Development of a core outcome set for adult traumatic brachial plexus injuries.

Miller, Caroline (2022) Development of a core outcome set for adult traumatic brachial plexus injuries. Doctoral thesis, University of East Anglia.

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Background: A traumatic Brachial Plexus Injury (BPI) involves major trauma to the large nerves of the arm, resulting in partial or complete paralysis, loss of feeling and unremitting pain. Outcome reporting in BPI research is inconsistent hindering synthesis of evidence to inform best care. This research aimed to develop a Core Outcome Set (COS) for adult BPI.

Methods: Patient interviews and a systematic review of outcomes in BPI studies identified a long list of outcomes. Key stakeholders (surgeons, therapists and adults with a BPI) rated their importance in a 3 round international online Delphi on a 9-point Likert scale. During online patient and clinician consensus meetings the COS-BPI was determined. A systematic review was conducted to identify potential instruments available to measure the domains in the COS.

Results: Sixty -four outcomes were identified from the systematic review and interviews. Seventy-two participants (21 people with a BPI, 20 surgeons and 31 therapists) from nineteen countries rated the importance of these outcomes in the online Delphi. Thirty-eight participants voted on 33 outcomes in the consensus meetings (25 clinicians and researchers and 13 people with the injury). Pain, voluntary movement and carrying out daily routine outcomes were included in the COS-BPI. A systematic review identified that the Brachial Assessment Tool (BrAT) and the Brief Pain Inventory could potentially measure the carrying out daily routine and pain outcomes in the COS-BPI. No suitable instrument to measure voluntary movement was identified.

Conclusion: International consensus was reached on a COS for BPI which includes pain, voluntary movement and carrying out daily routine. The BrAT and Brief Pain Inventory can be used to measure the carrying out daily routine and pain domains. This will ensure that relevant outcomes are measured and reported and facilitate comparison across studies supporting BPI data synthesis to inform evidence-based practice.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Kitty Laine
Date Deposited: 15 Feb 2023 14:44
Last Modified: 15 Feb 2023 14:44


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