Why Core Outcome Sets Do Not Get Used-And How Dissemination and Implementation Science can Help

Area of Science:

• Implementation Science
• Surgical Research
• Health Outcomes

Background:

• Core Outcome Sets (COSs) standardize outcome reporting but face low adoption in clinical practice.
• Barriers to COS implementation include workflow integration and stakeholder buy-in.
• Standardized outcome sets are crucial for trial comparability and reflecting patient priorities.

Purpose of the Study:

• To propose a conceptual framework for implementing COSs in surgical research using dissemination and implementation (D&I) science.
• To apply this framework to a new Core Outcome Set for peripheral nerve injury (PNI).

Main Methods:

• Integration of three D&I tools: Consolidated Framework for Implementation Research, Expert Recommendations for Implementing Change, and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM).
• These tools guide planning, barrier identification, and strategy selection for COS adoption.
• A newly developed PNI COS serves as a practical case example for framework application.

Main Results:

• The framework identifies contextual barriers using the Consolidated Framework for Implementation Research.
• Actionable strategies like champion engagement and EHR integration are suggested by Expert Recommendations for Implementing Change.
• The RE-AIM model provides metrics for evaluating COS uptake and long-term sustainability.

Conclusions:

• Embedding D&I strategies from the start is essential for closing the COS implementation gap.
• The proposed framework offers a generalizable approach for COS adoption in complex surgical settings.
• Further research is needed for tailored implementation strategies across surgical subspecialties.