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Original Investigation |

Defining a Research Agenda for Patient-Reported Outcomes in Surgery Using a Delphi Survey of Stakeholders ONLINE FIRST

Michael L. Pezold, MD1; Andrea L. Pusic, MD, MHS2; Wess A. Cohen, MD2; James P. Hollenberg, MD3; Zeeshan Butt, PhD4; David R. Flum, MD, MPH5; Larissa K. Temple, MD6
[+] Author Affiliations
1Department of Surgery, Weill Cornell Medical Center–New York Presbyterian Hospital, New York
2Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
3Department of Medicine, Weill Cornell Medical College, New York, New York
4Departments of Medical Social Sciences, Surgery, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
5Department of Surgery, University of Washington, Seattle
6Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Surg. Published online July 20, 2016. doi:10.1001/jamasurg.2016.1640
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Importance  Identifying timely and important research questions using relevant patient-reported outcomes (PROs) in surgery remains paramount in the current medical climate. The inaugural Patient-Reported Outcomes in Surgery (PROS) Conference brought together stakeholders in PROs research in surgery with the aim of creating a research agenda to help determine future directions and advance cross-disciplinary collaboration.

Objective  To create a research agenda to help determine future directions and advance cross-disciplinary collaboration on the use of PROs in surgery.

Design, Setting, and Participants  An iterative web-based interface was used to create a conference-based, modified Delphi survey for registrants at the PROS Conference (January 29-30, 2015), including surgeons, PRO researchers, payers, and other stakeholders. In round 1, research items were generated from qualitative review of responses to open-ended prompts. In round 2, items were ranked using a 5-point Likert scale; attendees were also asked to submit any new items. In round 3, the top 30 items and newly submitted items were redistributed for final ranking using a 3-point Likert scale. The top 20 items by mean rating were selected for the research agenda.

Main Outcomes and Measures  An expert-generated research agenda on PROs in surgery.

Results  Of the 143 people registered for the conference, 137 provided valid email addresses. There was a wide range of attendees, with the 3 most common groups being plastic surgeons (28 [19.6%]), general surgeons (19 [13.3%]), and researchers (25 [17.5%]). In round 1, participants submitted 459 items, which were reduced through qualitative review to 53 distinct items across 7 themes of PROs research. A research agenda was formulated after 2 successive rounds of ranking. The research agenda identified 3 themes important for future PROs research in surgery: (1) PROs in the decision-making process, (2) integrating PROs into the electronic health record, and (3) measuring quality in surgery with PROs.

Conclusions and Relevance  The PROS Conference research agenda was created using a modified Delphi survey of stakeholders that will help researchers, surgeons, and funders identify crucial areas of future PROs research in surgery.

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Figure 1.
Flowchart for the 3 Rounds of the Modified Delphi Survey
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Figure 2.
Most Important Themes for Patient-Reported Outcome Research in Surgery Identified From the Delphi Survey

EHR indicates electronic health record.

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