Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study

Objectives Presently, those outcomes that should be prioritised for chronic obstructive pulmonary disease (COPD) exacerbation studies remain unclear. In order to coordinate multicentre studies on eosinophilia-driven corticosteroid therapy for patients hospitalised for acute exacerbation of COPD (AEC...

Full description

Saved in:
Bibliographic Details
Main Authors: Romain Kessler, Alain Didier, Mathieu Molimard, A Bourdin, Thierry Chinet, Chantal Raherison, Nicolas Roche, Carey Meredith Suehs, Cécile Chenivesse, Pierre-Régis Burgel, F Couturaud, Gaëtan Deslee, Patrick Berger, Gilles Devouassoux, Christophe Brousse, Philippe Devillier, Pascal Chanez, Yan Martinat, Olivier Le Rouzic
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e035811.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850138011246788608
author Romain Kessler
Alain Didier
Mathieu Molimard
A Bourdin
Thierry Chinet
Chantal Raherison
Nicolas Roche
Carey Meredith Suehs
Cécile Chenivesse
Pierre-Régis Burgel
F Couturaud
Gaëtan Deslee
Patrick Berger
Gilles Devouassoux
Christophe Brousse
Philippe Devillier
Pascal Chanez
Yan Martinat
Olivier Le Rouzic
author_facet Romain Kessler
Alain Didier
Mathieu Molimard
A Bourdin
Thierry Chinet
Chantal Raherison
Nicolas Roche
Carey Meredith Suehs
Cécile Chenivesse
Pierre-Régis Burgel
F Couturaud
Gaëtan Deslee
Patrick Berger
Gilles Devouassoux
Christophe Brousse
Philippe Devillier
Pascal Chanez
Yan Martinat
Olivier Le Rouzic
author_sort Romain Kessler
collection DOAJ
description Objectives Presently, those outcomes that should be prioritised for chronic obstructive pulmonary disease (COPD) exacerbation studies remain unclear. In order to coordinate multicentre studies on eosinophilia-driven corticosteroid therapy for patients hospitalised for acute exacerbation of COPD (AECOPD), we aimed to find consensus among experts in the domain regarding the prioritisation of outcomes.Design A modified Delphi study was proposed to recognised COPD experts. Two brainstorming questionnaires were used to collect potential outcomes. Four subsequent rounds of questionnaires were used to rank items according to a six-point Likert scale for their importance in the protocol, as well as for being the primary outcome. Priority outcome criteria were predefined as those for which ≥70% of experts indicated that the outcome was essential for interpreting study results.Setting COPD exacerbation management in France.Participants 34 experts recommended by the French Language Pulmonology Society were invited to participate. Of the latter, 21 experts participated in brainstorming, and 19 participated in all four ranking rounds.Results 105 outcomes were ranked. Two achieved consensus as candidate primary outcomes: (1) treatment failure defined as death from any cause or the need for intubation and mechanical ventilation, readmission because of COPD or intensification of pharmacologic therapy, and (2) the time required to meet predefined discharge criteria. The 10 secondary priority outcomes included survival, time with no sign of improvement, episodes of hospitalisation, exacerbation, pneumonia, mechanical or non-invasive ventilation and oxygen use, as well as comorbidities during the initial hospitalisation.Conclusions This Delphi consensus project generated and prioritised a great many outcomes, documenting current expert views concerning a diversity of COPD endpoints. Among the latter, 12 reached consensus as priority outcomes for evaluating the efficacy of eosinophil-driven corticosteroid therapy in AECOPD inpatients.Study registration The eo-Delphi project/protocol was registered on 23 January 2018 at https://osf.io/4ahqw/.
format Article
id doaj-art-69426d2d97cc462995eaf4bdbba9be93
institution OA Journals
issn 2044-6055
language English
publishDate 2020-07-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-69426d2d97cc462995eaf4bdbba9be932025-08-20T02:30:42ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2019-035811Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus studyRomain Kessler0Alain Didier1Mathieu Molimard2A Bourdin3Thierry Chinet4Chantal Raherison5Nicolas Roche6Carey Meredith Suehs7Cécile Chenivesse8Pierre-Régis Burgel9F Couturaud10Gaëtan Deslee11Patrick Berger12Gilles Devouassoux13Christophe Brousse14Philippe Devillier15Pascal Chanez16Yan Martinat17Olivier Le Rouzic18Pneumologie, Fédération de médecine translationnelle, Université de Strasbourg, Strasbourg, FrancePôle des Voies Respiratoires, Hôpital Larrey, CHU de Toulouse et Université Paul Sabatier, Toulouse, France1 Inserm U1219, Bordeaux Population Health, Université de Bordeaux, Bordeaux, FranceMaladies Respiratoires, Univ Montpellier, CHU Montpellier, Montpellier, FrancePneumologie et Oncologie Thoracique, CHU Ambroise Paré, AP-HP, Université de Versailles SQY, Saint-Quentin-en-Yvelines, FranceBordeaux Population Health Research Center, U1219 BPH - Inserm - Université de Bordeaux, Bordeaux, France5 APHP Centre-Université de Paris, Hôpital et Institut Cochin, Service de Pneumologie, Paris, FranceMaladies Respiratoires, Univ Montpellier, CHU Montpellier, Montpellier, France3 Centre de Référence Constitutif des Maladies Pulmonaires Rares, Institut Cœur-Poumon, Service de Pneumologie et Immuno-Allergologie, CHRU Lille, Lille, FranceUniversité Paris Cité, Institut Cochin, Inserm U1016, Paris, FranceInternal Medicine and Chest Diseases, EA3878, CIC-INSERM1412, Brest University Hospital