TY - JOUR AU - Finfer Simon AU - Hodgson C. AU - Iwashyna T. AU - Turnbull A. AU - Parker A. AU - Davis W. AU - AU - Watts N. AU - Needham D. AB -

BACKGROUND: There is increasing interest in measuring the quality of survivorship for patients admitted to the intensive care (ICU) for acute respiratory failure (ARF). However, there is substantial variability in the patient outcomes reported in studies evaluating these patients, with few data on which outcomes are essential to inform clinical practice. PURPOSE: To determine clinicians' perspectives on the outcome domains that should always be reported in studies evaluating ARF survivors after hospital discharge, and to compare findings between the US and Australian perspectives. METHODS: A survey was developed, including 19 possible domains, to iteratively elicit clinician's perspectives on core outcome domains via a modified Delphi method. The survey was initially administered online. The survey results were then discussed at in-person meetings independently at scientific conferences in US and Australia, and the survey was repeated at the meeting following this discussion. MEASUREMENT AND MAIN RESULTS: The number of partipants who responded to both the online and real-time polling was 44 of 100 (44%) in US and 78 of 85 (92%) in Australia. Most respondents were ICU-based clinicians (US 33 (75%) and Australia 76 (89%)). Of 19 domains evaluated, both the US and Australian groups ranked physical function and symptoms as the most important, with quality of life, cognitive function and symptoms, and survival being the next 3 most important, yielding a total of 4 domains meeting our criteria for inclusion as core domains at both meetings. CONCLUSIONS: Clinicians agreed that physical function and symptoms, quality of life, cognitive function and survival are domains that should always be measured in research evaluating ARF survivor outcomes after hospital discharge.

AD - C.L. Hodgson, PhD, Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, Victoria 3004, Australia, and Department of Physiotherapy, Alfred Hospital, Melbourne, Victoria, Australia.
A.E. Turnbull, DVM, PhD, Outcomes After Critical Illness and Surgery (OACIS), Johns Hopkins University, Baltimore, Maryland; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University; and Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health.
T.J. Iwashyna, MD, PhD, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and Department of Epidemiology and Preventive Medicine, Monash University.
A.M. Parker, MD, Outcomes After Critical Illness and Surgery (OACIS), Johns Hopkins University, and Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine.
W. Davis, BA, Outcomes After Critical Illness and Surgery (OACIS), Johns Hopkins University, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University.
C.O. Bingham III, MD, Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University.
N.R. Watts, PhD, Division of Critical Care and Trauma, the George Institute for Global Health, Sydney, New South Wales, Australia.
S. Finfer, MD, Division of Critical Care and Trauma, The George Institute for Global Health, and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
D.M. Needham, MD, PhD, Outcomes After Critical Illness and Surgery (OACIS), Johns Hopkins University; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University; and Department of Physical Medicine and Rehabilitation, Johns Hopkins University. AN - 27758965 BT - Physical Therapy CN - [IF}; 2.526 DP - NLM ET - 2016/10/21 J2 - Physical therapy LA - Eng LB - AUS
CCT
FY17 N1 - Hodgson, Carol L
Turnbull, Alison E
Iwashyna, Theodore J
Parker, Ann
Davis, Wesley
Bingham, Clifton O 3rd
Watts, Nicola R
Finfer, Simon
Needham, Dale M
United States
Phys Ther. 2016 Oct 6. N2 -

BACKGROUND: There is increasing interest in measuring the quality of survivorship for patients admitted to the intensive care (ICU) for acute respiratory failure (ARF). However, there is substantial variability in the patient outcomes reported in studies evaluating these patients, with few data on which outcomes are essential to inform clinical practice. PURPOSE: To determine clinicians' perspectives on the outcome domains that should always be reported in studies evaluating ARF survivors after hospital discharge, and to compare findings between the US and Australian perspectives. METHODS: A survey was developed, including 19 possible domains, to iteratively elicit clinician's perspectives on core outcome domains via a modified Delphi method. The survey was initially administered online. The survey results were then discussed at in-person meetings independently at scientific conferences in US and Australia, and the survey was repeated at the meeting following this discussion. MEASUREMENT AND MAIN RESULTS: The number of partipants who responded to both the online and real-time polling was 44 of 100 (44%) in US and 78 of 85 (92%) in Australia. Most respondents were ICU-based clinicians (US 33 (75%) and Australia 76 (89%)). Of 19 domains evaluated, both the US and Australian groups ranked physical function and symptoms as the most important, with quality of life, cognitive function and symptoms, and survival being the next 3 most important, yielding a total of 4 domains meeting our criteria for inclusion as core domains at both meetings. CONCLUSIONS: Clinicians agreed that physical function and symptoms, quality of life, cognitive function and survival are domains that should always be measured in research evaluating ARF survivor outcomes after hospital discharge.

PY - 2016 SN - 1538-6724 (Electronic)
0031-9023 (Linking) ST - Phys TherPhys Ther T2 - Physical Therapy TI - Core Domains in Evaluating Patient Outcomes After Acute Respiratory Failure: International Multidisciplinary Clinician Consultation Y2 - FY17 ER -