Systematic review and consensus definitions for standardised endpoints in perioperative medicine: postoperative cancer outcomes.

Autor:	Buggy DJ; Department of Anaesthesia, Mater Misericordiae University Hospital, School of Medicine, University College Dublin, Ireland; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: donal.buggy@ucd.ie., Freeman J; Department of Anaesthesia, Mater Misericordiae University Hospital, School of Medicine, University College Dublin, Ireland., Johnson MZ; Department of Anaesthesia, Mater Misericordiae University Hospital, School of Medicine, University College Dublin, Ireland., Leslie K; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne Medical School, University of Melbourne, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia., Riedel B; Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre and University of Melbourne, Australia., Sessler DI; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA., Kurz A; Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Gottumukkala V; Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Short T; Auckland City Hospital, Auckland, New Zealand., Pace N; Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA., Myles PS; Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2018 Jul; Vol. 121 (1), pp. 38-44. Date of Electronic Publication: 2018 May 01.
DOI:	10.1016/j.bja.2018.03.020
Abstrakt:	Background: The Standardising Endpoints for Perioperative Medicine group was established to derive an appropriate set of endpoints for use in clinical trials related to anaesthesia and perioperative medicine. Anaesthetic or analgesic technique during cancer surgery with curative intent may influence the risk of recurrence or metastasis. However, given the current equipoise in the existing literature, prospective, randomised, controlled trials are necessary to test this hypothesis. As such, a cancer subgroup was formed to derive endpoints related to research in onco-anaesthesia based on a current evidence base, international consensus and expert guidance. Methods: We undertook a systematic review to identify measures of oncological outcome used in the oncological, surgical, and wider literature. A multiround Delphi consensus process that included up to 89 clinician-researchers was then used to refine a recommended list of endpoints. Results: We identified 90 studies in a literature search, which were the basis for a preliminary list of nine outcome measures and their definitions. A further two were added during the Delphi process. Response rates for Delphi rounds one, two, and three were 88% (n=9), 82% (n=73), and 100% (n=10), respectively. A final list of 10 defined endpoints was refined and developed, of which six secured approval by ≥70% of the group: cancer health related quality of life, days alive and out of hospital at 90 days, time to tumour progression, disease-free survival, cancer-specific survival, and overall survival (and 5-yr overall survival). Conclusion: Standardised endpoints in clinical outcomes studies will support benchmarking and pooling (meta-analysis) of trials. It is therefore recommended that one or more of these consensus-derived endpoints should be considered for inclusion in clinical trials evaluating a causal effect of anaesthesia-analgesia technique on oncological outcomes. (Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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