Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Achieving consensus on instruments for use in the Lung Cancer Rehabilitation core outcome set: An International Delphi study (UNITE)     (#421)

Lara Edbrooke 1 2 , Tom Davies 3 4 , Bronwen Connolly 5 , Linda Denehy 1 2
  1. Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
  2. Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
  4. Adult Critical Care Unit, Royal London Hospital, London, United Kingdom
  5. Wellcome-Wolfson Institute for Experimental Research, Queen's University Belfast, Belfast, United Kingdom

Aims

Using Delphi methodology we developed a core outcome set for evaluation of lung cancer rehabilitation in clinical practice. Core outcomes included physical function, health-related quality of life (HRQoL), breathlessness, emotional and mental wellbeing, activities of daily living, and pain[1]. The aim of this study was to gain consensus on a single instrument to measure each outcome.

Methods

An international Delphi consensus study involving consumers, healthcare professionals, and researchers. For each core outcome, measurement instruments with established psychometric properties were identified from our preliminary overview of reviews[2]. Participants rated each instrument’s importance over two survey rounds. Consensus criteria included ‘retain instrument’ if >70% of participants rated it ‘critical to include’ and <15% rated it ‘not important’. Online consensus meetings ratified survey findings through discussion and voting on the inclusion of instruments rated ‘critical to include’ by >50% of participants[3].    

Results

Sixty participants from 20 countries were involved. Twenty-one instruments were included in round 1, with an additional eight added in round 2. Consensus was achieved after two survey rounds on use of the six-minute walk test (6MWT) and the European Organisation for Research and Treatment of Cancer core questionnaire (EORTC-QLQ-C30) to measure physical function and HRQoL, respectively. Ten participants attended an online consensus meeting. Following discussion and voting, no further consensus was achieved on instruments to measure the remaining core outcomes.  

Conclusions

Measurement instruments were agreed for evaluating physical function and HRQoL in lung cancer rehabilitation. Although the EORTC-QLQ-C30 also includes items for breathlessness, emotional and mental well-being, and pain, consensus was not reached for measurement of these outcomes with this instrument. When evaluating outcomes that did not reach consensus we recommend clinicians choose valid patient-reported measures which are feasible to complete within clinical practice.

Registration: Prospectively registered Core Outcome Measures in Effectiveness Trials database (www.comet-initiative.org/Studies/Details/2086).

 

  1. [1] Edbrooke, L, Granger, CL, Francis, JJ, John, T, Kaadan, N, Halloran, E, Davies, T, Connolly, B, Denehy, L. Development of a Lung Cancer Rehabilitation Core Outcome Set: An International Delphi Study (UNITE). Journal of Thoracic Oncology. 2023;18(11), pS62. doi.org/10.1016/j.jtho.2023.09.055.
  2. [2] EDBROOKE, L, Bowman, A, Granger, CL, Burgess, N, Abo, S, Connolly, B* and Denehy, L*. Exercise across the lung cancer continuum: an overview of systematic reviews. JOURNAL OF CLINICAL MEDICINE (2023); 12(5):1871. doi.org/10.3390/jcm12051871 *joint senior authors
  3. [3] EDBROOKE, L, Granger, CL, Francis, JJ, John, T, Kaadan, N, Halloran, E, Connolly, B*, Denehy, L*. Rehabilitation outcomes for people with lung cancer (UNITE): protocol for the development of a core outcome set. BMJ OPEN RESPIRATORY RESEARCH (2023); 10(1): e001571. doi: 10.1136/bmjresp-2022-001571 *joint senior authors