Development of a core set of outcome measures for OAB treatment

© 2017, The Author(s). Introduction and hypothesis: Standardized measures enable the comparison of outcomes across providers and treatments giving valuable information for improving care quality and efficacy. The aim of this project was to define a minimum standard set of outcome measures and case-mix factors for evaluating the care of patients with overactive bladder (OAB). Methods: The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group (WG) of leading clinicians and patients to engage in a structured method for developing a core outcome set. Consensus was determined by a modified Delphi process, and discussions were supported by both literature review and patient input. Results: The standard set measures outcomes of care for adults seeking treatment for OAB, excluding residents of long-term care facilities. The WG focused on treatment outcomes identified as most important key outcome domains to patients: symptom burden and bother, physical functioning, emotional health, impact of symptoms and treatment on quality of life, and success of treatment. Demographic information and case-mix factors that may affect these outcomes were also included. Conclusions: The standardized outcome set for evaluating clinical care is appropriate for use by all health providers caring for patients with OAB, regardless of specialty or geographic location, and provides key data for quality improvement activities and research

Attitudes Toward Randomized, Controlled Trials in Surgery: Opinions of Gynecologists of the Gruppo Italiano di Studio sull'Endometriosi

in order to assess barriers and the attitudes of gynecologists toward randomized controlled trials (RCT) in surgery for endometriosis, we identified 62 gynecologists affilliated with the Gruppo Italiano di Studio sull'Endometriosi and sent them a questionnaire. A total of 52 (83.9%) gynecologists completed and sent it back to the coordinating center. Most gynecologists strongly agreed or agreed that RCTs should be the study design of choice for evaluating surgical procedures, but 66% also strongly agree/agree that RCTs are best suited to nonsurgical setting. With regard to the feasibility of RCT in surgery, there was a high level (<50%) of agreement with the statement: RCTs are insufficiently funded; the surgical community gives to RCTs too low priority; patients are unlikely to accept random allocation. A total of 43% agree or strongly agree that there is often consensus on new procedures without the need for RCTs, but 49% disagree or strongly disagree. Considering the statements on methodological problems in conducting RCTs in surgery, the main one was that comparisons of new and standard surgical procedures are often basically flawed because they cannot be performed with equal skill. This analysis indicates that RCTs are perceived as an important choice in the development of surgical treatments. However lack of funding, the impression that patients are unlikely to accept randomization, and the idea that comparison of new and old surgical procedures is flawed by the lack of skill in new procedures are important barriers to RCT in this field