A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications

T. E.F. Abbott; A. J. Fowler; P. Pelosi; M. Gama de Abreu; A. M. Møller; J. Canet; B. Creagh-Brown; M. Mythen; T. Gin; M. M. Lalu; E. Futier; M. P. Grocott; M. J. Schultz; R. M. Pearse; P. Myles; T. J. Gan; A. Kurz; P. Peyton; D. Sessler; M. Tramèr; A. Cyna; G. S. De Oliveira; C. Wu; M. Jensen; H. Kehlet; M. Botti; O. Boney; G. Haller; T. Cook; L. Fleisher; M. Neuman; D. Story; R. Gruen; S. Bampoe; Lis Evered; D. Scott; B. Silbert; D. van Dijk; C. Kalkman; M. Chan; H. Grocott; R. Eckenhoff; L. Rasmussen; L. Eriksson; S. Beattie; D. Wijeysundera; G. Landoni; K. Leslie; B. Biccard; S. Howell; P. Nagele; T. Richards; A. Lamy; M. Gabreu; A. Klein; T. Corcoran; D. Jamie Cooper; S. Dieleman; E. Diouf; D. McIlroy; R. Bellomo; A. Shaw; J. Prowle; K. Karkouti; J. Billings; D. Mazer; M. Jayarajah; M. Murphy; J. Bartoszko; R. Sneyd; S. Morris; R. George; R. Moonesinghe; M. Shulman; M. Lane-Fall; U. Nilsson; N. Stevenson; W. van Klei; L. Cabrini; T. Miller; N. Pace; S. Jackson; D. Buggy; T. Short; B. Riedel; V. Gottumukkala; B. Alkhaffaf; M. Johnson

doi:10.1016/j.bja.2018.02.007

A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications

T. E.F. Abbott, A. J. Fowler, P. Pelosi, M. Gama de Abreu, A. M. Møller, J. Canet, B. Creagh-Brown, M. Mythen, T. Gin, M. M. Lalu, E. Futier, M. P. Grocott, M. J. Schultz, R. M. Pearse, P. Myles, T. J. Gan, A. Kurz, P. Peyton, D. Sessler, M. TramèrA. Cyna, G. S. De Oliveira, C. Wu, M. Jensen, H. Kehlet, M. Botti, O. Boney, G. Haller, T. Cook, L. Fleisher, M. Neuman, D. Story, R. Gruen, S. Bampoe, Lis Evered, D. Scott, B. Silbert, D. van Dijk, C. Kalkman, M. Chan, H. Grocott, R. Eckenhoff, L. Rasmussen, L. Eriksson, S. Beattie, D. Wijeysundera, G. Landoni, K. Leslie, B. Biccard, S. Howell, P. Nagele, T. Richards, A. Lamy, M. Gabreu, A. Klein, T. Corcoran, D. Jamie Cooper, S. Dieleman, E. Diouf, D. McIlroy, R. Bellomo, A. Shaw, J. Prowle, K. Karkouti, J. Billings, D. Mazer, M. Jayarajah, M. Murphy, J. Bartoszko, R. Sneyd, S. Morris, R. George, R. Moonesinghe, M. Shulman, M. Lane-Fall, U. Nilsson, N. Stevenson, W. van Klei, L. Cabrini, T. Miller, N. Pace, S. Jackson, D. Buggy, T. Short, B. Riedel, V. Gottumukkala, B. Alkhaffaf, M. Johnson

Department of Clinical Medicine

61 Citations (Scopus)

Abstract

Background: There is a need for robust, clearly defined, patient-relevant outcome measures for use in randomised trials in perioperative medicine. Our objective was to establish standard outcome measures for postoperative pulmonary complications research. Methods: A systematic literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean Journal Database. Definitions were extracted from included manuscripts. We then conducted a three-stage Delphi consensus process to select the optimal outcome measures in terms of methodological quality and overall suitability for perioperative trials. Results: From 2358 records, the full texts of 81 manuscripts were retrieved, of which 45 met the inclusion criteria. We identified three main categories of outcome measure specific to perioperative pulmonary outcomes: (i) composite outcome measures of multiple pulmonary outcomes (27 definitions); (ii) pneumonia (12 definitions); and (iii) respiratory failure (six definitions). These were rated by the group according to suitability for routine use. The majority of definitions were given a low score, and many were imprecise, difficult to apply consistently, or both, in large patient populations. A small number of highly rated definitions were identified as appropriate for widespread use. The group then recommended four outcome measures for future use, including one new definition. Conclusions: A large number of postoperative pulmonary outcome measures have been used, but most are poorly defined. Our four recommended outcome measures include a new definition of postoperative pulmonary complications, incorporating an assessment of severity. These definitions will meet the needs of most clinical effectiveness trials of treatments to improve postoperative pulmonary outcomes.

