TY - JOUR
T1 - Defining definitions
T2 - a Delphi study to develop a core outcome set for conditions of severe maternal morbidity
AU - Schaap, T.
AU - Bloemenkamp, K.
AU - Deneux-Tharaux, C.
AU - Knight, M.
AU - Langhoff-Roos, J.
AU - Sullivan, E.
AU - van den Akker, T.
AU - Rigouzzo, Agnès
AU - Kristufkova, Alexandra
AU - Creanga, Andreea
AU - Koopman, Ankie
AU - Gemert, Van
AU - Tapper, Anna Maija
AU - Dijkman, Anneke
AU - Kwee, Anneke
AU - Franx, Arie
AU - Veersema, Bas
AU - Nemethova, Bianka
AU - Seelbach-Göbel, Birgit
AU - Bateman, Brian
AU - Daelemans, Caroline
AU - Zelop, Carolyn
AU - Andersson, Charlotte
AU - Nagata, Chie
AU - Farquhar, Cindy
AU - Huisman, Claartje
AU - von Kaisenberg, Constantin
AU - Henriquez, Dacia
AU - Ellwood, David
AU - Moolenaar, David
AU - Tuffnell, Derek
AU - Kuklina, Elena
AU - Main, Elliott
AU - Woods, Erica
AU - Stekkinger, Eva
AU - Gollo, Evelina
AU - Goffinet, François
AU - Kainer, Franz
AU - Mantel, Gerald
AU - Stralen, Giel
AU - Kayem, Gilles
AU - Duvekot, Hans
AU - Franz, Heiko B.G.
AU - Engjom, Hilde
AU - Beenakkers, Ingrid
AU - Al-Zirqi, Iqbal
AU - Danis, Jakub
AU - Berlac, Foss
AU - Kurinczuk, Jenny
AU - Krebs, Lone
AU - INOSS
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Objective: Develop a core outcome set of international consensus definitions for severe maternal morbidities. Design: Electronic Delphi study. Setting: International. Population: Eight expert panels. Methods: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions. Main outcome measures: Definitions with a rate of agreement of more than 70%. Results: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions. Conclusion: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative. Tweetable abstract: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.
AB - Objective: Develop a core outcome set of international consensus definitions for severe maternal morbidities. Design: Electronic Delphi study. Setting: International. Population: Eight expert panels. Methods: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions. Main outcome measures: Definitions with a rate of agreement of more than 70%. Results: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions. Conclusion: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative. Tweetable abstract: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.
KW - Abnormally invasive placentation
KW - amniotic fluid embolism
KW - cardiac arrest in pregnancy
KW - Delphi
KW - eclampsia
KW - pregnancy-related hysterectomy
KW - severe acute maternal morbidity
KW - severe primary postpartum haemorrhage
KW - spontaneous hemoperitoneum in pregnancy
KW - uterine rupture
UR - http://www.scopus.com/inward/record.url?scp=85028018087&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.14833
DO - 10.1111/1471-0528.14833
M3 - Journal article
C2 - 28755459
AN - SCOPUS:85028018087
SN - 1470-0328
VL - 126
SP - 394
EP - 401
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 3
ER -