Developing a core outcome set for paediatric wrist fractures: a systematic review of prior outcomes
Benjamin Thomas Crosby1, Abolfazl Behbahani1, Olivia Olujohungbe1,2
1University of Liverpool, Liverpool, UK.
Insights
This review found significant variation in how treatment effectiveness for pediatric wrist fractures is measured. Identifying common outcomes is crucial for developing a standardized core outcome set for future research.
Area of Science:
- Orthopedic surgery
- Pediatric medicine
- Clinical trial methodology
Background:
- Pediatric wrist fractures are common injuries.
- Existing literature lacks standardized outcome reporting for treatment effectiveness.
- This heterogeneity hinders comparative analysis and evidence synthesis.
Purpose of the Study:
- To systematically review and summarize outcome measures used in studies of pediatric wrist fracture treatments.
- To identify common outcome domains and measures reported in the literature.
- To inform the development of a core outcome set for pediatric wrist fracture research.
Main Methods:
- Comprehensive literature search of Cochrane Library, Scopus, and Ovid Medline.
- Independent screening and review of eligible studies by three authors.
- Mapping identified outcomes to domains defined by the COMET (Core Outcome Measures Effectiveness Trials) initiative.
Main Results:
- 30 studies were included from an initial search of 4,262 papers.
- Five outcome domains, 16 outcome measures, and 28 measurement instruments were identified.
- Most common outcomes included range of motion (24 studies), radiological measures (23 studies), and pain intensity (12 studies).
- Significant heterogeneity was observed in measurement instruments used within outcome domains.
Conclusions:
- Clinical effectiveness studies for pediatric wrist fractures exhibit considerable heterogeneity in outcome reporting.
- An overview of reported outcomes was provided.
- A list of potentially relevant outcomes was identified to guide the development of a core outcome set.
Objectives:
This review aims to summarize the outcomes used to describe effectiveness of treatments for paediatric wrist fractures within existing literature.
Method:
We searched the Cochrane Library, Scopus, and Ovid Medline for studies pertaining to paediatric wrist fractures. Three authors independently identified and reviewed eligible studies. This resulted in a list of outcome domains and outcomes measures used within clinical research. Outcomes were mapped onto domains defined by the COMET collaborative.
Results:
Our search terms identified 4,262 different papers. Screening of titles excluded 2,975, leaving 1,287 papers to be assessed for eligibility. Of this 1,287, 30 studies were included for full analysis. Overall, five outcome domains, 16 outcome measures, and 28 measurement instruments were identified as outcomes within these studies. 24 studies used at least one measurement pertaining to the physiological/clinical outcome domain. The technical, life impact, and adverse effect domains were recorded in 23, 20, and 11 of the studies respectively. Within each domain it was common for different measurement instruments to be used to assess each outcome measure. The most commonly reported outcome measures were range of movement, a broad array of "radiological measures" and pain intensity, which were used in 24, 23, and 12 of the 30 studies.
Conclusion:
This study highlights the heterogeneity in outcomes reported within clinical effectiveness studies of paediatric wrist fractures. We provided an overview of the types of outcomes reported in paediatric wrist fracture studies and identified a list of potentially relevant outcomes required for the development of a core outcome set.
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