Original language	Danish
Journal	British Journal of Anaesthesia
Volume	120
Issue number	5
Pages (from-to)	1066-1079
Number of pages	14
ISSN	0007-0912
DOIs	https://doi.org/10.1016/j.bja.2018.02.007
Publication status	Published - 1 May 2018

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10.1016/j.bja.2018.02.007

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Abbott, T. E. F., Fowler, A. J., Pelosi, P., Gama de Abreu, M., Møller, A. M., Canet, J., Creagh-Brown, B., Mythen, M., Gin, T., Lalu, M. M., Futier, E., Grocott, M. P., Schultz, M. J., Pearse, R. M., Myles, P., Gan, T. J., Kurz, A., Peyton, P., Sessler, D., ... Johnson, M. (2018). A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications. British Journal of Anaesthesia, 120(5), 1066-1079. https://doi.org/10.1016/j.bja.2018.02.007

Abbott, TEF, Fowler, AJ, Pelosi, P, Gama de Abreu, M, Møller, AM, Canet, J, Creagh-Brown, B, Mythen, M, Gin, T, Lalu, MM, Futier, E, Grocott, MP, Schultz, MJ, Pearse, RM, Myles, P, Gan, TJ, Kurz, A, Peyton, P, Sessler, D, Tramèr, M, Cyna, A, De Oliveira, GS, Wu, C, Jensen, M, Kehlet, H, Botti, M, Boney, O, Haller, G, Cook, T, Fleisher, L, Neuman, M, Story, D, Gruen, R, Bampoe, S, Evered, L, Scott, D, Silbert, B, van Dijk, D, Kalkman, C, Chan, M, Grocott, H, Eckenhoff, R, Rasmussen, L, Eriksson, L, Beattie, S, Wijeysundera, D, Landoni, G, Leslie, K, Biccard, B, Howell, S, Nagele, P, Richards, T, Lamy, A, Gabreu, M, Klein, A, Corcoran, T, Jamie Cooper, D, Dieleman, S, Diouf, E, McIlroy, D, Bellomo, R, Shaw, A, Prowle, J, Karkouti, K, Billings, J, Mazer, D, Jayarajah, M, Murphy, M, Bartoszko, J, Sneyd, R, Morris, S, George, R, Moonesinghe, R, Shulman, M, Lane-Fall, M, Nilsson, U, Stevenson, N, van Klei, W, Cabrini, L, Miller, T, Pace, N, Jackson, S, Buggy, D, Short, T, Riedel, B, Gottumukkala, V, Alkhaffaf, B & Johnson, M 2018, 'A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications', British Journal of Anaesthesia, vol. 120, no. 5, pp. 1066-1079. https://doi.org/10.1016/j.bja.2018.02.007

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title = "A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications",

abstract = "Background: There is a need for robust, clearly defined, patient-relevant outcome measures for use in randomised trials in perioperative medicine. Our objective was to establish standard outcome measures for postoperative pulmonary complications research. Methods: A systematic literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean Journal Database. Definitions were extracted from included manuscripts. We then conducted a three-stage Delphi consensus process to select the optimal outcome measures in terms of methodological quality and overall suitability for perioperative trials. Results: From 2358 records, the full texts of 81 manuscripts were retrieved, of which 45 met the inclusion criteria. We identified three main categories of outcome measure specific to perioperative pulmonary outcomes: (i) composite outcome measures of multiple pulmonary outcomes (27 definitions); (ii) pneumonia (12 definitions); and (iii) respiratory failure (six definitions). These were rated by the group according to suitability for routine use. The majority of definitions were given a low score, and many were imprecise, difficult to apply consistently, or both, in large patient populations. A small number of highly rated definitions were identified as appropriate for widespread use. The group then recommended four outcome measures for future use, including one new definition. Conclusions: A large number of postoperative pulmonary outcome measures have been used, but most are poorly defined. Our four recommended outcome measures include a new definition of postoperative pulmonary complications, incorporating an assessment of severity. These definitions will meet the needs of most clinical effectiveness trials of treatments to improve postoperative pulmonary outcomes.",

