Development of a core measurement set for research in degenerative cervical myelopathy: a study protocol (AO Spine RECODE-DCM CMS)

Abstract

IntroductionProgress in degenerative cervical myelopathy (DCM) is hindered by inconsistent measurement and reporting. This impedes data aggregation and outcome comparison across studies. This limitation can be reversed by developing a core measurement set (CMS) for DCM research. Previously, the AO Spine Research Objectives and Common Data Elements for DCM (AO Spine RECODE-DCM) defined ‘what’ should be measured in DCM: the next step of this initiative is to determine ‘how’ to measure these features. This protocol outlines the steps necessary for the development of a CMS for DCM research and audit.Methods and analysisThe CMS will be developed in accordance with the guidance developed by the Core Outcome Measures in Effectiveness Trials and the Consensus-based Standards for the selection of health Measurement Instruments. The process involves five phases. In phase 1, the steering committee agreed on the constructs to be measured by sourcing consensus definitions from patients, professionals and the literature. In phases 2 and 3, systematic reviews were conducted to identify tools for each construct and aggregate their evidence. Constructs with and without tools were identified, and scoping reviews were conducted for constructs without tools. Evidence on measurement properties, as well as on timing of assessments, are currently being aggregated. These will be presented in phase 4: a consensus meeting where a multi-disciplinary panel of experts will select the instruments that will form the CMS. Following selection, guidance on the implementation of the CMS will be developed and disseminated (phase 5). A preliminary CMS review scheduled at 4 years from release.Ethics and disseminationEthical approval was obtained from the University of Cambridge (HBREC2019.14). Dissemination strategies will include peer-reviewed scientific publications; conference presentations; podcasts; the identification of AO Spine RECODE-DCM ambassadors; and engagement with relevant journals, funders and the DCM community.

Brain MRI changes in degenerative cervical myelopathy: a systematic review

“…The advent of a minimum dataset for DCM (AO Spine RECODE-DCM) should help circumvent this in the future, by ensuring key determinants of disease are recorded. 91 …”

Translation, adaptation and validation of a Spanish version of the Japanese orthopaedic association cervical myelopathy questionnaire

“…This heterogeneity leads to publication bias, hampering interstudy comparison and guideline creation 15,16 . This has motivated recent interest in developing a core measurement set for DCM 9,17,18 and the recommendations to use a set of multiple subjective and objective measures 17 …”

“…This heterogeneity leads to publication bias, hampering interstudy comparison and guideline creation. 15,16 This has motivated recent interest in developing a core measurement set for DCM 9,17,18 and the recommendations to use a set of multiple subjective and objective measures. 17 The JOACMEQ questionnaire is the first DCM-specific questionnaire that attempts to jointly assess neurological function, disability, and QoL associated with.…”

“…15,16 This has motivated recent interest in developing a core measurement set for DCM 9,17,18 and the recommendations to use a set of multiple subjective and objective measures. 17 The JOACMEQ questionnaire is the first DCM-specific questionnaire that attempts to jointly assess neurological function, disability, and QoL associated with. [10][11][12][13][14] It has been demonstrated to have good validity as well as reliability and correlate strongly with other commonly used neck pain, myelopathic, and QOL questionnaires.…”

The m6A demethylase ALKBH5-mediated upregulation of DDIT4-AS1 maintains pancreatic cancer stemness and suppresses chemosensitivity by activating the mTOR pathway

“…DNA damage-inducible transcript 4 (DDIT4), also called DNA damage response 1 (REDD1) and stresstriggered protein (RTP801), consists of 232 amino acids and is mainly found in the cytoplasm and nucleus [11,12]. Upon stress induction, including oxidative stress, endoplasmic reticulum stress, hypoxia and starvation [11,[13][14][15], DDIT4 inhibits mTOR signalling by stabilizing the tuberous sclerosis complex (TSC1-TSC2) [16,17], DDIT4 is aberrantly expressed at low levels in multiple tumours, including gastric cancer [18], breast cancer [19], glioma [20] and other tumours [21][22][23] The antisense transcript of DDIT4 encodes the lncRNA DDIT4-AS1, which has a length of 847 bp and consists of two exons. Numerous studies have indicated that abnormal expression of antisense lncRNAs contributes to tumorigenesis, oncogenic progression and the hallmarks of cancer [24].…”