Patient-directed development of a novel set of quality indicators of outcome (QOI) for metastatic bone disease (MBD)

This study will seek to determine the outcomes from orthopaedic care for patients with metastatic bone disease (MBD) which are deemed most important by patients and their relatives. The initial quality indicators of outcome (QOI) dataset will be developed through a systematic review of the literature and published guidelines and will be field tested in a powered retrospective study for practicality and relevance.

The revised QOI dataset will then be validated through a questionnaire delivered to patients with MBD, their carers/relatives and a specialty group of healthcare professionals. The final MBD QOI list will be those prioritised by patients and will be applied in a multi-centre retrospective study to identify variation in care across the UK.


Chief Investigator: Dr Samantha Downie
Supervisors: Professor Hamish Simpson, Professor Cathie Sudlow, Mr Matthew Moran, Dr Alison Stillie (University of Edinburgh)

Further Study Information

Current Stage: Ongoing
Date: October 2020 - September 2025
Funding source(s): Royal College of Surgeons of Edinburgh and AO UK

Health Area

Disease Category: Orthopaedics & trauma

Disease Name: Metastatic bone disease

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Charities
- Clinical experts
- Consumers (caregivers)
- Consumers (patients)
- Families
- Policy makers
- Researchers

Study Type

- Core indicator set


- Delphi process
- Survey
- Systematic review

1) Undertake systematic literature review to identify existing quality indicators of care in MBD utilising published guidelines from BOOS/BASO/NICE, MEDLINE and EMBASE, Cochrane systematic reviews and COMET database.
2) Generate primary QOI dataset in consultation with author group (wide range of specialties including orthopaedic oncology, clinical oncology, the consensus process and data management).
3) Undertake field test with retrospective MBD patient data from three UK centres to ascertain feasibility of provisional QOIs for application to electronic patient records on retrospective basis.
4) Two stage Delphi consensus process in group of patient representatives (with additional input from healthcare professionals and patient relatives/friends).
5) Final list of QOIs chosen based on patient prioritisation. Results from healthcare professionals and relatives/carers analysed separately.

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