keywords = "outcome assessment (healthcare)/standards, perioperative care/methods",

author = "Abbott, {T. E.F.} and Fowler, {A. J.} and P. Pelosi and {Gama de Abreu}, M. and M{\o}ller, {A. M.} and J. Canet and B. Creagh-Brown and M. Mythen and T. Gin and Lalu, {M. M.} and E. Futier and Grocott, {M. P.} and Schultz, {M. J.} and Pearse, {R. M.} and P. Myles and Gan, {T. J.} and A. Kurz and P. Peyton and D. Sessler and M. Tram{\`e}r and A. Cyna and {De Oliveira}, {G. S.} and C. Wu and M. Jensen and H. Kehlet and M. Botti and O. Boney and G. Haller and T. Cook and L. Fleisher and M. Neuman and D. Story and R. Gruen and S. Bampoe and Lis Evered and D. Scott and B. Silbert and {van Dijk}, D. and C. Kalkman and M. Chan and H. Grocott and R. Eckenhoff and L. Rasmussen and L. Eriksson and S. Beattie and D. Wijeysundera and G. Landoni and K. Leslie and B. Biccard and S. Howell and P. Nagele and T. Richards and A. Lamy and M. Gabreu and A. Klein and T. Corcoran and {Jamie Cooper}, D. and S. Dieleman and E. Diouf and D. McIlroy and R. Bellomo and A. Shaw and J. Prowle and K. Karkouti and J. Billings and D. Mazer and M. Jayarajah and M. Murphy and J. Bartoszko and R. Sneyd and S. Morris and R. George and R. Moonesinghe and M. Shulman and M. Lane-Fall and U. Nilsson and N. Stevenson and {van Klei}, W. and L. Cabrini and T. Miller and N. Pace and S. Jackson and D. Buggy and T. Short and B. Riedel and V. Gottumukkala and B. Alkhaffaf and M. Johnson",

year = "2018",

month = may,

day = "1",

doi = "10.1016/j.bja.2018.02.007",

language = "Dansk",

volume = "120",

pages = "1066--1079",

journal = "British Journal of Anaesthesia",

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TY - JOUR

T1 - A systematic review and consensus definitions for standardised end-points in perioperative medicine

T2 - pulmonary complications

AU - Abbott, T. E.F.

AU - Fowler, A. J.

AU - Pelosi, P.

AU - Gama de Abreu, M.

AU - Møller, A. M.

AU - Canet, J.

AU - Creagh-Brown, B.

AU - Mythen, M.

AU - Gin, T.

AU - Lalu, M. M.

AU - Futier, E.

AU - Grocott, M. P.

AU - Schultz, M. J.

AU - Pearse, R. M.

AU - Myles, P.

AU - Gan, T. J.

AU - Kurz, A.

AU - Peyton, P.

AU - Sessler, D.

AU - Tramèr, M.

AU - Cyna, A.

AU - De Oliveira, G. S.

AU - Wu, C.

AU - Jensen, M.

AU - Kehlet, H.

AU - Botti, M.

AU - Boney, O.

AU - Haller, G.

AU - Cook, T.

AU - Fleisher, L.

AU - Neuman, M.

AU - Story, D.

AU - Gruen, R.

AU - Bampoe, S.

AU - Evered, Lis

AU - Scott, D.

AU - Silbert, B.

AU - van Dijk, D.

AU - Kalkman, C.

AU - Chan, M.

AU - Grocott, H.

AU - Eckenhoff, R.

AU - Rasmussen, L.

AU - Eriksson, L.

AU - Beattie, S.

AU - Wijeysundera, D.

AU - Landoni, G.

