以评估涉及深静脉的CVD干预措施的影响。本研究旨在为评估这一CVD亚组干预措施的研究制定一套核心结局集(COS)。
使用有效性试验中的核心结局指标(COMET)方法制定COS。通过系统综述以及对19例深静脉血栓形成后出现血栓后综合征的患者进行访谈,得出了一份结局长清单,然后由一个指导小组进行完善。在德尔菲调查中,患者和医疗从业者使用9点李克特量表对每个结局的重要性进行评分。在第一轮中未达到共识标准的结局在第二轮中重新排序。在患者与国际专家的最终会议上讨论了符合至关重要标准的结局,以制定COS。
综述和访谈产生了80个结局,进入了德尔菲过程。第一轮共有233名利益相关者做出回应,第二轮有143名。就29个被认为至关重要的结局达成了共识。在最终会议上对这些结局进行了讨论,得出了7个一般结局和6个特定手术结局,因为有些结局并非与所有CVD患者都相关。一般结局为死亡、下肢溃疡、静脉血栓栓塞、出血、生活质量、肢体疼痛以及水肿或肢体肿胀。特定手术结局为装置移位、装置机械故障、通畅性、技术和/或手术成功、再次干预以及血管并发症。
为评估涉及深静脉的CVD干预措施的研究制定了一套COS,包括7个一般结局和6个特定手术结局。报告这些结局将促进对涉及深静脉的CVD干预措施的比较。