Centre, Brest University, Brest, FrancePulmonary Medicine, INSERM U1250, University Hospital of Reims, Reims, FranceCentre de Recherche Cardio-thoracique de Bordeaux, INSERM U1045, Univ. Bordeaux, Bordeaux, FrancePneumologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon et Université Claude Bernard Lyon 1, EA7426, Lyon, FranceClinique du Parc, 34170 Castelnau le Lez, FranceAirway Diseases, UPRES EA 220, Foch hospital, University Paris-Saclay, Suresnes, FranceRespiratory Diseases, AP-HM, INSERM, INRA, C2VN Aix Marseille Université, Marseille, FranceCM PAROT, Lyon, FranceCHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de Référence Constitutif des Maladies Pulmonaires Rares, Lille, UKObjectives Presently, those outcomes that should be prioritised for chronic obstructive pulmonary disease (COPD) exacerbation studies remain unclear. In order to coordinate multicentre studies on eosinophilia-driven corticosteroid therapy for patients hospitalised for acute exacerbation of COPD (AECOPD), we aimed to find consensus among experts in the domain regarding the prioritisation of outcomes.Design A modified Delphi study was proposed to recognised COPD experts. Two brainstorming questionnaires were used to collect potential outcomes. Four subsequent rounds of questionnaires were used to rank items according to a six-point Likert scale for their importance in the protocol, as well as for being the primary outcome. Priority outcome criteria were predefined as those for which ≥70% of experts indicated that the outcome was essential for interpreting study results.Setting COPD exacerbation management in France.Participants 34 experts recommended by the French Language Pulmonology Society were invited to participate. Of the latter, 21 experts participated in brainstorming, and 19 participated in all four ranking rounds.Results 105 outcomes were ranked. Two achieved consensus as candidate primary outcomes: (1) treatment failure defined as death from any cause or the need for intubation and mechanical ventilation, readmission because of COPD or intensification of pharmacologic therapy, and (2) the time required to meet predefined discharge criteria. The 10 secondary priority outcomes included survival, time with no sign of improvement, episodes of hospitalisation, exacerbation, pneumonia, mechanical or non-invasive ventilation and oxygen use, as well as comorbidities during the initial hospitalisation.Conclusions This Delphi consensus project generated and prioritised a great many outcomes, documenting current expert views concerning a diversity of COPD endpoints. Among the latter, 12 reached consensus as priority outcomes for evaluating the efficacy of eosinophil-driven corticosteroid therapy in AECOPD inpatients.Study registration The eo-Delphi project/protocol was registered on 23 January 2018 at https://osf.io/4ahqw/.https://bmjopen.bmj.com/content/10/7/e035811.full
spellingShingle Romain Kessler
Alain Didier
Mathieu Molimard
A Bourdin
Thierry Chinet
Chantal Raherison
Nicolas Roche
Carey Meredith Suehs
Cécile Chenivesse
Pierre-Régis Burgel
F Couturaud
Gaëtan Deslee
Patrick Berger
Gilles Devouassoux
Christophe Brousse
Philippe Devillier
Pascal Chanez
Yan Martinat
Olivier Le Rouzic
Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study
BMJ Open
title Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study
title_full Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study
title_fullStr Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study
title_full_unstemmed Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study
title_short Prioritising outcomes for evaluating eosinophil-guided corticosteroid therapy among patients with acute COPD exacerbations requiring hospitalisation: a Delphi consensus study
title_sort prioritising outcomes for evaluating eosinophil guided corticosteroid therapy among patients with acute copd exacerbations requiring hospitalisation a delphi consensus study
url https://bmjopen.bmj.com/content/10/7/e035811.full
work_keys_str_mv AT romainkessler prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT alaindidier prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT mathieumolimard prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT abourdin prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT thierrychinet prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT chantalraherison prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT nicolasroche prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT careymeredithsuehs prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT cecilechenivesse prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT pierreregisburgel prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT fcouturaud prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT gaetandeslee prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT patrickberger prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT gillesdevouassoux prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT christophebrousse prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT philippedevillier prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT pascalchanez prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT yanmartinat prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy
AT olivierlerouzic prioritisingoutcomesforevaluatingeosinophilguidedcorticosteroidtherapyamongpatientswithacutecopdexacerbationsrequiringhospitalisationadelphiconsensusstudy