AU - Leslie, K.

AU - Biccard, B.

AU - Howell, S.

AU - Nagele, P.

AU - Richards, T.

AU - Lamy, A.

AU - Gabreu, M.

AU - Klein, A.

AU - Corcoran, T.

AU - Jamie Cooper, D.

AU - Dieleman, S.

AU - Diouf, E.

AU - McIlroy, D.

AU - Bellomo, R.

AU - Shaw, A.

AU - Prowle, J.

AU - Karkouti, K.

AU - Billings, J.

AU - Mazer, D.

AU - Jayarajah, M.

AU - Murphy, M.

AU - Bartoszko, J.

AU - Sneyd, R.

AU - Morris, S.

AU - George, R.

AU - Moonesinghe, R.

AU - Shulman, M.

AU - Lane-Fall, M.

AU - Nilsson, U.

AU - Stevenson, N.

AU - van Klei, W.

AU - Cabrini, L.

AU - Miller, T.

AU - Pace, N.

AU - Jackson, S.

AU - Buggy, D.

AU - Short, T.

AU - Riedel, B.

AU - Gottumukkala, V.

AU - Alkhaffaf, B.

AU - Johnson, M.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: There is a need for robust, clearly defined, patient-relevant outcome measures for use in randomised trials in perioperative medicine. Our objective was to establish standard outcome measures for postoperative pulmonary complications research. Methods: A systematic literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean Journal Database. Definitions were extracted from included manuscripts. We then conducted a three-stage Delphi consensus process to select the optimal outcome measures in terms of methodological quality and overall suitability for perioperative trials. Results: From 2358 records, the full texts of 81 manuscripts were retrieved, of which 45 met the inclusion criteria. We identified three main categories of outcome measure specific to perioperative pulmonary outcomes: (i) composite outcome measures of multiple pulmonary outcomes (27 definitions); (ii) pneumonia (12 definitions); and (iii) respiratory failure (six definitions). These were rated by the group according to suitability for routine use. The majority of definitions were given a low score, and many were imprecise, difficult to apply consistently, or both, in large patient populations. A small number of highly rated definitions were identified as appropriate for widespread use. The group then recommended four outcome measures for future use, including one new definition. Conclusions: A large number of postoperative pulmonary outcome measures have been used, but most are poorly defined. Our four recommended outcome measures include a new definition of postoperative pulmonary complications, incorporating an assessment of severity. These definitions will meet the needs of most clinical effectiveness trials of treatments to improve postoperative pulmonary outcomes.

AB - Background: There is a need for robust, clearly defined, patient-relevant outcome measures for use in randomised trials in perioperative medicine. Our objective was to establish standard outcome measures for postoperative pulmonary complications research. Methods: A systematic literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean Journal Database. Definitions were extracted from included manuscripts. We then conducted a three-stage Delphi consensus process to select the optimal outcome measures in terms of methodological quality and overall suitability for perioperative trials. Results: From 2358 records, the full texts of 81 manuscripts were retrieved, of which 45 met the inclusion criteria. We identified three main categories of outcome measure specific to perioperative pulmonary outcomes: (i) composite outcome measures of multiple pulmonary outcomes (27 definitions); (ii) pneumonia (12 definitions); and (iii) respiratory failure (six definitions). These were rated by the group according to suitability for routine use. The majority of definitions were given a low score, and many were imprecise, difficult to apply consistently, or both, in large patient populations. A small number of highly rated definitions were identified as appropriate for widespread use. The group then recommended four outcome measures for future use, including one new definition. Conclusions: A large number of postoperative pulmonary outcome measures have been used, but most are poorly defined. Our four recommended outcome measures include a new definition of postoperative pulmonary complications, incorporating an assessment of severity. These definitions will meet the needs of most clinical effectiveness trials of treatments to improve postoperative pulmonary outcomes.

KW - outcome assessment (healthcare)/standards

KW - perioperative care/methods

U2 - 10.1016/j.bja.2018.02.007

DO - 10.1016/j.bja.2018.02.007

M3 - Tidsskriftartikel

SN - 0007-0912

VL - 120

SP - 1066

EP - 1079

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

IS - 5

ER -