Trial outcomes and information for clinical decision-making: a comparative study of opinions of health professionals

Angus G K McNair; Sara T Brookes; Robert N Whistance; Rachael O Forsythe; Rhiannon Macefield; Jonathan Rees; James Jones; George Smith; Anne M Pullyblank; Kerry N L Avery; Michael G Thomas; Paul A Sylvester; Anne Russell; Alfred Oliver; Dion Morton; Robin Kennedy; David G Jayne; Richard Huxtable; Rowland Hackett; Susan J Dutton; Mark G Coleman; Mia Card; Julia Brown; Jane M Blazeby; CONSENSUS-CRC (Core Outcomes and iNformation SEts iN SUrgical Studies – ColoRectal Cancer) working group

doi:10.1186/s13063-016-1492-0

Trial outcomes and information for clinical decision-making: a comparative study of opinions of health professionals

Angus G K McNair, Sara T Brookes, Robert N Whistance, Rachael O Forsythe, Rhiannon Macefield, Jonathan Rees, James Jones, George Smith, Anne M Pullyblank, Kerry N L Avery, Michael G Thomas, Paul A Sylvester, Anne Russell, Alfred Oliver, Dion Morton, Robin Kennedy, David G Jayne, Richard Huxtable, Rowland Hackett, Susan J DuttonMark G Coleman, Mia Card, Julia Brown, Jane M Blazeby, CONSENSUS-CRC (Core Outcomes and iNformation SEts iN SUrgical Studies – ColoRectal Cancer) working group

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Trials are robust sources of data for clinical practice; however, trial outcomes may not reflect what is important to communicate for decision-making. The study compared clinicians' views of outcomes to include in a core outcome set for colorectal cancer (CRC) surgery, with what clinicians considered important information for clinical practice (core information).

METHODS: Potential outcome/information domains were identified through systematic literature reviews, reviews of hospital information leaflets and interviews with patients. These were organized into six categories and used to design a questionnaire survey that asked surgeons and nurses from a sample of CRC centers to rate the importance of each domain as an outcome or as information on a nine-point Likert scale. Respondents were re-surveyed (round 2) following group feedback (Delphi methods). Comparisons were made by calculating the difference in mean scores between the outcomes and information domains, and paired t tests were used to explore the difference between mean scores of the six outcome/information categories.

RESULTS: Data sources identified 1216 outcome/information items for CRC surgery that informed a 94-item questionnaire. First-round questionnaires were returned from 63/81 (78 %) of centers. Clinicians rated 76/94 (84 %) domains of higher importance to measure in trials than information to communicate to patients in round 1. This was reduced to 24/47 (51 %) in round 2. The greatest difference was evident in domains regarding survival, which was rated much more highly as a trial outcome than an important piece of information for decision-making (difference in mean 2.3, 95 % CI 1.9 to 2.8, p <0.0001). Specific complications and quality-of-life domains were rated similarly (difference in mean 0.18, 95 % CI -0.1 to 0.4, p = 0.2 and difference in mean 0.2, 95 % CI -0.1 to 0.5, p = 0.2, respectively).

CONCLUSIONS: Whilst clinicians want to measure key outcomes in trials, they rate these as less important to communicate in decision-making with patients. This discrepancy needs to be explored and addressed to maximize the impact of trials on clinical practice.

Original language	English
Pages (from-to)	344
Journal	Trials
Volume	17
Issue number	1
DOIs	https://doi.org/10.1186/s13063-016-1492-0
Publication status	Published - 25 Jul 2016

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McNair, A. G. K., Brookes, S. T., Whistance, R. N., Forsythe, R. O., Macefield, R., Rees, J., Jones, J., Smith, G., Pullyblank, A. M., Avery, K. N. L., Thomas, M. G., Sylvester, P. A., Russell, A., Oliver, A., Morton, D., Kennedy, R., Jayne, D. G., Huxtable, R., Hackett, R., ... CONSENSUS-CRC (Core Outcomes and iNformation SEts iN SUrgical Studies – ColoRectal Cancer) working group (2016). Trial outcomes and information for clinical decision-making: a comparative study of opinions of health professionals. Trials, 17(1), 344. https://doi.org/10.1186/s13063-016-1492-0

