Core information set for oesophageal cancer surgery

Author:

Blazeby J M12,Macefield R1,Blencowe N S12,Jacobs M3,McNair A G K1,Sprangers M3,Brookes S T1,Avery K N L4,Blazeby J M4,Blencowe N S4,Brookes S T4,Elliot J5,Jacobs M6,Korfage I7,Macefield R4,Mackichan F4,Nicklin J8,Smets E M A6,Sprangers M A G6,Strong S4,Titcomb D R8,van Berge Henegouwen M I6,Whistance R4,Witherstone J8,Berrisford R9,Blazeby J M4,Byrne J10,Dwerryhouse S11,Galloway S12,Griffin S M13,Hassn A14,Hewin D11,Higgs S11,Lamb P15,Manson J16,Moxon R17,Osbourn S18,Pursnani K19,Shackcloth M20,Underwood T10,Whiting J21,Williamson P22

Affiliation:

1. Centre for Surgical Research, School of Social and Community Medicine, University of Bristol

2. Division of Surgery, Head and Neck, University Hospitals NHS Foundation Trust, Bristol, UK

3. Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

4. University of Bristol, Bristol, UK

5. Oesophageal Patients Association, Bristol, UK

6. Academic Medical Centre, Amsterdam, The Netherlands

7. University Medical Centre, Rotterdam, The Netherlands

8. University Hospitals Bristol NHS Foundation Trust, Bristol, UK

9. Plymouth Hospitals NHS Trust, Plymouth, UK

10. University of Southampton, Southampton, UK

11. Gloucester Hospitals NHS Foundation Trust, Gloucester, UK

12. Wythenshawe Hospital, Manchester, UK

13. Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK

14. Princess of Wales Hospital, Bridgend, UK

15. Royal Infirmary of Edinburgh, Edinburgh, UK

16. Abertawe Bro Morgannwg University Health Board, Swansea, UK

17. Royal Berkshire NHS Foundation Trust, Reading, UK

18. Yeovil District Hospital NHS Foundation Trust, Yeovil, UK

19. Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK

20. Liverpool Heart and Chest NHS Foundation Trust, Liverpool, UK

21. University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

22. University of Liverpool, Liverpool, UK

Abstract

Abstract Background Surgeons provide patients with information before surgery, although standards of information are lacking and practice varies. The development and use of a ‘core information set’ as baseline information before surgery may improve understanding. A core set is a minimum set of information to use in all consultations before a specific procedure. This study developed a core information set for oesophageal cancer surgery. Methods Information was identified from the literature, observations of clinical consultations and patient interviews. This was integrated to create a questionnaire survey. Stakeholders (patients and professionals) were surveyed twice to assess views on importance of information from ‘not essential’ to ‘absolutely essential’ using Delphi methods. Items not meeting predefined criteria were discarded after each survey and the final retained items were voted on, in separate patient and professional stakeholder meetings, to agree the core set. Results Some 67 information items were identified initially from multiple sources. Survey response rates were 76·5 per cent (185 of 242) and 54·8 per cent (126 of 230) for patients and professionals respectively (first round), and over 83 per cent in both groups thereafter. Health professionals rated short-term clinical outcomes most highly (technical complications), whereas patients prioritized information related to long-term benefits. The consensus meetings agreed the final set, which consisted of: in-hospital milestones to recovery, rates of open-and-close surgery, in-hospital mortality, major complications (reoperation), milestones in recovery after discharge, longer-term eating and drinking and overall quality of life, and chances of survival. Conclusion This study has established a core information set for surgery for oesophageal cancer.

Funder

NIHR Research for patient benefit grant

Publisher

Oxford University Press (OUP)

Subject

Surgery

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