A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS).

Freeman-Sanderson, A; Brodsky, MB; Dale, C; Gupta, A; Haines, K; Happ, MB; Hart, N; Hemsley, B; Istanboulian, L; Spronk, P; Sullivan, R; Sutt, A-L; Rose, L

A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS).

Freeman-Sanderson, A Brodsky, MB Dale, C Gupta, A Haines, K Happ, MB Hart, N Hemsley, B

Istanboulian, L Spronk, P Sullivan, R

Sutt, A-L Rose, L

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Publisher:: LIPPINCOTT WILLIAMS & WILKINS
Publication Type:: Journal Article
Citation:: Crit Care Med, 2024, 52, (9), pp. e450-e462
Issue Date:: 2024-09-01

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Field	Value	Language
dc.contributor.author	Freeman-Sanderson, A
dc.contributor.author	Brodsky, MB
dc.contributor.author	Dale, C
dc.contributor.author	Gupta, A
dc.contributor.author	Haines, K
dc.contributor.author	Happ, MB
dc.contributor.author	Hart, N
dc.contributor.author	Hemsley, B https://orcid.org/0000-0002-6255-3140
dc.contributor.author	Istanboulian, L
dc.contributor.author	Spronk, P
dc.contributor.author	Sullivan, R https://orcid.org/0000-0003-3502-999X
dc.contributor.author	Sutt, A-L
dc.contributor.author	Rose, L
dc.date.accessioned	2024-09-05T09:00:41Z
dc.date.available	2024-09-05T09:00:41Z
dc.date.issued	2024-09-01
dc.identifier.citation	Crit Care Med, 2024, 52, (9), pp. e450-e462
dc.identifier.issn	0090-3493
dc.identifier.issn	1530-0293
dc.identifier.uri	http://hdl.handle.net/10453/180636
dc.description.abstract	OBJECTIVES: Critically ill adults requiring artificial airways experience profound communication deficits. Studies of interventions supporting communication report disparate outcomes, creating subsequent challenges in the interpretation of their effectiveness. Therefore, we aimed to develop international consensus for a communication core outcome set (Comm-COS) for future trials of communication interventions in this population. DESIGN: 1) Systematic review, 2) patient/family interviews, 3) two-round modified Delphi, and 4) virtual consensus meetings with a final voting round. A multidisciplinary expert steering committee oversaw all stages. SETTING: Interviews and consensus meetings were conducted via videoconferencing. Digital methods were used for Delphi and final Comm-COS voting. SUBJECTS: Three stakeholder groups: 1) patient and family members with lived experience within 3 years, 2) clinicians with experience working in critical care, and 3) researchers publishing in the field. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: We identified 59 outcomes via our systematic review, 3 unique outcomes from qualitative interviews, and 2 outcomes from our steering committee. Following item reduction, 32 outcomes were presented in Delphi round 1; 134 participants voted; 15 patient/family (11%), 91 clinicians (68%), and 28 researchers (21%). Nine additional outcomes were generated and added to round 2; 106 (81%) participants voted. Following completion of the consensus processes, the Comm-COS includes seven outcomes: 1) changes in emotions and wellbeing associated with ability to communicate, 2) physical impact of communication aid use, 3) time to functional communication, 4) ability to communicate healthcare needs (comfort/care/safety/decisions), 5) conversation agency, 6) ability to establish a communication connection to develop and maintain relationships, and 7) acceptability of the communication intervention. CONCLUSIONS: This is the first COS to specifically focus on communication for critically ill adults. Limitations for operationalization include selection of measures to use with these outcomes. Identification of suitable measures and adoption of the Comm-COS in future trials will help establish effective interventions to ameliorate the highly prevalent and negative experience of communicative incapacity.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	LIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartof	Crit Care Med
dc.relation.isbasedon	10.1097/CCM.0000000000006347
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Emergency & Critical Care Medicine
dc.subject.classification	3202 Clinical sciences
dc.subject.classification	4205 Nursing
dc.subject.mesh	Humans
dc.subject.mesh	Delphi Technique
dc.subject.mesh	Communication
dc.subject.mesh	Consensus
dc.subject.mesh	Critical Illness
dc.subject.mesh	Respiration, Artificial
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Humans
dc.subject.mesh	Critical Illness
dc.subject.mesh	Respiration, Artificial
dc.subject.mesh	Communication
dc.subject.mesh	Consensus
dc.subject.mesh	Delphi Technique
dc.subject.mesh	Outcome Assessment, Health Care
dc.subject.mesh	Humans
dc.subject.mesh	Delphi Technique
dc.subject.mesh	Communication
dc.subject.mesh	Consensus
dc.subject.mesh	Critical Illness
dc.subject.mesh	Respiration, Artificial
dc.subject.mesh	Outcome Assessment, Health Care
dc.title	A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS).
dc.type	Journal Article
utslib.citation.volume	52
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Speech Pathology
pubs.organisational-group	University of Technology Sydney/All Manual Groups
pubs.organisational-group	University of Technology Sydney/All Manual Groups/UTS Ageing Research Collaborative (UARC)
pubs.organisational-group	University of Technology Sydney/All Manual Groups/Visualisation Institute (VI)
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated	2024-09-05T09:00:36Z
pubs.issue	9
pubs.publication-status	Published
pubs.volume	52
utslib.citation.issue	9

Abstract:

OBJECTIVES: Critically ill adults requiring artificial airways experience profound communication deficits. Studies of interventions supporting communication report disparate outcomes, creating subsequent challenges in the interpretation of their effectiveness. Therefore, we aimed to develop international consensus for a communication core outcome set (Comm-COS) for future trials of communication interventions in this population. DESIGN: 1) Systematic review, 2) patient/family interviews, 3) two-round modified Delphi, and 4) virtual consensus meetings with a final voting round. A multidisciplinary expert steering committee oversaw all stages. SETTING: Interviews and consensus meetings were conducted via videoconferencing. Digital methods were used for Delphi and final Comm-COS voting. SUBJECTS: Three stakeholder groups: 1) patient and family members with lived experience within 3 years, 2) clinicians with experience working in critical care, and 3) researchers publishing in the field. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: We identified 59 outcomes via our systematic review, 3 unique outcomes from qualitative interviews, and 2 outcomes from our steering committee. Following item reduction, 32 outcomes were presented in Delphi round 1; 134 participants voted; 15 patient/family (11%), 91 clinicians (68%), and 28 researchers (21%). Nine additional outcomes were generated and added to round 2; 106 (81%) participants voted. Following completion of the consensus processes, the Comm-COS includes seven outcomes: 1) changes in emotions and wellbeing associated with ability to communicate, 2) physical impact of communication aid use, 3) time to functional communication, 4) ability to communicate healthcare needs (comfort/care/safety/decisions), 5) conversation agency, 6) ability to establish a communication connection to develop and maintain relationships, and 7) acceptability of the communication intervention. CONCLUSIONS: This is the first COS to specifically focus on communication for critically ill adults. Limitations for operationalization include selection of measures to use with these outcomes. Identification of suitable measures and adoption of the Comm-COS in future trials will help establish effective interventions to ameliorate the highly prevalent and negative experience of communicative incapacity.

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