Core outcome set for liver trauma: a consensus approach using modified Delphi methodology.

Area of Science:

• Trauma Surgery
• Clinical Research Methodology

Background:

• Liver trauma management has shifted towards algorithmic approaches, integrating non-operative strategies with surgical interventions for severe injuries.
• Inconsistent outcome measures across studies hinder effective clinical research and evidence synthesis in liver trauma.
• Standardizing outcome reporting is crucial for advancing liver trauma research.

Purpose of the Study:

• To develop a core outcome set (COS) for liver trauma research.
• To standardize outcome reporting in liver trauma studies.
• To improve the comparability and evidence synthesis of liver trauma research.

Main Methods:

• A modified Delphi consensus methodology, adhering to COMET and COS-STAD guidelines, was employed.
• Twenty trauma surgery experts participated in three consensus rounds.
• Consensus was achieved using a 9-point Likert scale, with specific criteria for critical importance and irrelevance, and assessed via Intraclass Correlation (ICC).

Main Results:

• Twenty experts completed all three rounds, with a 95% response rate.
• Out of 102 initial suggestions, 41 unique outcomes were identified and refined.
• Twelve outcomes were prioritized across four domains: operative decision-making, non-operative management success, hepatic complications, and healthcare utilization. Strong inter-rater reliability (ICC=0.89) was observed.

Conclusions:

• A rigorously developed core outcome set (COS) for liver trauma has been established.
• This COS will guide future research by providing standardized outcomes for liver trauma.
• Adoption of this COS is expected to enhance reporting consistency and facilitate evidence synthesis in the field.