Developing consensus with health professionals and policy makers to define a core outcome set for emergency general surgery

Preliminary work to inform an NIHR programme grant

Chief Investigator	Institution	Dates	Funding Stream	Amount
Mr Jonathan Rees	University Hospitals Bristol NHS Foundation Trust	01/05/2017 to 30/04/2018	RCF Autumn 2016	£15,850

Summary

Emergency general surgery (EGS) is a term used to describe a broad range of conditions. The commonest include problems with the large and small bowel, appendix, pancreas, gallbladder and hernias and abscesses. It does not include trauma surgery.

The care of these patients is often difficult. It constitutes half of the workload of a UK general surgeon. Recent data from a National audit in this field demonstrates huge variability in care and outcomes between hospitals who provide EGS especially following bowel resection. The report calls for better standards underpinned by high quality research.  Yet this is challenging.

Our planned programme grant seeks to address these issues. It will develop methods to, overcome problems with recruitment, deliver interventions, measure outcomes, and pilot trials in EGS. This initial work will be important to inform that grant and it focusses on the selection, measurement and reporting of outcomes from the perspective of health professionals and policy makers.

We propose to develop a Core Outcome Set for EGS. This is a minimum agreed set of outcomes to be reported in all studies in this area. It will allow data to be combined, comparisons between hospitals and treatments be made, reducing research waste and preventing overly optimistic reporting of untrue results. Developing a core outcome set involves literature analyses, and obtaining views of key stakeholders (patients and professionals). This project will focus on views of professionals to inform a core outcome set whilst the patient work will be part of a NIHR programme grant itself.

Work carried out

The project has gathered all outcomes from the literature used in emergency surgery, updated the searches, produced long lists of outcomes, classified these into domains for both clinical and patient reported outcomes.

The heterogeneity and number of outcomes identified is very large as is seen in many other disease sites and this heterogeneity data will form part of an abstract.

These domains have been operationalised into questionnaires and questionnaire production is now due.

Main findings

Highlights the heterogeneity and lack of standardisation of outcome reporting in emergency surgery, the lack of clear guidance on the most important outcomes.

Impact

Validates the need for a core outcome set in emergency surgery.

Other project outcomes

Facilitated collaboration with Robert Hinchliffe, Professor of Vascular Surgery and Ronelle Mouton Consultant Vascular Anaesthetist together with Natalie Blencowe, Academic Clinical Lecturer in Upper GI Surgery / MRC Clinician Scientist.

Last updated 07/08/2018