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  6. Faecal Incontinence Core Outcome Set: An International Delphi Consensus Exercise Among Patients, Health-care Professionals, And Researchers

Faecal incontinence core outcome set: an international Delphi consensus exercise among patients, health-care professionals, and researchers

Sadé L Assmann1, Daniel Keszthelyi2, Merel L Kimman3

  • 1Department of Surgery and Colorectal Surgery, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Gastroenterology-Hepatology, Maastricht University Medical Centre, Maastricht, Netherlands; Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands.

The Lancet. Gastroenterology & Hepatology|June 14, 2025

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View abstract on PubMed

Summary

This study developed a core outcome set (COS) for faecal incontinence research, ensuring patient-centered outcomes are prioritized alongside clinical measures. The new COS includes 13 essential outcomes to improve treatment evaluation and patient care.

Area of Science:

  • Anorectal Disorders Research
  • Patient-Reported Outcomes
  • Clinical Trial Methodology

Background:

  • Faecal incontinence significantly impacts quality of life, yet treatment studies often lack standardized, patient-relevant outcome measures.
  • Variability in reported outcomes hinders evidence synthesis and weakens treatment recommendations for faecal incontinence.
  • Existing research frequently overlooks patient-centric outcomes crucial for daily living.

Framework:

  • Developed a Core Outcome Set (COS) for faecal incontinence research following COMET initiative guidelines.
  • Employed a three-step process: outcome identification (patient interviews, literature review), outcome refinement (Delphi surveys), and finalization (consensus meeting).
  • Incorporated diverse stakeholder perspectives, including patients, healthcare professionals, and researchers.

Implementation:

  • Conducted two rounds of Delphi surveys with 109 and 74 participants, respectively.
  • Utilized a 9-point Likert scale for ranking potential outcomes.
  • A consensus meeting finalized the COS after discussing 34 potential outcomes.

Implications:

  • The finalized COS includes 13 outcomes: 7 quality of life-related and 6 clinical outcomes.
  • This standardized set aims to improve the quality and comparability of faecal incontinence treatment research.
  • Future research is needed to identify appropriate measurement instruments and assessment timing for the COS outcomes.

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