Context: Outcomes in renal cell carcinoma (RCC) are reported inconsistently, with
variability in definitions and measurement. Hence, it is difficult to compare intervention effectiveness and synthesise outcomes for systematic reviews and to create clinical practice guidelines. This uncertainty in the evidence makes it difficult to guide patient-clinician decision-making. One solution is a core outcome set (COS): an agreed minimum set of outcomes.
Objective: To describe outcome reporting, definitions, and measurement heterogeneity as the first stage in co-creating a COS for localised renal cancer.
Evidence acquisition: We systematically reviewed outcome reporting heterogeneity in effectiveness trials and observational studies in localised RCC. In total, 2822
studies (randomised controlled trials, cohort studies, case-control studies, systematic reviews) up to June 2020 meeting our inclusion criteria were identified.
Abstracts and full texts were screened independently by two reviewers; in cases
of disagreement, a third reviewer arbitrated. Data extractions were double-checked. Evidence synthesis: We included 149 studies and found that there was inconsistency
in which outcomes were reported across studies and variability in the definitions used for outcomes that were conceptually the same. We structured our analysis using the outcome classification taxonomy proposed by Dodd et al. Outcomes linked to adverse events (eg, bleeding, outcomes linked to surgery) and renal injury outcomes (reduced renal function) were reported most commonly. Outcomes related to deaths from any cause and from cancer were reported in 44% and 25% of studies, respectively, although the time point for measurement and the analysis methods were inconsistent. Outcomes linked to life impact (eg, global quality of life) were reported least often. Clinician-reported outcomes are more frequently reported than patient-reported outcomes in the renal cancer literature.
Conclusions: This systematic review underscores the heterogeneity of outcome reporting, definitions, and measurement in research on localised renal cancer. It catalogues the variety of outcomes and serves as a first step towards the development of a COS for localised renal cancer.
Patient summary: We reviewed studies on localised kidney cancer and found that
multiple terms and definitions have been used to describe outcomes. These are
not defined consistently, and often not defined at all. Our review is the first phase
in developing a core outcome set to allow better comparisons of studies to improve
medical care.
To describe outcome reporting, definitions, and measurement heterogeneity as the first stage in co-creating a COS for localised renal cancer.
ContributorsKatharina Beyer, Christiaan Widdershoven, Lisa M. Wintner, Saeed Dabestani, Lorenzo Marconi, Charlotte Moss, Netty Kinsella, Yuhong Yuan, Rachel H. Giles, Ravi Barod, Mieke Van Hemelrijck, Axel Bex, Patricia Zondervan, Steven MacLennan
Disease Category: Cancer
Disease Name: localised renal cancer
Age Range: 18
Sex: Either
Nature of Intervention: Any
- Systematic review of outcomes measured in trials
- Systematic review
We searched Medline, EMBASE, Cochrane CENTRAL, and
Cochrane Database of Systematic Reviews (via Ovid) from
inception to June 2020.