SynthesisBMC health services research2026
Development of a core outcome set for studies on centralization of healthcare services.
Synthesis in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis 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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Development of a core outcome set for studies on centralization of healthcare services.BMC health services research · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCentralization defined as the reorganization of healthcare services into fewer specialized units serving a higher volume of patients is a strategy to improve the outcome quality of medical procedures. Studies on centralization, however, tend to measure and report different outcomes impeding evidence syntheses. To advance research on the effects of centralization, this study aimed at developing a core outcome set (COS) for studies on centralization of hospital procedures. The envisaged COS should be generic and include all relevant outcomes irrespective of available data or measurement instruments.
methodsFor developing the COS, we conducted (1) a systematic review on the effects of minimum volume standards in hospitals, (2) a focus group study with patient representatives, (3) two interview studies with representatives of medical societies and statutory health insurance funds, (4) an online study with health services researchers, (5) the development of a longlist of outcomes and (6) a two-round Delphi study with all aforementioned participants. All interest-holder groups were based in Germany. The collected outcomes were categorized according to the Cochrane Effective Practice and Organisation of Care (EPOC) outcome taxonomy. A priori, we defined to include an outcome if ≥75% of all participants in a respective interest-holder group rated an outcome with 7-9 (critically important) on a 9-point Likert scale, and if this criterion was met by at least two interest-holder groups.
resultsIn total, 61 participants took part in the focus groups (n = 14), the interviews (n = 28) and the online survey (n = 19). Of these 36 and 34 participated in Delphi I and II, respectively. From the studies, 48 outcomes were derived and presented in Delphi I. Based on participants' comments 45 outcomes were displayed in the Delphi II survey. The final COS comprises 27 outcomes in all EPOC outcome domains. Nine of these belong to the EPOC outcome domain "Outcomes related to the quality of care".
conclusionsFuture studies on centralization should measure and report outcomes from a broad range of outcome domains, including outcomes in the domain "Quality of care". Instruments for measuring these outcomes need to be consented.
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