Development of the Residual Lesion Score for congenital heart surgery: the RAND Delphi methodology

Area of Science:

• Congenital heart surgery
• Surgical outcomes assessment
• Medical device development

Background:

• The Residual Lesion Score (RLS) is a novel tool for assessing surgical objectives in congenital heart surgery.
• It utilizes readily available clinical and echocardiographic data.
• This study details the development of the RLS from the Technical Performance Score.

Purpose of the Study:

• To describe the methodology for developing the Residual Lesion Score (RLS).
• To adapt the RLS for five common congenital cardiac procedures.
• To utilize the RAND Delphi methodology for RLS development.

Main Methods:

• A panel of 11 experts in pediatric cardiology and cardiac surgery was convened.
• Experts reviewed and scored the validity and feasibility of RLS sub-components via email and in-person rounds.
• The RAND Delphi methodology guided the iterative refinement and finalization of the RLS.

Main Results:

• Sub-components meeting median validity (≥7) and feasibility (≥4) scores, with low disagreement, were included in the final RLS.
• The RAND Delphi process facilitated consensus on RLS components.
• The final RLS was established for five specific congenital cardiac procedures.

Conclusions:

• The RAND Delphi methodology successfully developed Residual Lesion Score modules.
• These modules are applicable to five critical congenital cardiac procedures.
• The RLS provides a standardized method for assessing surgical outcomes in pediatric congenital heart surgery.