Faculty, Staff and Student Publications

Language

English

Publication Date

1-1-2026

Journal

Trauma Surgery & Acute Care Open

DOI

10.1136/tsaco-2025-002164

PMID

41788742

PMCID

PMC12959056

PubMedCentral® Posted Date

2-26-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Objectives: Liver trauma management has evolved over recent decades, shifting from primarily operative to algorithmic approaches incorporating initial non-operative management alongside operative intervention for severe injuries. Inconsistent core outcome measures between studies hamper meaningful clinical research and evidence synthesis. This study aimed to develop a core outcome set (COS) for liver trauma research to standardize outcome reporting and improve study comparability.

Methods: A modified Delphi consensus methodology after COMET (Core Outcome Measures in Effectiveness Trials) and COS-STAD (Core Outcome Set-Standards for Development) guidelines was employed and twenty trauma surgery experts were recruited through purposive sampling of high-impact publications and professional networks. Round 1 collected free-text outcome suggestions. Round 2 used a 9-point Likert scale rating of those previously identified outcomes. Consensus was defined as ≥70% rating outcomes as critically important (7-9) and ≤15% as unimportant (1-3). Intraclass correlation (ICC) assessed agreement. Round 3 involved reprioritization of non-consensus outcomes.

Results: All 20 experts completed three rounds (95% response rate). From 102 initial suggestions, 41 unique outcomes were identified. By consensus, 12 outcomes were prioritized spanning four domains: operative decision-making, non-operative management success, hepatic complications, and healthcare utilization-related outcomes. The ICC was 0.89 (95% CI 0.84 to 0.94), indicating strong inter-rater reliability.

Conclusions: This rigorously developed COS for liver trauma provides standardized outcomes to guide future research and improve cross-study comparability. Adoption of these outcomes may enhance reporting consistency and facilitate evidence synthesis in liver trauma research.

Study type: Consensus development study (modified Delphi).

Level of evidence: V.

Keywords

liver; Outcome Assessment, Health Care

Published Open-Access

yes

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.