Trauma surgery & acute care open · 2026
Core outcome set for liver trauma: a consensus approach using modified Delphi methodology.
СтатьяНазвание и аннотация: Перевод в очереди
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Cain Christian Damone, Byerly Saskya, Stassen Nicole A, Efron David, Scalea Thomas M, Holcomb John B, Jurkovich Gregory J, Callcut Rachael, Stein Deborah M, Harvin John A, Rozycki Grace, Livingston David H, Ball Chad G, Demetriades Demetrios, Salim Ali, Kozar Rosemary, Malhotra Ajai K, Croce Martin, Fabian Timothy, Peitzman Andrew B, Yeh Dante
Аннотация
OBJECTIVES: Liver trauma management has evolved over recent decades, shifting from primarily operative to algorithmic approaches incorporating initial non-operative management alongside operative intervention for severe injuries. Inconsistent core outcome measures between studies hamper meaningful clinical research and evidence synthesis. This study aimed to develop a core outcome set (COS) for liver trauma research to standardize outcome reporting and improve study comparability.
METHODS: A modified Delphi consensus methodology after COMET (Core Outcome Measures in Effectiveness Trials) and COS-STAD (Core Outcome Set-Standards for Development) guidelines was employed and twenty trauma surgery experts were recruited through purposive sampling of high-impact publications and professional networks. Round 1 collected free-text outcome suggestions. Round 2 used a 9-point Likert scale rating of those previously identified outcomes. Consensus was defined as ≥70% rating outcomes as critically important (7-9) and ≤15% as unimportant (1-3). Intraclass correlation (ICC) assessed agreement. Round 3 involved reprioritization of non-consensus outcomes.
RESULTS: All 20 experts completed three rounds (95% response rate). From 102 initial suggestions, 41 unique outcomes were identified. By consensus, 12 outcomes were prioritized spanning four domains: operative decision-making, non-operative management success, hepatic complications, and healthcare utilization-related outcomes. The ICC was 0.89 (95% CI 0.84 to 0.94), indicating strong inter-rater reliability.
CONCLUSIONS: This rigorously developed COS for liver trauma provides standardized outcomes to guide future research and improve cross-study comparability. Adoption of these outcomes may enhance reporting consistency and facilitate evidence synthesis in liver trauma research.
STUDY TYPE: Consensus development study (modified Delphi).
LEVEL OF EVIDENCE: V.
METHODS: A modified Delphi consensus methodology after COMET (Core Outcome Measures in Effectiveness Trials) and COS-STAD (Core Outcome Set-Standards for Development) guidelines was employed and twenty trauma surgery experts were recruited through purposive sampling of high-impact publications and professional networks. Round 1 collected free-text outcome suggestions. Round 2 used a 9-point Likert scale rating of those previously identified outcomes. Consensus was defined as ≥70% rating outcomes as critically important (7-9) and ≤15% as unimportant (1-3). Intraclass correlation (ICC) assessed agreement. Round 3 involved reprioritization of non-consensus outcomes.
RESULTS: All 20 experts completed three rounds (95% response rate). From 102 initial suggestions, 41 unique outcomes were identified. By consensus, 12 outcomes were prioritized spanning four domains: operative decision-making, non-operative management success, hepatic complications, and healthcare utilization-related outcomes. The ICC was 0.89 (95% CI 0.84 to 0.94), indicating strong inter-rater reliability.
CONCLUSIONS: This rigorously developed COS for liver trauma provides standardized outcomes to guide future research and improve cross-study comparability. Adoption of these outcomes may enhance reporting consistency and facilitate evidence synthesis in liver trauma research.
STUDY TYPE: Consensus development study (modified Delphi).
LEVEL OF EVIDENCE: V.