title: Development of a Core Outcome Set for Clinical Effectiveness Trials in Esophageal Cancer Resection Surgery.
abstract: Development of a core outcome set (COS) for clinical effectiveness trials in esophageal cancer resection surgery.
  
  
  
  Inconsistency and heterogeneity in outcome reporting after esophageal cancer resection surgery hampers comparison of trial results and undermines evidence synthesis. COSs provide an evidence-based approach to these challenges.
  
  
  
  A long list of clinical and patient-reported outcomes was identified and categorized into outcome domains. Domains were operationalized into a questionnaire and patients and health professionals rated the importance of items from 1 (not important) to 9 (extremely important) in 2 Delphi survey rounds. Retained items were discussed at a consensus meeting and a final COS proposed. Professionals were surveyed to request endorsement of the COS.
  
  
  
  A total of 68 outcome domains were identified and operationalized into a questionnaire; 116 (91%) of consenting patients and 72 (77%) of health professionals completed round 1. Round 2 response rates remained high (87% patients, 93% professionals). Rounds 1 and 2 prioritized 43 and 19 items, respectively. Retained items were discussed at a patient consensus meeting and a final 10-item COS proposed, endorsed by 61/67 (91%) professionals and including: overall survival; in-hospital mortality; inoperability; need for another operation; respiratory complications; conduit necrosis and anastomotic leak; severe nutritional problems; ability to eat/drink; problems with acid indigestion or heartburn; and overall quality of life.
  
  
  
  The COS is recommended for all pragmatic clinical effectiveness trials in esophageal cancer resection surgery. Further work is needed to delineate the definitions and parameters and explore best methods for measuring the individual outcomes.
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Kerry N L
authors.initials: KNL
authors.lastname: Avery
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Katy A
authors.initials: KA
authors.lastname: Chalmers
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Sara T
authors.initials: ST
authors.lastname: Brookes
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Natalie S
authors.initials: NS
authors.lastname: Blencowe
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Karen
authors.initials: K
authors.lastname: Coulman
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.
authors.forename: Katie
authors.initials: K
authors.lastname: Whale
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.|Bristol Randomised Trials Collaboration, University of Bristol, Bristol, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Metcalfe
authors.affiliation: Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, United Kingdom.|Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Blazeby
mesh_terms: D004938:Esophageal Neoplasms / Q000601:surgery*; D006801:Humans; D063868:Patient Outcome Assessment; D064792:Pragmatic Clinical Trials as Topic; D012107:Research Design; D011795:Surveys and Questionnaires; D016896:Treatment Outcome