Abstract
Background
The introduction of robot-assisted surgery is costly and requires whole system transformation, which makes the assessment of benefits (or drawbacks) complex. To date, there has been little agreement on which outcomes should be used in this regard. The aim of the RoboCOS study was to develop a core outcome set for the evaluation of robot-assisted surgery that would account for its impact on the whole system.
Methods
Identification of a long-list of potentially relevant outcomes through systematic review of trials and health technology assessments; interviews with individuals from a range of stakeholder groups (surgeons, service managers, policy makers and evaluators) and a focus group with patients and public; prioritisation of outcomes via a 2-round online international Delphi survey; consensus meeting.
Results
721 outcomes were extracted from the systematic reviews, interviews and focus group which were conceptualised into 83 different outcome domains across four distinct levels (patient, surgeon, organisation and population) for inclusion in the international Delphi prioritisation survey (128 completed both rounds). The consensus meeting led to the agreement of a 10-item core outcome set including outcomes at: patient level (treatment effectiveness; overall quality of life; disease-specific quality of life; complications (including mortality); surgeon level (precision/accuracy; visualisation); organisation (equipment failure; standardisation of operative quality; cost-effectiveness); and population (equity of access).
The introduction of robot-assisted surgery is costly and requires whole system transformation, which makes the assessment of benefits (or drawbacks) complex. To date, there has been little agreement on which outcomes should be used in this regard. The aim of the RoboCOS study was to develop a core outcome set for the evaluation of robot-assisted surgery that would account for its impact on the whole system.
Methods
Identification of a long-list of potentially relevant outcomes through systematic review of trials and health technology assessments; interviews with individuals from a range of stakeholder groups (surgeons, service managers, policy makers and evaluators) and a focus group with patients and public; prioritisation of outcomes via a 2-round online international Delphi survey; consensus meeting.
Results
721 outcomes were extracted from the systematic reviews, interviews and focus group which were conceptualised into 83 different outcome domains across four distinct levels (patient, surgeon, organisation and population) for inclusion in the international Delphi prioritisation survey (128 completed both rounds). The consensus meeting led to the agreement of a 10-item core outcome set including outcomes at: patient level (treatment effectiveness; overall quality of life; disease-specific quality of life; complications (including mortality); surgeon level (precision/accuracy; visualisation); organisation (equipment failure; standardisation of operative quality; cost-effectiveness); and population (equity of access).
| Original language | English |
|---|---|
| Article number | e0283000. |
| Number of pages | 14 |
| Journal | PloS ONE |
| Volume | 18 |
| Issue number | 3 |
| Early online date | 30 Mar 2023 |
| DOIs | |
| Publication status | Published - 30 Mar 2023 |
Bibliographical note
Open Access via the PLOS AgreementACKNOWLEDGEMENTS
We would like to thank sincerely all those who contributed to the interviews, the focus group, the Delphi survey and the consensus meeting, and Paul Manson (Health Services Research Unit, University of Aberdeen) for helping to retrieve full text copies of reports identified by the literature search. We also thank HSRU (Health Services Research Unit) at University of Aberdeen for providing support for
this work.
Funding: The study was funded from NHS Grampian Endowment Fund and the University of Aberdeen. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Keywords
- Humans
- Robotic Surgical Procedures
- Quality of Life
- Research Design
- Delphi Technique
- Endpoint Determination
- Treatment Outcome
- Surgeons