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title = "Trial outcomes and information for clinical decision-making: a comparative study of opinions of health professionals",

abstract = "BACKGROUND: Trials are robust sources of data for clinical practice; however, trial outcomes may not reflect what is important to communicate for decision-making. The study compared clinicians' views of outcomes to include in a core outcome set for colorectal cancer (CRC) surgery, with what clinicians considered important information for clinical practice (core information).METHODS: Potential outcome/information domains were identified through systematic literature reviews, reviews of hospital information leaflets and interviews with patients. These were organized into six categories and used to design a questionnaire survey that asked surgeons and nurses from a sample of CRC centers to rate the importance of each domain as an outcome or as information on a nine-point Likert scale. Respondents were re-surveyed (round 2) following group feedback (Delphi methods). Comparisons were made by calculating the difference in mean scores between the outcomes and information domains, and paired t tests were used to explore the difference between mean scores of the six outcome/information categories.RESULTS: Data sources identified 1216 outcome/information items for CRC surgery that informed a 94-item questionnaire. First-round questionnaires were returned from 63/81 (78 %) of centers. Clinicians rated 76/94 (84 %) domains of higher importance to measure in trials than information to communicate to patients in round 1. This was reduced to 24/47 (51 %) in round 2. The greatest difference was evident in domains regarding survival, which was rated much more highly as a trial outcome than an important piece of information for decision-making (difference in mean 2.3, 95 % CI 1.9 to 2.8, p <0.0001). Specific complications and quality-of-life domains were rated similarly (difference in mean 0.18, 95 % CI -0.1 to 0.4, p = 0.2 and difference in mean 0.2, 95 % CI -0.1 to 0.5, p = 0.2, respectively).CONCLUSIONS: Whilst clinicians want to measure key outcomes in trials, they rate these as less important to communicate in decision-making with patients. This discrepancy needs to be explored and addressed to maximize the impact of trials on clinical practice.",

author = "McNair, {Angus G K} and Brookes, {Sara T} and Whistance, {Robert N} and Forsythe, {Rachael O} and Rhiannon Macefield and Jonathan Rees and James Jones and George Smith and Pullyblank, {Anne M} and Avery, {Kerry N L} and Thomas, {Michael G} and Sylvester, {Paul A} and Anne Russell and Alfred Oliver and Dion Morton and Robin Kennedy and Jayne, {David G} and Richard Huxtable and Rowland Hackett and Dutton, {Susan J} and Coleman, {Mark G} and Mia Card and Julia Brown and Blazeby, {Jane M} and {CONSENSUS-CRC (Core Outcomes and iNformation SEts iN SUrgical Studies – ColoRectal Cancer) working group}",

year = "2016",

month = jul,

day = "25",

doi = "10.1186/s13063-016-1492-0",

language = "English",

volume = "17",

pages = "344",

journal = "Trials",

issn = "1745-6215",

publisher = "Springer",

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McNair, AGK, Brookes, ST, Whistance, RN, Forsythe, RO, Macefield, R, Rees, J, Jones, J, Smith, G, Pullyblank, AM, Avery, KNL, Thomas, MG, Sylvester, PA, Russell, A, Oliver, A, Morton, D, Kennedy, R, Jayne, DG, Huxtable, R, Hackett, R, Dutton, SJ, Coleman, MG, Card, M, Brown, J, Blazeby, JM & CONSENSUS-CRC (Core Outcomes and iNformation SEts iN SUrgical Studies – ColoRectal Cancer) working group 2016, 'Trial outcomes and information for clinical decision-making: a comparative study of opinions of health professionals', Trials, vol. 17, no. 1, pp. 344. https://doi.org/10.1186/s13063-016-1492-0

TY - JOUR

T1 - Trial outcomes and information for clinical decision-making

T2 - a comparative study of opinions of health professionals

AU - McNair, Angus G K

AU - Brookes, Sara T

AU - Whistance, Robert N

AU - Forsythe, Rachael O

AU - Macefield, Rhiannon

AU - Rees, Jonathan

AU - Jones, James

AU - Smith, George

AU - Pullyblank, Anne M

AU - Avery, Kerry N L

AU - Thomas, Michael G

AU - Sylvester, Paul A

AU - Russell, Anne

AU - Oliver, Alfred

AU - Morton, Dion

AU - Kennedy, Robin

AU - Jayne, David G

AU - Huxtable, Richard

AU - Hackett, Rowland

AU - Dutton, Susan J

AU - Coleman, Mark G

AU - Card, Mia

AU - Brown, Julia

AU - Blazeby, Jane M

AU - CONSENSUS-CRC (Core Outcomes and iNformation SEts iN SUrgical Studies – ColoRectal Cancer) working group

