Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

Pervez Sultan; Ron George; Carolyn F. Weiniger; K. El-Boghdadly; Perman Pandal; Brendan Carvalho; Jessica R. Ansari; Dan Benhamou; Moris Baluku; Peter S. Bernstein; Laurent A. Bollag; Sarah J. Bowden; Emily Fay; Ashraf S. Habib; Sunil Halder; Ruth Landau; Grace Lim; Vincent Liu; Colleen Moreno; Gregg S. Nelson; Mark F. Powell; Borislava Pujic; Nadir Sharawi; Natasha Singh; Roger Smith; Emily Stockert; Ellile Sultan; Mohamed Tiouririne; R. Douglas Wilson; Ian J. Wrench; Romy Yun; Mark Zakowski

doi:10.1097/ALN.0000000000004263

Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

Pervez Sultan, Ron George, Carolyn F. Weiniger, K. El-Boghdadly, Perman Pandal, Brendan Carvalho, Jessica R. Ansari, Dan Benhamou, Moris Baluku, Peter S. Bernstein, Laurent A. Bollag, Sarah J. Bowden, Emily Fay, Ashraf S. Habib, Sunil Halder, Ruth Landau, Grace Lim, Vincent Liu, Colleen Moreno, Gregg S. NelsonMark F. Powell, Borislava Pujic, Nadir Sharawi, Natasha Singh, Roger Smith, Emily Stockert, Ellile Sultan, Mohamed Tiouririne, R. Douglas Wilson, Ian J. Wrench, Romy Yun, Mark Zakowski

Obstetrics & Gynecology and Women's Health

Research output: Contribution to journal › Review article › peer-review

17 Scopus citations

Abstract

Background: Heterogeneity among reported outcomes from enhanced recovery after cesarean delivery impact studies is high. This study aimed to develop a standardized enhanced recovery core outcome set for use in future enhanced recovery after cesarean delivery studies. Methods: An international consensus study involving physicians, patients, and a director of midwifery and nursing services was conducted using a three-round modified Delphi approach (two rounds of electronic questionnaires and a third-round e-discussion) to produce the core outcome set. An initial list of outcomes was based on a previously published systematic review. Consensus was obtained for the final core outcome set, including definitions for key terms and preferred units of measurement. Strong consensus was defined as 70% or greater agreement and weak consensus as 50 to 69% agreement. Of the 64 stakeholders who were approached, 32 agreed to participate. All 32, 31, and 26 stakeholders completed Rounds 1, 2 and 3, respectively. Results: The number of outcomes in the final core outcome set was reduced from 98 to 15. Strong consensus (70% or greater stakeholder agreement) was achieved for 15 outcomes. The core outcome set included length of hospital stay; compliance with enhanced recovery protocol; maternal morbidity (hospital re-admissions or unplanned consultations); provision of optimal analgesia (maternal satisfaction, compliance with analgesia, opioid consumption or requirement and incidence of nausea or vomiting); fasting times; breastfeeding success; and times to mobilization and urinary catheter removal. The Obstetric Quality of Recovery-10 item composite measure was also included in the final core outcome set. Areas identified as requiring further research included readiness for discharge and analysis of cost savings. Conclusions: Results from an international consensus to develop a core outcome set for enhanced recovery after cesarean delivery are presented. These are outcomes that could be considered when designing future enhanced recovery studies.

Original language	English (US)
Pages (from-to)	201-211
Number of pages	11
Journal	Anesthesiology
Volume	137
Issue number	2
DOIs	https://doi.org/10.1097/ALN.0000000000004263
State	Published - Aug 1 2022

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

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Sultan, P., George, R., Weiniger, C. F., El-Boghdadly, K., Pandal, P., Carvalho, B., Ansari, J. R., Benhamou, D., Baluku, M., Bernstein, P. S., Bollag, L. A., Bowden, S. J., Fay, E., Habib, A. S., Halder, S., Landau, R., Lim, G., Liu, V., Moreno, C., ... Zakowski, M. (2022). Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study. Anesthesiology, 137(2), 201-211. https://doi.org/10.1097/ALN.0000000000004263

