A core outcome set for lower limb orthopaedic surgery for children with cerebral palsy: An international multi-stakeholder consensus study.
Hajar Almoajil, Sally Hopewell, Helen Dawes and 2 others
PMID 35869637WHAT IT FOUND
International consensus identified 19 outcomes across 8 domains to measure after lower limb surgery in children with cerebral palsy.
These include pain, walking, independence, and self-esteem. Adverse events and assistive device use were excluded from the core set.
Key findings
01The final core outcome set includes 19 outcomes within eight domains: pain and fatigue, lower limb structure, motor function, daily life activities, walking-related outcomes, physical activity, independence, and quality of life.
02Outcomes related to the use of assistive devices were discussed at length but excluded from the core set due to insufficient evidence of decreased use following surgery.
03Adverse events were not included in the core outcome set, although the consensus group recommended they be reported in future clinical studies as essential for safety and decision-making.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The Delphi survey and consensus meeting were conducted only in English, potentially excluding non-English speaking stakeholders and limiting global generalizability. Attrition between Delphi rounds was high (40.5%), with 111 respondents in round 1 dropping to 86 in round 2. There was a small number of individuals with CP and their representatives (18 in round 1), and representation from children was less than that of adults with CP who had surgery years earlier, which may have biased priorities toward long-term rather than immediate post-surgical outcomes. The final set includes 19 outcomes, which the authors acknowledge is a large number that may not be feasible for all studies to measure, particularly those requiring long-term follow-up.
Declared interests
One author (H.A.) is funded by a postgraduate scholarship from Imam Abdulrahman Bin Faisal University, Saudi Arabia. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the exclusion of adverse events from the core outcome set as a statement that they are unimportant. The consensus group explicitly recommended that adverse events be reported in all future clinical studies because they are essential for defining safety and informing clinical decision-making.