Development of a clinical core outcome set to evaluate lung cancer rehabilitation

Significant heterogeneity exists in the outcomes and instruments used in clinical practice to evaluate lung cancer rehabilitation. This study aimed to develop a lung cancer rehabilitation clinical core outcome set and establish consensus on accompanying outcome measurement instruments.

An international modified Delphi consensus study was carried out following recommended guidelines, involving patients and carers, healthcare professionals and researchers. Two survey rounds, in each study phase, rated the importance of a range of outcomes to include in the core outcome set (Phase One) and measurement instruments for each core outcome (Phase Two). Online consensus meetings ratified survey findings through discussion and voting.

Phase One: 27 outcomes were included in round one (113 participants), with an additional two outcomes in round two (95 participants, 84% retention). Outcomes reaching consensus as "critical to include" were breathlessness, activities of daily living, physical function, health-related quality of life (HRQoL), emotional and mental wellbeing, and pain. Phase Two: 21 instruments were included (round one, 64 participants), with eight added in round two (60 participants (one patient), 94% retention). The 6-min walk test and European Organisation for Research and Treatment of Cancer core questionnaire reached consensus to measure physical function and HRQoL, respectively. No further consensus was achieved on instruments following online consensus meetings (10 participants).

Consensus was achieved regarding six core outcomes to be used to standardise the evaluation of lung cancer rehabilitation in clinical practice. Measurement instruments were agreed upon for use when evaluating physical function and HRQoL.