title: Standardizing endpoints in perioperative research.
abstract: Measuring patient-relevant, clinically important, and valid outcomes is fundamental to the delivery of high-quality clinical care and to the innovation and development of such care through research. As surgical innovations become more complex and the burden of age and comorbidities in the surgical patient population continues to increase, understanding the benefits and harms of surgical interventions becomes ever more important. Nevertheless, we can understand only what we can adequately describe. Truly collaborative decision-making, delivery of safe effective care, and on-going quality improvement are also critically dependent on reliable valid measurement of patient-relevant and clinically important data. Attempts to describe the full spectrum of outcomes following surgery necessarily entail moving beyond the traditional endpoints of mortality and resource use towards more complex measures of morbidity, patient-reported outcomes, and functional status. Without standardization and consensus to guide the use of increasingly complex and nuanced endpoints, there is a real risk that perioperative research will become embroiled in a mire of inconsistent heterogeneous outcome measures that cannot be meaningfully compared and contrasted between trials or combined within meta-analyses. This would result in limiting the value of the research effort and depriving patients and clinicians of definitive answers. Collaboration in perioperative medicine-whether between institutions or across continents-has enormous potential to improve the value of research output. Standardizing endpoints for outcome measurement is fundamental to maximizing the quality of such collaboration and ensuring the impact of future perioperative research.
authors.affiliation: Surgical Outcomes Research Centre, University College Hospital, London, UK.|Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Boney
authors.affiliation: Surgical Outcomes Research Centre, University College Hospital, London, UK.|Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
authors.forename: Suneetha R
authors.initials: SR
authors.lastname: Moonesinghe
authors.affiliation: Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Myles
authors.affiliation: Surgical Outcomes Research Centre, University College Hospital, London, UK. mike.grocott@soton.ac.uk.|Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK. mike.grocott@soton.ac.uk.|Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Road, Southampton, UK. mike.grocott@soton.ac.uk.|Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK. mike.grocott@soton.ac.uk.|Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK. mike.grocott@soton.ac.uk.
authors.forename: Michael P W
authors.initials: MP
authors.lastname: Grocott
mesh_terms: D035843:Biomedical Research / Q000379:methods* / Q000592:standards; D003299:Cooperative Behavior; D003657:Decision Making; D023381:Endpoint Determination / Q000379:methods / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019990:Perioperative Care / Q000379:methods; D011787:Quality of Health Care; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods*