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. 2023 Jul 14;7(6):2304-2310.
doi: 10.1016/j.jseint.2023.06.012. eCollection 2023 Nov.

A modified Delphi study to identify which items should be evaluated in shoulder instability research: a first step in developing a core outcome set

Lukas P E Verweij  1   2   3 , Inger N Sierevelt  4   5 , David N Baden  6 , Robert Jan Derksen  7 , Henk-Jan van der Woude  3   8 , Karin M C Hekman  3   9   10 , Michel P J van den Bekerom  3   10   11   12 ; SINC study group
Collaborators, Affiliations

A modified Delphi study to identify which items should be evaluated in shoulder instability research: a first step in developing a core outcome set

Lukas P E Verweij et al. JSES Int. .

Abstract

Background: The aim of this study was to identify items that healthcare providers and/or patients consider important to include in a questionnaire for clinical trials and cohort studies in shoulder instability research. This could serve as a basis to develop a core outcome set for shoulder instability research.

Methods: Healthcare providers and patients were included in a panel for a modified Delphi consensus study. The study consisted of three rounds, comprising (1) identifying items, (2) rating the importance of the items, and (3) rating the importance again after seeing a summary of the results of round two. Importance was rated on a 9-point Likert scale. Consensus was defined as ≥ 80% of the panel giving a score of 7 or higher.

Results: In total, 44 healthcare providers and 30 patients completed all three rounds. Round one identified 54 items. After round three, the panel reached a consensus on 11 items that should be included in a questionnaire, comprising re-dislocation (99%), instable feeling of the shoulder (96%), limitations during sport (93%), patient satisfaction with the shoulder (93%), fear/anxiety for re-dislocation (91%), range of motion (88%), return to old level of functioning (85%), performing daily activities (85%), return to sport (82%), return to work (82%), and trusting the shoulder (81%).

Conclusion: Healthcare providers and patients reached a consensus on 11 items that should be included in a questionnaire for shoulder instability research. These items can facilitate design and development of future clinical trials and form the basis for the development of a core outcome set.

Keywords: Consensus; Core outcome set; Delphi; Dislocation; Instability; Outcome; Shoulder.

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Figures

Figure 1
Figure 1
All items that were identified in round one were classified according to the International Classification of Functioning, Disability and Health (ICF) with the additional categories “health-related quality of life” and “patient experience.” The items are subdivided with colors, which indicate if the items reached consensus in round three for the entire panel (green), only the patients (orange), only the healthcare providers (blue), and if there was no consensus (gray).
Figure 2
Figure 2
Each item is presented here with the percentage of the panel that gave the item a score of 7 or higher during round two (red) and three (blue). The figure also shows the results of the healthcare providers and patients separately.
See this image and copyright information in PMC

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