Core outcome set for burn care research: Delphi survey data

Background: Collated evidence from systematic reviews supports clinicians
in identifying optimal treatment for patients. Evidence is created from
outcomes that, in burn care, include survival, function, cosmesis, pain,
and psychological well-being. Currently, this is limited because of
variation in outcomes reported across trials. Improved selection and
reporting of outcomes in primary research in burn care could improve
treatment globally by improving data synthesis and the quality of
evidence. The availability of a Core Outcome Set (COS), a minimum set of
the most important outcomes to be reported in all trials of a medical
condition, would resolve this issue. The aim of this study is to develop a
COS for international burn care research. Methods and findings: Candidate
outcomes were identified from systematic reviews and stakeholder
interviews. Through two rounds of a Delphi survey, international
multi-disciplinary clinicians, researchers, and UK patients and carers
prioritised the outcomes. Anonymised feedback aimed to achieve consensus.
Pre-defined criteria for retaining and dropping outcomes were agreed upon.
A consensus meeting with voting was held to finalise the COS. Examination
of all data sources identified 1,021 unique outcomes grouped into 88
candidate outcomes. Stakeholders included 668 health professionals from 77
countries and 126 UK patients/carers; 25% of clinical participants were
from low- or low-middle-income countries. After Round 1, one outcome was
discarded, and 13 new outcomes were added. After Round 2, 69 items were
discarded, leaving 31 outcomes for the consensus meeting. Discussion and
voting agreed on seven core outcomes: death, specified complications,
ability to do daily tasks, time to wound healing, neuropathic pain and
itch, psychological well-being, and time to return to school/work.
Conclusions: This is the first COS for international burn care research.
Implementation is now needed to improve data synthesis, and support
evidence-based clinical decision-making in global burn care. It is
recommended that future trials include measures of these seven outcomes.