Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

INOSS

doi:10.1111/1471-0528.14833

Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

INOSS

65 Citations (Scopus)

Abstract

OBJECTIVE: Develop a core outcome set of international consensus definitions for severe maternal morbidities.

DESIGN: Electronic Delphi study.

SETTING: International.

POPULATION: Eight expert panels.

METHODS: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions.

MAIN OUTCOME MEASURES: Definitions with a rate of agreement of more than 70%.

RESULTS: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions.

CONCLUSION: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative.

TWEETABLE ABSTRACT: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.

Original language	English
Journal	BJOG : an international journal of obstetrics and gynaecology
Volume	126
Issue number	3
Pages (from-to)	394-401
Number of pages	8
ISSN	1470-0328
DOIs	https://doi.org/10.1111/1471-0528.14833
Publication status	Published - Feb 2019

Keywords

Consensus
Delphi Technique
Developed Countries
Eclampsia
Embolism, Amniotic Fluid
Female
Heart Arrest
Hemoperitoneum
Humans
Hysterectomy
International Cooperation
Outcome Assessment (Health Care)
Placenta Diseases
Postpartum Hemorrhage
Pregnancy
Pregnancy Complications
Pregnancy Complications, Cardiovascular
Quality Assurance, Health Care
Severity of Illness Index
Uterine Rupture
pregnancy-related hysterectomy
spontaneous hemoperitoneum in pregnancy
amniotic fluid embolism
severe acute maternal morbidity
uterine rupture
Abnormally invasive placentation
severe primary postpartum haemorrhage
Delphi
cardiac arrest in pregnancy
eclampsia

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10.1111/1471-0528.14833

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@article{d8d794d0569e499b8dfd36982f6210f1,

title = "Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity",

abstract = "OBJECTIVE: Develop a core outcome set of international consensus definitions for severe maternal morbidities.DESIGN: Electronic Delphi study.SETTING: International.POPULATION: Eight expert panels.METHODS: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions.MAIN OUTCOME MEASURES: Definitions with a rate of agreement of more than 70%.RESULTS: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions.CONCLUSION: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative.TWEETABLE ABSTRACT: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.",

keywords = "Consensus, Delphi Technique, Developed Countries, Eclampsia, Embolism, Amniotic Fluid, Female, Heart Arrest, Hemoperitoneum, Humans, Hysterectomy, International Cooperation, Outcome Assessment (Health Care), Placenta Diseases, Postpartum Hemorrhage, Pregnancy, Pregnancy Complications, Pregnancy Complications, Cardiovascular, Quality Assurance, Health Care, Severity of Illness Index, Uterine Rupture, pregnancy-related hysterectomy, spontaneous hemoperitoneum in pregnancy, amniotic fluid embolism, severe acute maternal morbidity, uterine rupture, Abnormally invasive placentation, severe primary postpartum haemorrhage, Delphi, cardiac arrest in pregnancy, eclampsia",

author = "T Schaap and K Bloemenkamp and C Deneux-Tharaux and M Knight and J Langhoff-Roos and E Sullivan and {van den Akker}, T and INOSS",

note = "{\textcopyright} 2017 Royal College of Obstetricians and Gynaecologists.",

year = "2019",

month = feb,

doi = "10.1111/1471-0528.14833",

language = "English",

volume = "126",

pages = "394--401",

journal = "BJOG : an international journal of obstetrics and gynaecology",

issn = "1470-0328",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "3",

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T1 - Defining definitions

T2 - a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

AU - Schaap, T

AU - Bloemenkamp, K

AU - Deneux-Tharaux, C

AU - Knight, M

AU - Langhoff-Roos, J

AU - Sullivan, E

AU - van den Akker, T

AU - INOSS

PY - 2019/2

Y1 - 2019/2

N2 - OBJECTIVE: Develop a core outcome set of international consensus definitions for severe maternal morbidities.DESIGN: Electronic Delphi study.SETTING: International.POPULATION: Eight expert panels.METHODS: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions.MAIN OUTCOME MEASURES: Definitions with a rate of agreement of more than 70%.RESULTS: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions.CONCLUSION: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative.TWEETABLE ABSTRACT: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.

AB - OBJECTIVE: Develop a core outcome set of international consensus definitions for severe maternal morbidities.DESIGN: Electronic Delphi study.SETTING: International.POPULATION: Eight expert panels.METHODS: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions.MAIN OUTCOME MEASURES: Definitions with a rate of agreement of more than 70%.RESULTS: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions.CONCLUSION: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative.TWEETABLE ABSTRACT: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.

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KW - Delphi Technique

KW - Developed Countries

KW - Eclampsia

KW - Embolism, Amniotic Fluid

KW - Female

KW - Heart Arrest

KW - Hemoperitoneum

KW - Humans

KW - Hysterectomy

KW - International Cooperation

KW - Outcome Assessment (Health Care)

KW - Placenta Diseases

KW - Postpartum Hemorrhage

KW - Pregnancy

KW - Pregnancy Complications

KW - Pregnancy Complications, Cardiovascular

KW - Quality Assurance, Health Care

KW - Severity of Illness Index

KW - Uterine Rupture

KW - pregnancy-related hysterectomy

KW - spontaneous hemoperitoneum in pregnancy

KW - amniotic fluid embolism

KW - severe acute maternal morbidity

KW - uterine rupture

KW - Abnormally invasive placentation

KW - severe primary postpartum haemorrhage

KW - Delphi

KW - cardiac arrest in pregnancy

KW - eclampsia

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U2 - 10.1111/1471-0528.14833

DO - 10.1111/1471-0528.14833

M3 - Journal article

C2 - 28755459

SN - 1470-0328

VL - 126

SP - 394

EP - 401

JO - BJOG : an international journal of obstetrics and gynaecology

JF - BJOG : an international journal of obstetrics and gynaecology

IS - 3

ER -

Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

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