Core Outcome Measures for Clinical Research in Acute Respiratory Failure Survivors. An International Modified Delphi Consensus Study

Abstract

This Core Outcome Measurement Set is recommended for use in all clinical research evaluating ARF survivors after hospital discharge. In the future, researchers should evaluate measures for outcomes not reaching consensus.

Measuring physical function after ICU: one step at a time

“…Long-term recovery after critical illness is important to patients, families and clinicians [1]. Powerful messages from patients highlight the persistent functional legacy of an intensive care unit (ICU) stay and describe the difficulties in recovering physical strength, functional capacity, and resuming domestic roles [2,3].…”

“…Researchers should be cognisant that patient report and performance tests may measure different constructs; however, the benefits of questionnaire-based data are the minimization of both loss to follow-up and use of resources. Interestingly, in a recent Delphi process to identify a core outcome set for long-term outcomes of survivors of acute respiratory failure, there was no consensus for a measure of performance-based physical function which should be used in all survivors of acute respiratory failure [1]. The 6MWD came closest to consensus at 54% agreement, although the SF-36 was suggested as a core outcome measure [1].…”

“…First, we need consensus on a measure of physical function that can be used across the continuum of survivorship, which is sensitive to change and agreement on the time-point of measurement. While health status questionnaires are commonly used and SF-36 is regarded as a core outcome [1], results across studies for this outcome are most inconsistent. Second, we need to define the most effective intervention, the timing of commencement, a dose that may need to be individually titrated and the interaction of multiple interventions (e.g.…”

Critical illness, disability, and the road home

“…A plethora of different domains of outcome instruments are currently used to assess long term outcomes across the critical care continuum. Recently a core set of outcome measures was developed using rigorous methodology [8,9]. The "what" to measure identified eight domains, including HRQoL expressed as satisfaction with life and personal enjoyment.…”

Hindsight and moving the needle forwards on rehabilitation trial design

“…The primary outcome in EPICC was the SF-36 PCS measuring patient-reported health-related quality of life at 6 months; the SF-36 is a generic instrument, commonly used in this population and a priority measurement instrument for this outcome 19. The PCS comprises data from multiple domains of the SF-36, including specific physical function ability for activities such as walking and stair-climbing and broader questions around pain, general health and work-related effort.…”