title: Defining a Research Agenda for Patient-Reported Outcomes in Surgery: Using a Delphi Survey of Stakeholders.
abstract: Identifying timely and important research questions using relevant patient-reported outcomes (PROs) in surgery remains paramount in the current medical climate. The inaugural Patient-Reported Outcomes in Surgery (PROS) Conference brought together stakeholders in PROs research in surgery with the aim of creating a research agenda to help determine future directions and advance cross-disciplinary collaboration.
  
  
  
  To create a research agenda to help determine future directions and advance cross-disciplinary collaboration on the use of PROs in surgery.
  
  
  
  An iterative web-based interface was used to create a conference-based, modified Delphi survey for registrants at the PROS Conference (January 29-30, 2015), including surgeons, PRO researchers, payers, and other stakeholders. In round 1, research items were generated from qualitative review of responses to open-ended prompts. In round 2, items were ranked using a 5-point Likert scale; attendees were also asked to submit any new items. In round 3, the top 30 items and newly submitted items were redistributed for final ranking using a 3-point Likert scale. The top 20 items by mean rating were selected for the research agenda.
  
  
  
  An expert-generated research agenda on PROs in surgery.
  
  
  
  Of the 143 people registered for the conference, 137 provided valid email addresses. There was a wide range of attendees, with the 3 most common groups being plastic surgeons (28 [19.6%]), general surgeons (19 [13.3%]), and researchers (25 [17.5%]). In round 1, participants submitted 459 items, which were reduced through qualitative review to 53 distinct items across 7 themes of PROs research. A research agenda was formulated after 2 successive rounds of ranking. The research agenda identified 3 themes important for future PROs research in surgery: (1) PROs in the decision-making process, (2) integrating PROs into the electronic health record, and (3) measuring quality in surgery with PROs.
  
  
  
  The PROS Conference research agenda was created using a modified Delphi survey of stakeholders that will help researchers, surgeons, and funders identify crucial areas of future PROs research in surgery.
authors.affiliation: Department of Surgery, Weill Cornell Medical Center-New York Presbyterian Hospital, New York.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Pezold
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Pusic
authors.affiliation: Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Wess A
authors.initials: WA
authors.lastname: Cohen
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, New York.
authors.forename: James P
authors.initials: JP
authors.lastname: Hollenberg
authors.affiliation: Departments of Medical Social Sciences, Surgery, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Butt
authors.affiliation: Department of Surgery, University of Washington, Seattle.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.affiliation: Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Larissa K
authors.initials: LK
authors.lastname: Temple
mesh_terms: D000328:Adult; D035843:Biomedical Research; D003226:Congresses as Topic; D003657:Decision Making; D003697:Delphi Technique; D057286:Electronic Health Records; D006801:Humans; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D013043:Specialties, Surgical; D013514:Surgical Procedures, Operative / Q000592:standards*