Rehabilitation outcomes for people with lung cancer (UNITE): protocol for the development of a core outcome set

Lara Edbrooke; Catherine L Granger; Jill J Francis; Tom John; Nasreen Kaadan; Emma Halloran; Bronwen Connolly; Linda Denehy

doi:10.1136/bmjresp-2022-001571

Rehabilitation outcomes for people with lung cancer (UNITE): protocol for the development of a core outcome set

BMJ Open Respir Res. 2023 Jun;10(1):e001571. doi: 10.1136/bmjresp-2022-001571.

Authors

Lara Edbrooke^{1

2}, Catherine L Granger^{3

4}, Jill J Francis^{2

5}, Tom John^{6

7}, Nasreen Kaadan⁸, Emma Halloran⁹, Bronwen Connolly¹⁰, Linda Denehy^{3

2}

Affiliations

¹ Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia larae@unimelb.edu.au.
² Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
³ Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁵ Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁷ The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.
⁸ Consumer Representative, Sydney, New South Wales, Australia.
⁹ Lung Foundation Australia, Milton, Queensland, Australia.
¹⁰ Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, County Antrim, UK.

Abstract

Introduction: With treatment-related improvements in survival, rehabilitation is essential to improve function and health-related quality of life and manage the high symptom burden associated with lung cancer. Despite this, significant heterogeneity exists in the outcomes and instruments used to evaluate lung cancer rehabilitation programme impact. This study aims to develop a core set of clinically relevant lung cancer rehabilitation outcomes for use in clinical practice.

Methods and analysis: An international Delphi consensus study involving consumer, healthcare professional and researcher stakeholders to determine which outcomes to include and how to measure these. Stage 1 (preliminary): mixed methods to develop the potential list of outcomes (1) overview of systematic reviews of lung cancer exercise interventions and (2) focus groups and individual interviews with people with lung cancer. Stage 2: outcomes were grouped according to the International Classification of Functioning, Disability and Health domains. Stage 3: to determine priority outcomes for core outcome set (COS) inclusion participants will rate each outcome's importance (one-nine-point Likert scale) over two-three survey rounds. Stage 4: following review by the steering committee, a consensus meeting will be held if agreement on the COS has not been reached.Stage 5: recommendations will be made regarding a single instrument for measuring each COS outcome by reviewing existing resources where consensus has already been reached. Where resources do not exist the quality and feasibility of potential measurement instruments will be appraised, and the Delphi consensus survey and meeting process outlined in stages 3-4 will be repeated.This protocol adheres to the COS-Standardised Protocol statement and will be conducted and reported according to the COS-Standards for Development recommendations and the COS-Standards for Reporting.

Ethics and dissemination: Ethics approval (20/9/22, University of Melbourne ID 2022-24839-32231-3). Dissemination in peer-reviewed journals and conference presentations.

Keywords: Exercise; Lung Cancer; Pulmonary Rehabilitation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Delphi Technique
Humans
Lung Neoplasms*
Quality of Life*
Research Design
Systematic Reviews as Topic
Treatment Outcome