PY - 2016/7/25

Y1 - 2016/7/25

N2 - BACKGROUND: Trials are robust sources of data for clinical practice; however, trial outcomes may not reflect what is important to communicate for decision-making. The study compared clinicians' views of outcomes to include in a core outcome set for colorectal cancer (CRC) surgery, with what clinicians considered important information for clinical practice (core information).METHODS: Potential outcome/information domains were identified through systematic literature reviews, reviews of hospital information leaflets and interviews with patients. These were organized into six categories and used to design a questionnaire survey that asked surgeons and nurses from a sample of CRC centers to rate the importance of each domain as an outcome or as information on a nine-point Likert scale. Respondents were re-surveyed (round 2) following group feedback (Delphi methods). Comparisons were made by calculating the difference in mean scores between the outcomes and information domains, and paired t tests were used to explore the difference between mean scores of the six outcome/information categories.RESULTS: Data sources identified 1216 outcome/information items for CRC surgery that informed a 94-item questionnaire. First-round questionnaires were returned from 63/81 (78 %) of centers. Clinicians rated 76/94 (84 %) domains of higher importance to measure in trials than information to communicate to patients in round 1. This was reduced to 24/47 (51 %) in round 2. The greatest difference was evident in domains regarding survival, which was rated much more highly as a trial outcome than an important piece of information for decision-making (difference in mean 2.3, 95 % CI 1.9 to 2.8, p <0.0001). Specific complications and quality-of-life domains were rated similarly (difference in mean 0.18, 95 % CI -0.1 to 0.4, p = 0.2 and difference in mean 0.2, 95 % CI -0.1 to 0.5, p = 0.2, respectively).CONCLUSIONS: Whilst clinicians want to measure key outcomes in trials, they rate these as less important to communicate in decision-making with patients. This discrepancy needs to be explored and addressed to maximize the impact of trials on clinical practice.

AB - BACKGROUND: Trials are robust sources of data for clinical practice; however, trial outcomes may not reflect what is important to communicate for decision-making. The study compared clinicians' views of outcomes to include in a core outcome set for colorectal cancer (CRC) surgery, with what clinicians considered important information for clinical practice (core information).METHODS: Potential outcome/information domains were identified through systematic literature reviews, reviews of hospital information leaflets and interviews with patients. These were organized into six categories and used to design a questionnaire survey that asked surgeons and nurses from a sample of CRC centers to rate the importance of each domain as an outcome or as information on a nine-point Likert scale. Respondents were re-surveyed (round 2) following group feedback (Delphi methods). Comparisons were made by calculating the difference in mean scores between the outcomes and information domains, and paired t tests were used to explore the difference between mean scores of the six outcome/information categories.RESULTS: Data sources identified 1216 outcome/information items for CRC surgery that informed a 94-item questionnaire. First-round questionnaires were returned from 63/81 (78 %) of centers. Clinicians rated 76/94 (84 %) domains of higher importance to measure in trials than information to communicate to patients in round 1. This was reduced to 24/47 (51 %) in round 2. The greatest difference was evident in domains regarding survival, which was rated much more highly as a trial outcome than an important piece of information for decision-making (difference in mean 2.3, 95 % CI 1.9 to 2.8, p <0.0001). Specific complications and quality-of-life domains were rated similarly (difference in mean 0.18, 95 % CI -0.1 to 0.4, p = 0.2 and difference in mean 0.2, 95 % CI -0.1 to 0.5, p = 0.2, respectively).CONCLUSIONS: Whilst clinicians want to measure key outcomes in trials, they rate these as less important to communicate in decision-making with patients. This discrepancy needs to be explored and addressed to maximize the impact of trials on clinical practice.

U2 - 10.1186/s13063-016-1492-0

DO - 10.1186/s13063-016-1492-0

M3 - Article

C2 - 27456848

SN - 1745-6215

VL - 17

SP - 344

JO - Trials

JF - Trials

IS - 1

ER -

Trial outcomes and information for clinical decision-making: a comparative study of opinions of health professionals

Abstract

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