目的:坏疽性脓皮病(PG)是一种罕见的溃疡性皮肤病,目前尚无标准化结局或结局指标。有丰富的研究性治疗管道,结果的标准化以及数据质量和可解释性的改进将促进对潜在新疗法的适当和一致的评估.核心结果集(COS)是商定的标准化结果集,代表在特定条件的所有临床试验中应测量和报告的最小值。
目的:确定并就哪些领域(要测量的内容)应包括在“了解坏疽性脓皮病:疾病影响的回顾和分析(升级)”核心领域中达成共识PG临床试验。
方法:患者和PG专家之间的合作讨论,并对文献确定的项目和预期领域进行了系统回顾。进行了三轮国际eDelphi练习,以确定域的优先级并完善临时项目(共识:≥70%的参与者将域评为“极其重要”,<15%的参与者投票“不重要”,随后举行国际会议,就核心领域达成共识(共识:<30%分歧)。
方法:项目生成讨论和共识会议通过在线视频会议进行。使用Qualtrics电子调查软件进行Delphi练习和共识投票。
方法:患有PG的成年人,医疗保健专业人员,研究人员,和行业代表。
结果:合作讨论和系统审查产生了115个项目,将其蒸馏成15个预期域。eDelphi练习删除了三个优先级最低的域(实验室测试,治疗费用,和疾病对家庭的影响)和排名疼痛,生活质量,和身体症状作为最高优先级的预期领域。在疼痛领域达成了共识,生活质量,和临床体征。病程/疾病进展的领域几乎没有达成共识,无法将其纳入核心组(32.2%的参与者投票否决)。将需要对该领域定义进行完善,并在未来的共识会议上进行审议。
结论:PG临床试验的升级核心领域集已经获得国际多方利益相关者共识。未来的工作将为这些领域开发和/或选择结果测量工具,以建立核心结果集。
BACKGROUND: Pyoderma gangrenosum (PG) is a rare ulcerative skin condition with no current standardized outcomes or outcome measures. With a rich investigational therapeutic pipeline, standardization of outcomes and improvement of data quality and interpretability will promote the appropriate and consistent evaluation of potential new therapies. Core outcome sets (COS) are agreed, standardized sets of outcomes that represent the minimum that should be measured and reported in all clinical trials of a specific condition.
OBJECTIVE: To identify and reach a
consensus on which domains (what to be measured) should be included in the Understanding Pyoderma Gangrenosum: Review and Analysis of Disease Effects (UPGRADE) core domain set for clinical trials in PG.
METHODS: Collaborative discussions between patients and PG experts, and a systematic review of the literature identified items and prospective domains. A three-round international eDelphi exercise was performed to prioritize the domains and refine the provisional items (consensus: ≥ 70% of participants rating a domain as \'extremely important\' and < 15% of participants voting \'not important\'), followed by an international meeting to reach consensus on the core domain set (
consensus: < 30% disagreement). Item-generation discussions and
consensus meetings were hosted via online videoconferences. The eDelphi exercise and
consensus voting were performed using Qualtrics survey software. Participants were adults with PG, healthcare professionals, researchers and industry representatives.
RESULTS: Collaborative discussions and systematic reviews yielded 115 items, which were distilled into 15 prospective domains. The eDelphi exercise removed the three lowest-priority domains (\'laboratory tests\', \'treatment costs\' and \'disease impact on family\') and ranked \'pain\', \'quality of life\' and \'physical symptoms\' as the highest-priority prospective domains.
Consensus was reached on the domains of \'pain\', \'quality of life\' and \'clinical signs\'. The domain of \'disease course/disease progression\' narrowly failed to reach consensus for inclusion in the core set (32% of participants voted \'no\'). Refinement of this domain definition will be required and presented for consideration at future consensus meetings.
CONCLUSIONS: The UPGRADE core domain set for clinical trials in PG has been agreed by international multistakeholder consensus. Future work will develop and/or select outcome measurement instruments for these domains to establish a COS.