Developing a core outcome set for hand fractures and joint injuries in adults: a systematic review

Abstract

This study identifies the treatment outcome domains used in recently published studies on the treatment of hand fractures and joint injuries with the aim to inform development of a core outcome set. Seven databases were searched from January 2014 to March 2019 for randomized and quasi-randomized studies and large prospective observational studies. We identified 1777 verbatim outcomes in 160 eligible studies. From the verbatim outcomes we distinguished 639 unique outcomes, which we categorized into 74 outcome domains based on the World Health Organization International Classification of Functioning, Disability, and Health framework. The primary outcome was appropriately identified in only 65% (72/110) of randomized and quasi-randomized controlled trials. Of the 72 studies with a primary outcome identified, 74% (53/72) had an appropriate power calculation. The vast heterogeneity in outcome selection across studies highlights the need for a core outcome set of what outcomes to measure in future clinical research on hand fractures and joint injuries.

Developing a core outcome set for hand fractures and joint injuries in adults

“…These ranged across 74 WHO ICF outcome domains. 16 The qualitative study developed 35 outcome domains across six broad themes. The two sets of domains were synthesized by the research group to form a longlist of 37 outcome domains, with linking of outcome domains as shown in Supplementary Material table i.…”

“…Phase 1: outcome identification. A systematic review of published clinical research over a five-year period from 2014 to 2019 was conducted, 16 as per the protocol registered on PROSPERO (CRD42019126299), with outcomes extracted verbatim. In brief, we extracted unique outcomes from recently published clinical studies on management of hand fractures and joint injuries.…”

“…In addition, we contacted the corresponding authors of all studies included in our earlier systematic review of treatment outcomes to invite them to participate, and encouraged them to spread the word to any other clinicians in the field that they felt might be interested in participating. 16…”

“…In addition, we contacted the corresponding authors of all studies included in our earlier systematic review of treatment outcomes to invite them to participate, and encouraged them to spread the word to any other clinicians in the field that they felt might be interested in participating. 16 The first step consisted of patients, surgeons and therapists completing a three-round online Delphi survey using the COMET Initiative DelphiManager software. 21 Participants rated each outcome for importance to be measured in all future clinical research on hand fractures and joint injuries, using a nine-point Likert scale with three distinct categories specified (1 to 3 = 'less important/not important'; 4 to 6 = 'important but Flowchart of the key steps and phases of the SO-HANDI study.…”

Identification of outcomes reported for hospital antimicrobial stewardship interventions using a systematic review of reviews

“…Future COS development studies may consider the approach suggested by Dwan et al 59 to assess outcome reporting bias in reviews. Other COS developers reviewing primary studies of hand 60 and cancer surgery 61 have explored this and found a high risk of outcome reporting bias. We did not determine the overlap of primary studies across included reviews, and this may have influenced the number of duplicate outcomes in the list.…”