Developing a core outcome set for traumatic brachial plexus injuries: a systematic review of outcomes

Caroline Miller, Jane Cross, Joel O'Sullivan, Dominic Power, Derek Kyte, Christina Jerosch-Herold

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Abstract

Objective To identify what outcomes have been assessed in traumatic brachial plexus injury (TBPI) research to inform the development of a core outcome set for TBPI. Design Systematic review. Method Medline (OVID), EMBASE, CINAHL and AMED were systematically searched for studies evaluating the clinical effectiveness of interventions in adult TBPIs from January 2013 to September 2018 updated in May 2021. Two authors independently screened papers. Outcome reporting bias was assessed. All outcomes were extracted verbatim from studies. Patient-reported outcomes or performance outcome measures were extracted directly from the instrument. Variation in outcome reporting was determined by assessing the number of unique outcomes reported across all included studies. Outcomes were categorised into domains using a prespecified taxonomy. Results Verbatim outcomes (n=1491) were extracted from 138 studies including 32 questionnaires. Unique outcomes (n=157) were structured into 4 core areas and 11 domains. Outcomes within the musculoskeletal domain were measured in 86% of studies, physical functioning in 25%, emotional functioning in 25% and adverse events in 33%. We identified 63 different methods for measuring muscle strength, 16 studies for range of movement and 63 studies did not define how they measured movement. More than two-thirds of the outcomes were incompletely reported in prospective studies. Conclusion This review of outcome reporting in TBPI research demonstrated an impairment focus and heterogeneity. A core outcome set would ensure standardised and relevant outcomes are reported to facilitate future systematic review and meta-analysis. PROSPERO registration number CRD42018109843.

Original languageEnglish
Article numbere044797
Number of pages10
JournalBMJ Open
Volume11
Issue number7
DOIs
Publication statusPublished - 30 Jul 2021

Keywords

  • elbow & shoulder
  • limb reconstruction
  • neurological injury
  • neurological pain
  • plastic & reconstructive surgery
  • trauma management

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