Sultan, P, George, R, Weiniger, CF, El-Boghdadly, K, Pandal, P, Carvalho, B, Ansari, JR, Benhamou, D, Baluku, M, Bernstein, PS, Bollag, LA, Bowden, SJ, Fay, E, Habib, AS, Halder, S, Landau, R, Lim, G, Liu, V, Moreno, C, Nelson, GS, Powell, MF, Pujic, B, Sharawi, N, Singh, N, Smith, R, Stockert, E, Sultan, E, Tiouririne, M, Wilson, RD, Wrench, IJ, Yun, R & Zakowski, M 2022, 'Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study', Anesthesiology, vol. 137, no. 2, pp. 201-211. https://doi.org/10.1097/ALN.0000000000004263

@article{4192ba5d6206452084d38cc7e92fc553,

title = "Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study",

abstract = "Background: Heterogeneity among reported outcomes from enhanced recovery after cesarean delivery impact studies is high. This study aimed to develop a standardized enhanced recovery core outcome set for use in future enhanced recovery after cesarean delivery studies. Methods: An international consensus study involving physicians, patients, and a director of midwifery and nursing services was conducted using a three-round modified Delphi approach (two rounds of electronic questionnaires and a third-round e-discussion) to produce the core outcome set. An initial list of outcomes was based on a previously published systematic review. Consensus was obtained for the final core outcome set, including definitions for key terms and preferred units of measurement. Strong consensus was defined as 70% or greater agreement and weak consensus as 50 to 69% agreement. Of the 64 stakeholders who were approached, 32 agreed to participate. All 32, 31, and 26 stakeholders completed Rounds 1, 2 and 3, respectively. Results: The number of outcomes in the final core outcome set was reduced from 98 to 15. Strong consensus (70% or greater stakeholder agreement) was achieved for 15 outcomes. The core outcome set included length of hospital stay; compliance with enhanced recovery protocol; maternal morbidity (hospital re-admissions or unplanned consultations); provision of optimal analgesia (maternal satisfaction, compliance with analgesia, opioid consumption or requirement and incidence of nausea or vomiting); fasting times; breastfeeding success; and times to mobilization and urinary catheter removal. The Obstetric Quality of Recovery-10 item composite measure was also included in the final core outcome set. Areas identified as requiring further research included readiness for discharge and analysis of cost savings. Conclusions: Results from an international consensus to develop a core outcome set for enhanced recovery after cesarean delivery are presented. These are outcomes that could be considered when designing future enhanced recovery studies.",

author = "Pervez Sultan and Ron George and Weiniger, {Carolyn F.} and K. El-Boghdadly and Perman Pandal and Brendan Carvalho and Ansari, {Jessica R.} and Dan Benhamou and Moris Baluku and Bernstein, {Peter S.} and Bollag, {Laurent A.} and Bowden, {Sarah J.} and Emily Fay and Habib, {Ashraf S.} and Sunil Halder and Ruth Landau and Grace Lim and Vincent Liu and Colleen Moreno and Nelson, {Gregg S.} and Powell, {Mark F.} and Borislava Pujic and Nadir Sharawi and Natasha Singh and Roger Smith and Emily Stockert and Ellile Sultan and Mohamed Tiouririne and Wilson, {R. Douglas} and Wrench, {Ian J.} and Romy Yun and Mark Zakowski",

year = "2022",

month = aug,

day = "1",

doi = "10.1097/ALN.0000000000004263",

language = "English (US)",

volume = "137",

pages = "201--211",

journal = "Anesthesiology",

issn = "0003-3022",

publisher = "Lippincott Williams and Wilkins",

number = "2",

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TY - JOUR

T1 - Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies

T2 - A Delphi Study

AU - Sultan, Pervez

AU - George, Ron

AU - Weiniger, Carolyn F.

AU - El-Boghdadly, K.

AU - Pandal, Perman

AU - Carvalho, Brendan

AU - Ansari, Jessica R.

AU - Benhamou, Dan

AU - Baluku, Moris

AU - Bernstein, Peter S.

AU - Bollag, Laurent A.

AU - Bowden, Sarah J.

AU - Fay, Emily

AU - Habib, Ashraf S.

AU - Halder, Sunil

AU - Landau, Ruth

AU - Lim, Grace

AU - Liu, Vincent

AU - Moreno, Colleen

AU - Nelson, Gregg S.

