Development of a core outcome set for lower limb orthopaedic surgical interventions in ambulant children and young people with cerebral palsy: a study protocol

Hajar Almoajil; Helen Dawes; Sally Hopewell; Francine Toye; Crispin Jenkinson; Tim Theologis

doi:10.1136/bmjopen-2019-034744

Development of a core outcome set for lower limb orthopaedic surgical interventions in ambulant children and young people with cerebral palsy: a study protocol

BMJ Open. 2020 Mar 4;10(3):e034744. doi: 10.1136/bmjopen-2019-034744.

Authors

Hajar Almoajil^{1

2}, Helen Dawes^{3

4}, Sally Hopewell⁵, Francine Toye⁶, Crispin Jenkinson⁷, Tim Theologis^{5

8}

Affiliations

¹ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK hajar.almoajil@ndorms.ox.ac.uk.
² Department of Physical Therapy, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
³ Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.
⁴ Department of Clinical Neurology, University of Oxford, Oxford, UK.
⁵ Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
⁶ Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
⁷ Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁸ Paediatric Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Abstract

Introduction: Musculoskeletal deformities and gait deviations are common features in ambulatory cerebral palsy (CP). Deformity correction through lower limb orthopaedic surgery is the standard form of care aimed at improving or preserving motor function. Current research on CP care does not always take into account individual patients' expectations and needs. There is a wide range of outcome domains and outcome measures used to assess outcome from treatment. This can lead to reporting bias and make it difficult to compare and contrast studies. A core outcome set (COS) would enhance the efficiency, relevance and overall quality of CP orthopaedic surgery research. The aim of this study is to establish a standardised COS for use in evaluating lower limb orthopaedic surgery for ambulatory children and young people with CP.

Methods/analysis: A set of outcomes domains and outcome measures will be developed as follows: (1) a qualitative evidence synthesis to identify relevant outcomes from children and young people and family perspective; (2) a scoping review to identify relevant outcomes and outcome measures; (3) qualitative research to explore the experience of key stakeholders; (4) prioritisation of outcome domains will be achieved through a two-round Delphi process with key stakeholders; (5) a final COS will be developed at a consensus meeting with representation from key stakeholder groups.

Ethics and dissemination: Ethical approval for this study was granted in the UK by the Oxfordshire Research Ethics Committee B (REC reference 19/SC/0357). Informed consent will be obtained from participants taking part in the qualitative research and Delphi process. Study findings will be published in an open access journal and presented at relevant national and international conferences. Charities and associations will be engaged to promote awareness of the project COS results.

Trial registration number: COMET registration: 1236.

Prospero registration number: CRD42018089538.

Keywords: musculoskeletal disorders; paediatric orthopaedic & trauma surgery; paediatric orthopaedics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cerebral Palsy / surgery*
Child
Delphi Technique
Humans
Lower Extremity / surgery*
Orthopedic Procedures / standards
Outcome Assessment, Health Care / methods*
Parents
Qualitative Research
Research Design
Stakeholder Participation