A core outcome set for acute necrotizing pancreatitis: An Eastern Association for the Surgery of Trauma modified
Michael S Farrell1, Adanan Alseidi, Saskya Byerly
1From the Division of General and Trauma Surgery, Department of Surgery (M.S.F., J.G.), Lehigh Valley Health Network, Allentown, Pennsylvania; Department of Surgery (A.A.), University of California, San Francisco, California; Division of Trauma/Surgical Critical Care, Department of Surgery (S.B.), University of Tennessee Health Science Center, Memphis, Tennessee; Department of Gastroenterology and Hepatology (P.F.), Amsterdam University Medical Centers, University of Amsterdam/Free University; Amsterdam Gastroenterology Endocrinology Metabolism (P.F., R.P.V.), Research Institute; Cancer Center Amsterdam (P.F., R.P.V.), Amsterdam, the Netherlands; Department of Surgery (F.A.G.), Institution Christiana Care Health Services, Newark, Delaware; Department of Surgery (K.H.), University of Washington, Seattle, Washington; National Pancreas Foundation (D.J.), Chicago, Illinois; Department of Trauma, Emergency Surgery and Surgical Critical Care (C.L.), Massachusetts General Hospital, Boston, Massachusetts; Department of Surgery (N.M.), Wake Forest University, Winston Salem, North Carolina; Department of Surgery (B.R.H.R.), Harborview Medical Center, Seattle, Washington; National Pancreas Foundation (A.R.), Rockland, New York; Division of Gastroenterology, Department of Medicine (V.K.S.), Johns Hopkins Medical Institutions, Baltimore, Maryland; Regional Hepato-Pancreato-Biliary Unit (A.K.S.), Manchester Royal Infirmary, Manchester, England; Division of Gastroenterology and Hepatology (S.S.V.), Mayo Clinic, Rochester, Minnesota; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine (G.T.), University of Minnesota Medical Center, Minneapolis, Minnesota; Department of Surgery (B.C.V.), Stanford University School of Medicine, Stanford, California; Department of Gastroenterology and Hepatology (R.P.V.), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Surgery (D.D.Y.), Denver Health, Denver, Colorado; and Department of Surgery (R.B.G.), University of Alabama at Birmingham, Birmingham, Alabama.
Background:
The management of acute necrotizing pancreatitis (ANP) has changed dramatically over the past 20 years including the use of less invasive techniques, the timing of interventions, nutritional management, and antimicrobial management. This study sought to create a core outcome set (COS) to help shape future research by establishing a minimal set of essential outcomes that will facilitate future comparisons and pooling of data while minimizing reporting bias.
Methods:
A modified Delphi process was performed through involvement of ANP content experts. Each expert proposed a list of outcomes for consideration, and the panel anonymously scored the outcomes on a 9-point Likert scale. Core outcome consensus defined a priori as >70% of scores receiving 7 to 9 points and <15% of scores receiving 1 to 3 points. Feedback and aggregate data were shared between rounds with interclass correlation trends used to determine the end of the study.
Results:
A total of 19 experts agreed to participate in the study with 16 (84%) participating through study completion. Forty-three outcomes were initially considered with 16 reaching consensuses after four rounds of the modified Delphi process. The final COS included outcomes related to mortality, organ failure, complications, interventions/management, and social factors.
Conclusion:
Through an iterative consensus process, content experts agreed on a COS for the management of ANP. This will help shape future research to generate data suitable for pooling and other statistical analyses that may guide clinical practice.
Level Of Evidence:
Therapeutic/Care Management; Level V.
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:29Chronic Pancreatitis II: Collaborative Care
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