Aims
Periprosthetic joint infection (PJI) is a devastating complication of arthroplasty, with substantial morbidity, mortality, and healthcare costs. Despite advances in diagnosis and treatment, inconsistencies in outcome reporting have hindered evidence synthesis, limiting progress in understanding and management. This study aimed to develop a core outcome set (COS) for PJI to standardize outcome reporting in the literature.
Methods
A two-stage modified Delphi process was conducted to establish consensus across a range of domains. Stage 1 involved the identification of core outcomes in PJI research by an international expert panel. A patient group was also consulted to ensure that the domains were relevant to patient priorities. Stage 2 included a broader group of 55 stakeholders in an online consensus process to finalize the COS. Quantitative and qualitative data were collated to redefine the outcomes throughout the Delphi process.
Results
Following the modified two-stage Delphi process, a high level of consensus was achieved for all outcomes. The final COS included 23 outcomes across the following four domains: patient demographics and baseline characteristics; infection characteristics; surgical and treatment details; and outcomes and follow-up.
Conclusion
The developed COS provides a standardized framework for reporting outcomes in PJI research. By addressing variability and inconsistency in the literature, this COS aims to enhance comparability across studies, support robust evidence synthesis, and ultimately guide clinical decision-making.
Ian W. Kennedy, Fares S. Haddad, COS PJI Group : Matthew P. Abdel, Donald S. Garbuz, Vanya Grant, R. M. D Meek, Carsten Perka, Chloe E. H Scott, Bryan D. Springer, Sam Oussedik, Micheal R. Whitehouse
Disease Category: Orthopaedics & trauma
Disease Name: Periprosthetic Joint Infection
Age Range: 18 - 100
Sex: Either
Nature of Intervention: Non-surgical, Surgery
- Clinical experts
- Journal editors
- Patient/ support group representatives
- Researchers
- COS for clinical trials or clinical research
- Delphi process
An editorial was published by the authors, appraising the current literature and identifying gaps in current research methodologies. A core group of PJI experts and patients will be established to determine the core outcomes set (COS) for a Delphi process. A Delphi process will be undertaken with a range of key stakeholders, including clinicians and researchers, through online surveys. The level of agreement for accepting outcomes will be set at 75%. Qualitative feedback will also be collected during the process. If additional outcomes, or amendments to the existing outcomes, are recommended by two or more participants these will go forward to the subsequent Delphi rounds. All responses will be anonymous. A summary of the quantitative feedback will be shared anonymously to participants at the end of each round of the Delphi process.