AU - Powell, Mark F.

AU - Pujic, Borislava

AU - Sharawi, Nadir

AU - Singh, Natasha

AU - Smith, Roger

AU - Stockert, Emily

AU - Sultan, Ellile

AU - Tiouririne, Mohamed

AU - Wilson, R. Douglas

AU - Wrench, Ian J.

AU - Yun, Romy

AU - Zakowski, Mark

PY - 2022/8/1

Y1 - 2022/8/1

N2 - Background: Heterogeneity among reported outcomes from enhanced recovery after cesarean delivery impact studies is high. This study aimed to develop a standardized enhanced recovery core outcome set for use in future enhanced recovery after cesarean delivery studies. Methods: An international consensus study involving physicians, patients, and a director of midwifery and nursing services was conducted using a three-round modified Delphi approach (two rounds of electronic questionnaires and a third-round e-discussion) to produce the core outcome set. An initial list of outcomes was based on a previously published systematic review. Consensus was obtained for the final core outcome set, including definitions for key terms and preferred units of measurement. Strong consensus was defined as 70% or greater agreement and weak consensus as 50 to 69% agreement. Of the 64 stakeholders who were approached, 32 agreed to participate. All 32, 31, and 26 stakeholders completed Rounds 1, 2 and 3, respectively. Results: The number of outcomes in the final core outcome set was reduced from 98 to 15. Strong consensus (70% or greater stakeholder agreement) was achieved for 15 outcomes. The core outcome set included length of hospital stay; compliance with enhanced recovery protocol; maternal morbidity (hospital re-admissions or unplanned consultations); provision of optimal analgesia (maternal satisfaction, compliance with analgesia, opioid consumption or requirement and incidence of nausea or vomiting); fasting times; breastfeeding success; and times to mobilization and urinary catheter removal. The Obstetric Quality of Recovery-10 item composite measure was also included in the final core outcome set. Areas identified as requiring further research included readiness for discharge and analysis of cost savings. Conclusions: Results from an international consensus to develop a core outcome set for enhanced recovery after cesarean delivery are presented. These are outcomes that could be considered when designing future enhanced recovery studies.

AB - Background: Heterogeneity among reported outcomes from enhanced recovery after cesarean delivery impact studies is high. This study aimed to develop a standardized enhanced recovery core outcome set for use in future enhanced recovery after cesarean delivery studies. Methods: An international consensus study involving physicians, patients, and a director of midwifery and nursing services was conducted using a three-round modified Delphi approach (two rounds of electronic questionnaires and a third-round e-discussion) to produce the core outcome set. An initial list of outcomes was based on a previously published systematic review. Consensus was obtained for the final core outcome set, including definitions for key terms and preferred units of measurement. Strong consensus was defined as 70% or greater agreement and weak consensus as 50 to 69% agreement. Of the 64 stakeholders who were approached, 32 agreed to participate. All 32, 31, and 26 stakeholders completed Rounds 1, 2 and 3, respectively. Results: The number of outcomes in the final core outcome set was reduced from 98 to 15. Strong consensus (70% or greater stakeholder agreement) was achieved for 15 outcomes. The core outcome set included length of hospital stay; compliance with enhanced recovery protocol; maternal morbidity (hospital re-admissions or unplanned consultations); provision of optimal analgesia (maternal satisfaction, compliance with analgesia, opioid consumption or requirement and incidence of nausea or vomiting); fasting times; breastfeeding success; and times to mobilization and urinary catheter removal. The Obstetric Quality of Recovery-10 item composite measure was also included in the final core outcome set. Areas identified as requiring further research included readiness for discharge and analysis of cost savings. Conclusions: Results from an international consensus to develop a core outcome set for enhanced recovery after cesarean delivery are presented. These are outcomes that could be considered when designing future enhanced recovery studies.

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U2 - 10.1097/ALN.0000000000004263

DO - 10.1097/ALN.0000000000004263

M3 - Review article

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AN - SCOPUS:85134330630

SN - 0003-3022

VL - 137

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JO - Anesthesiology

JF - Anesthesiology

IS - 2

ER -

Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study

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