Identifying Outcome Domains for Clinical Trials of Physical Rehabilitation Among Adults Undergoing Solid Organ Transplantation Using a Delphi Approach.
Tathiana Santana Shiguemoto, Tania Janaudis-Ferreira, Neha Dewan and 1 others
PMID 36510644WHAT IT FOUND
Transplant patients and clinicians agreed on eight key outcome domains for rehabilitation trials, including exercise capacity and quality of life.
However, consensus on a final core set failed in the second round, with only organ rejection remaining critical early post-transplant.
Key findings
01Eight outcome domains were considered very important across all three phases of transplant: exercise capacity, mobility, quality of life, frailty, cardiovascular functions, lung function, muscle strength, and physical activity level.
02In the second round, no outcome domains met the criteria for consensus in the pretransplant or late posttransplant phases; only organ rejection was considered very important in the early posttransplant phase.
03There were no significant differences in how patients and professionals rated the importance of any outcome domains across any transplant phase.
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 study stopped at Round 2 because participants did not reach a consensus on any outcome domains to move to a third round, meaning a final core outcome set was not established. Participants were restricted to English-speaking Canadians with internet access, limiting the generalizability of the results to international or non-English speaking populations. The initial list of outcome domains was predefined by investigators based on a systematic review, which may have limited the range of outcomes considered compared to an open-start Delphi process. The sample size was small (38 in Round 1, 36 in Round 2), which may affect the stability of the consensus estimates.
Declared interests
No conflicts of interest or funding sources were explicitly stated in the provided text.
The easy way to misread this
Do not interpret this study as having established a finalized core outcome set for transplant rehabilitation. The authors explicitly state that consensus was not reached in the second round, and this work is described only as a first step toward developing such a set.