SynthesisBMJ open2020
Systematic review of international Delphi surveys for core outcome set development: representation of international patients.
Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Core outcome sets for trials of interventions to prevent and to treat multimorbidity in adults in low and middle-income countries: the COSMOS study.BMJ global health · 2024Pooled it
- Synthesizing Core Outcome Sets for outcomes research in cohort studies: a systematic review.Pediatric research · 2022Pooled it
- Pooled it
- Developing a core outcome set for intervention studies in post stroke cognitive impairment (COS-PSCI): a protocol.BMJ open · 2026Article
- Article
- The COCOS-IPF core outcome set for idiopathic pulmonary fibrosis/progressive pulmonary fibrosis care: a mixed-method multi-perspective approach.ERJ open research · 2026Article
- Developing multi-perspective practice-based evidence theses for breaking bad news in the German pediatric oncology: A participatory group Delphi study.PEC innovation · 2025Article
- A Core Outcome Set for Stillbirth Care: An International Consensus Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Core outcome domains forERJ open research · 2025Article
- Prioritisation of head, neck, and respiratory outcomes in mucopolysaccharidosis type II: lessons from a rare disease consensus exercise and comparison of parental and clinical priorities.Orphanet journal of rare diseases · 2025Article
- Use, knowledge, & attitudes on core outcome sets among trialists & systematic reviewers in India: A survey.The Indian journal of medical research · 2024Article
- Article
- Core outcome sets for trials of interventions to prevent and to treat multimorbidity in low- and middle-income countries: the COSMOS study.medRxiv : the preprint server for health sciences · 2024Article
- Experiences of core outcome set developers on including stakeholders from low- and middle-income countries: An online survey.PLOS global public health · 2024Article
- Article
- Awareness and experiences on core outcome set development and use amongst stakeholders from low- and middle- income countries: An online survey.PLOS global public health · 2023Article
- The Management of Asymptomatic Congenital Pulmonary Airway Malformation: Results of a European Delphi Survey.Children (Basel, Switzerland) · 2022Article
- Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries.Journal of clinical epidemiology · 2022Article
- Development of a core outcome set for multimorbidity trials in low/middle-income countries (COSMOS): study protocol.BMJ open · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
objectivesA core outcome set (COS) describes a minimum set of outcomes to be reported by all clinical trials of one healthcare condition. Delphi surveys are frequently used to achieve consensus on core outcomes. International input is important to achieve global COS uptake. We aimed to investigate participant representation in international Delphi surveys, with reference to the inclusion of patients and participants from low and middle income countries as stakeholders (LMICs).
designSystematic review. DATA SOURCES: EMBASE, Medline, Web of Science, COMET database and hand-searching. ELIGIBILITY CRITERIA: Protocols and studies describing Delphi surveys used to develop an international COS for trial reporting, published between 1 January 2017 and 6 June 2019. DATA EXTRACTION AND SYNTHESIS: Delphi participants were grouped as patients or healthcare professionals (HCPs). Participants were considered international if their country of origin was different to that of the first or senior author. Data extraction included participant numbers, country of origin, country income group and whether Delphi surveys were translated. We analysed the impact these factors had on outcome prioritisation.
resultsOf 90 included studies, 69% (n=62) were completed and 31% (n=28) were protocols. Studies recruited more HCPs than patients (median 60 (IQR 30-113) vs 30 (IQR 14-66) participants, respectively). A higher percentage of HCPs was international compared with patients (57% (IQR 37-78) vs 20% (IQR 0-68)). Only 31% (n=28) studies recruited participants from LMICs. Regarding recruitment from LMICs, patients were under-represented (16% studies; n=8) compared with HCPs (22%; n=28). Few (7%; n=6) studies translated Delphi surveys. Only 3% studies (n=3) analysed Delphi responses by geographical location; all found differences in outcome prioritisation.
conclusionsThere is a disproportionately lower inclusion of international patients, compared with HCPs, in COS-development Delphi surveys, particularly within LMICs. Future international Delphi surveys should consider exploring for geographical and income-based differences in outcome prioritisation. PROSPERO REGISTRATION NUMBER: CRD42019138519.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.