Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;65(2):254-263.
doi: 10.1111/dmcn.15351. Epub 2022 Jul 22.

A core outcome set for lower limb orthopaedic surgery for children with cerebral palsy: An international multi-stakeholder consensus study

Hajar Almoajil  1   2 , Sally Hopewell  1 , Helen Dawes  3   4 , Francine Toye  5 , Tim Theologis  1   5
Affiliations

A core outcome set for lower limb orthopaedic surgery for children with cerebral palsy: An international multi-stakeholder consensus study

Hajar Almoajil et al. Dev Med Child Neurol. 2023 Feb.

Abstract

Aim: To develop a core set of outcome domains to be measured in clinical studies on lower limb orthopaedic surgery for ambulant children with cerebral palsy (CP) that represents the priorities of an international multi-stakeholder group (children, parent/carers, and health professionals).

Method: Potential outcome domains were identified through literature review and qualitative interviews with key stakeholders. These were scored in an international two-round Delphi survey, using a 9-point Likert scale. A final consensus meeting with key stakeholders agreed on the most important outcome domains and refined the core outcome set (COS).

Results: One hundred and sixty-one health professionals and 36 individuals with CP and their parents/carers rated 21 of 41 outcomes as important in the Delphi survey. The final consensus group agreed 19 outcomes within eight domains to be included in the final COS: pain and fatigue, lower limb structure, motor function, mobility (daily life activities), gait-related outcomes, physical activity, independence, and quality of life.

Interpretation: A COS for lower limb orthopaedic surgery for children with CP was developed. Incorporating this in the design of future clinical studies will provide a more holistic assessment of the impact of treatment while allowing meaningful comparisons and future synthesis of results from primary studies.

What this paper adds: Eight core outcome domains were identified as important to measure in future clinical research. Key stakeholders perceived pain, balance and fall, and independence as very important outcomes. Six contextual factors were identified as essential in surgical decision-making.

PubMed Disclaimer

Conflict of interest statement

The authors have stated that they had no interests that might be perceived as posing a conflict or bias.

Figures

FIGURE 1
FIGURE 1
Pre‐Delphi stage of identifying long‐list outcomes.
FIGURE 2
FIGURE 2
Prioritization of outcomes throughout the consensus methods.
See this image and copyright information in PMC

Comment in

References

    1. Eunson P. Aetiology and epidemiology of cerebral palsy. Paediatrics and Child Health 2016; 26: 367–72.
    1. Glinianaia SV, Best KE, Lingam R, Rankin J. Predicting the prevalence of cerebral palsy by severity level in children aged 3 to 15 years across England and Wales by 2020. Dev Med Child Neurol 2017; 59: 864–70. - PubMed
    1. Sharan D. Orthopedic surgery in cerebral palsy: Instructional course lecture. Indian J Orthop 2017; 51: 240–55. - PMC - PubMed
    1. Edwards TA, Theologis T, Wright J. Predictors affecting outcome after single‐event multilevel surgery in children with cerebral palsy: a systematic review. Dev Med Child Neurol 2018; 60: 1201–8. - PubMed
    1. Lamberts RP, Burger M, du Toit J, Langerak NG. A Systematic Review of the Effects of Single‐Event Multilevel Surgery on Gait Parameters in Children with Spastic Cerebral Palsy. PLoS One 2016; 11: e0164686. - PMC - PubMed

Publication types