Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Developing a Lung Cancer Rehabilitation core outcome set: An International Delphi Study (UNITE).   (#98)

Lara Edbrooke 1 2 , Catherine L Granger 1 3 , Jill J Francis 2 4 , Thomas John 5 6 , Nasreen Kaadan 7 , Emma Halloran 8 , Thomas Davies 9 10 , Bronwen Connolly 11 , Linda Denehy 1 2
  1. Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
  2. Health Services Research, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  4. Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
  5. Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  6. The Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  7. N/A , - consumer representative
  8. The Lung Foundation Australia, Milton, Queensland, Australia
  9. William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
  10. Adult Critical Care Unit, Royal London Hospital, London, United Kingdom
  11. Wellcome-Wolfson Institute for Experimental Research, Queen's University Belfast, Belfast, United Kingdom

Aims

With treatment-related improvements in survival, lung cancer rehabilitation is essential. Significant heterogeneity exists in the outcomes and instruments used to evaluate the impact of rehabilitation. The aim of this research was to develop a core set of lung cancer rehabilitation outcomes for use in clinical practice.

Methods

An international Delphi consensus study involving consumer, healthcare professional and researcher stakeholder panels was conducted. To develop the potential list of outcomes, preparatory work involved 1) an overview of systematic reviews; and 2) focus groups and individual interviews with people with lung cancer. Participants rated the importance of each outcome (1-9 point Likert scale) over two survey rounds. Consensus criteria for each panel included ‘retain outcome’ if >70% of participants scored 7-9 (critical to include) and <15% scored 1-3 (not important); and ‘remove outcome’ if <50% of participants scored 7-9.

Results

One-hundred and twelve participants from 19 countries completed round 1 and 85% (95/112) completed round 2 (consumers n=8/11, healthcare professionals n=46/56 and researchers n=41/45). Twenty-seven outcomes were included in round 1, with an additional two outcomes (survival and frailty) added in round 2. Consensus was achieved after two survey rounds. The outcomes reaching consensus as ‘critical to include’ in the lung cancer rehabilitation core outcome set by all stakeholder groups were breathlessness, activities of daily living, physical function, health-related quality of life, emotional and mental well-being and pain. No outcomes met the consensus criteria for removal.

Conclusions

Consensus was achieved across each stakeholder group regarding six core outcomes to be used in clinical practice to evaluate lung cancer rehabilitation programs. The next stage of this project will include a second Delphi study to reach consensus regarding use of a single instrument for measuring each of these outcomes.   

Registration: Prospectively registered on the Core Outcome Measures in Effectiveness Trials database (www.comet-initiative.org/Studies/Details/2086).