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

delete2026-02-01
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OA
AI
C
Christian Damone Cain *
S
Saskya Byerly
N
Nicole A. Stassen
D
David T. Efron
T
Thomas M Scalea
H
Holcomb, John B.
G
Gregory J. Jurkovich
C
Callcut, Rachael
D
Deborah M Stein
J
John A Harvin
G
Grace S. Rozycki
D
David H Livingston
C
C. Ball
D
Demetrios Demetriades
A
Ali Salim
R
Rosemary Kozar
A
Ajai K. Malhotra
C
Croce, Martin
F
Fabian, Timothy
A
Andrew B. Peitzman
D
Dante D Yeh
DOI:10.1136/tsaco-2025-002164delete
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Abstract

Abstract

En 中文
Objectives Liver trauma management has evolved over recent decades, shifting from primarily operative to algorithmic approaches incorporating initial non-operative management alongside operative intervention for severe injuries. Inconsistent core outcome measures between studies hamper meaningful clinical research and evidence synthesis. This study aimed to develop a core outcome set (COS) for liver trauma research to standardize outcome reporting and improve study comparability.Methods A modified Delphi consensus methodology after COMET (Core Outcome Measures in Effectiveness Trials) and COS-STAD (Core Outcome Set-Standards for Development) guidelines was employed and twenty trauma surgery experts were recruited through purposive sampling of high-impact publications and professional networks. Round 1 collected free-text outcome suggestions. Round 2 used a 9-point Likert scale rating of those previously identified outcomes. Consensus was defined as >= 70% rating outcomes as critically important (7-9) and <= 15% as unimportant (1-3). Intraclass correlation (ICC) assessed agreement. Round 3 involved reprioritization of non-consensus outcomes.Results All 20 experts completed three rounds (95% response rate). From 102 initial suggestions, 41 unique outcomes were identified. By consensus, 12 outcomes were prioritized spanning four domains: operative decision-making, non-operative management success, hepatic complications, and healthcare utilization-related outcomes. The ICC was 0.89 (95% CI 0.84 to 0.94), indicating strong inter-rater reliability.Conclusions This rigorously developed COS for liver trauma provides standardized outcomes to guide future research and improve cross-study comparability. Adoption of these outcomes may enhance reporting consistency and facilitate evidence synthesis in liver trauma research.Study type Consensus development study (modified Delphi)Level of evidence V.
Keywords:
liver
Outcome Assessment, Health Care

Journal

T
TRAUMA SURGERY & ACUTE CARE OPEN
IF:
2.2
Papers:
143
Citations:
0

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