Association between the Orthopaedic Trauma Society classification of open fractures and economic costs

Png, May Ee; Petrou, Stavros; Bourget-Murray, Jonathan; Knight, Ruth; Trompeter, Alex; Costa, Matt L

doi:10.1302/0301-620x.104b3.bjj-2021-1237.r1

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…12 Health economic outcomes were considered out of scope. 13 Information sources. Outcomes important to healthcare professionals and researchers were identified using a systematic literature review to collect, summarize, and categorize contemporary outcomes reported in clinical studies on skeletally mature patients following open lower limb fracture over ten years from 2009.…”

Section: Methodsmentioning

confidence: 99%

Development of a core outcome set for open lower limb fracture

et al. 2023

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AimsOpen lower limb fracture is life-changing, resulting in substantial morbidity and resource demand, while inconsistent outcome-reporting hampers systematic review and meta-analysis. A core outcome set establishes consensus among key stakeholders for the recommendation of a minimum set of outcomes. This study aims to define a core outcome set for adult open lower limb fracture.MethodsCandidate outcomes were identified from a previously published systematic review and a secondary thematic analysis of 25 patient interviews exploring the lived experience of recovery from open lower limb fracture. Outcomes were categorized and sequentially refined using healthcare professional and patient structured discussion groups. Consensus methods included a multi-stakeholder two-round online Delphi survey and a consensus meeting attended by a purposive sample of stakeholders, facilitated discussion, and voting using a nominal group technique.ResultsThematic analysis and systematic review identified 121 unique outcomes, reduced to 68 outcomes following structured discussion groups. Outcomes were presented to 136 participants who completed a two-round online Delphi survey. The Delphi survey resulted in 11 outcomes identified as consensus ‘in’ only. All outcomes were discussed at a consensus meeting attended by 15 patients, 14 healthcare professionals, 11 researchers, and one patient-carer. Consensus was achieved for a four-core outcome set: ‘Walking, gait and mobility’, ‘Being able to return to life roles’, ‘Pain or discomfort’, and ‘Quality of life’.ConclusionThis study used robust consensus methods to establish a core outcome set that should be measured in all future research studies and audits of clinical practice without precluding the measurement of additional outcomes.Cite this article: Bone Joint Res 2023;12(4):294–305.

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Section: Methodsmentioning

confidence: 99%

Development of a core outcome set for open lower limb fracture

et al. 2023

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“…15 Health economic outcomes were considered out of scope. 16 The COS defined for this population was: 'Walking, gait and mobility', 'Being able to return to life roles', 'Pain or discomfort', and 'Quality of life'. 12 Identifying existing outcome measurement instruments.…”

Section: Methodsmentioning

confidence: 99%

The core outcomes for open lower limb fracture study

et al. 2023

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AimsA core outcome set for adult, open lower limb fracture has been established consisting of ‘Walking, gait and mobility’, ‘Being able to return to life roles’, ‘Pain or discomfort’, and ‘Quality of life’. This study aims to identify which outcome measurement instruments (OMIs) should be recommended to measure each core outcome.MethodsA systematic review and quality assessment were conducted to identify existing instruments with evidence of good measurement properties in the open lower limb fracture population for each core outcome. Additionally, shortlisting criteria were developed to identify suitable instruments not validated in the target population. Candidate instruments were presented, discussed, and voted on at a consensus meeting of key stakeholders.ResultsThe Wales Lower Limb Trauma Recovery scale was identified, demonstrating validation evidence in the target population. In addition, ten candidate OMIs met the shortlisting criteria. Six patients, eight healthcare professionals, and 11 research methodologists attended the consensus meeting. Consensus was achieved for the EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and the Lower Extremity Functional Scale (LEFS) to measure ‘Quality of life’ and ‘Walking, gait and mobility’ in future research trials, audit, and clinical assessment, respectively. No instrument met consensus criteria to measure ‘Being able to return to life roles’ and ‘Pain or discomfort’. However, the EQ-5D-5L was found to demonstrate good face validity and could also be used pragmatically to measure these two outcomes, accepting limitations in sensitivity.ConclusionThis study recommends the LEFS and EQ-5D-5L to measure the core outcome set for adult open lower limb fracture.Cite this article: Bone Joint Res 2023;12(6):352–361.

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