Development of a core outcome set for physiotherapy trials in adults with bronchiectasis (the COS-PHyBE study): A Delphi study and consensus meeting

Background: Physiotherapy is recommended for bronchiectasis management, but there is disparity in evidence supporting its use. This is partly because of inconsistency and poor reporting of outcomes in available studies. A Core Outcome Set (COS) may improve trial consistency and decrease reporting bias. This study aimed to develop a COS for physiotherapy clinical trials in adults with bronchiectasis.
Methods: A comprehensive list of outcomes was developed using a systematic review and qualitative semi-structured interviews with patients with bronchiectasis and physiotherapists. An international two-round online Delphi survey was conducted. Outcomes scored 7–9 (crucial) by = 70 % of participants and 1–3 (not that important) by = 15 % of participants from each stakeholder in the Likert scale were nominated for inclusion in the COS. Nominated outcomes and those considered crucial by only one of the stakeholders’ groups were further discussed and voted in an international consensus meeting.
Results: A list of 137 outcomes was generated; 104 from literature and 33 from interviews. A Delphi survey containing 59 outcomes was completed by 171 participants from 20 countries. After the consensus meeting, representatives agreed on seven outcomes: health-related quality of life, respiratory symptoms, physical functioning, emotional and psychological functioning, fatigue, adherence to treatment, and functional exercise capacity

Aim

This study aimed to develop a COS for physiotherapy clinical trials in adults with bronchiectasis.

Contributors

Hayat Hamzeh, Carol Kelly, Annemarie L. Lee, Arietta Spinou, Alda Marques, Beatriz Herrero-Cortina, Chris Burtin, Kathleen Hall, Sally Spencer

Publication

Journal: Heliyon
Volume: 10
Issue:
Pages: -
Year: 2024
DOI: 10.1016/j.heliyon.2024.e34101

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This doctoral research is supported by a Graduate Teaching Assistant studentship from Edge Hill University, UK.


Health Area

Disease Category: Lungs & airways

Disease Name: Bronchiectasis

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Physiotherapy

Stakeholders Involved

- Clinical experts
- Consumers (patients)
- Researchers

Study Type

- COS for clinical trials or clinical research

Method(s)

- Consensus meeting
- Delphi process
- Interview
- Systematic review

1. A systematic review of randomised controlled trials (RCTs) and protocols for RCTs of physiotherapy interventions for adults with bronchiectasis was performed to collect reported outcomes.
2. Semi-structured interviews were conducted to identify additional outcomes important to patients who receive any of the treatments described and physiotherapists who assess these outcomes in daily practice.
3. Consensus on core outcomes was achieved using a modified Delphi survey.
4. Consensus meeting to agree on final COS from Delphi survey results.