Diagnostic criteria and core outcome set development for necrotising otitis externa: the COSNOE Delphi consensus study

被引：3

作者：

Lodhi, Sirat ^{[1
]}

Dodgson, Kirsty ^{[2
]}

Dykes, Michael ^{[3
]}

Vishwanath, Veena ^{[3
]}

Bazaz, Rohit ^{[4
]}

Mathur, Sachin ^{[5
]}

Watson, Glen ^{[6
]}

Cartwright, Katherine ^{[7
]}

Pearson, Amy ^{[8
]}

Wearmouth, Deborah ^{[9
]}

List, Richard ^{[10
]}

Yates, Phillip ^{[11
]}

Dixon, Joanna ^{[12
]}

Puveendran, Arullendran ^{[13
]}

Wilson, Margarita ^{[13
]}

Watson, Katherine ^{[14
]}

Cullinan, Milo ^{[14
]}

Mentias, Youssef ^{[15
]}

Capper, Ruth ^{[16
]}

Jewes, Linda ^{[17
]}

Wallis, Sebastian ^{[18
]}

Hamilton, David ^{[19
]}

Adams, Brook ^{[20
]}

Khalid-Raja, Mamoona ^{[21
]}

Faris, Barzo ^{[22
]}

Khan, Maha ^{[1
]}

Linton, Stefan ^{[23
]}

Abrar, Rohma ^{[16
]}

Owen, Eloise ^{[24
]}

Bisbinas, Vasiliki ^{[1
]}

Ijaz, Ali ^{[25
]}

Lau, Kimberley ^{[6
]}

Timms, Sara ^{[26
]}

Bruce, Jack ^{[24
]}

Stapleton, Emma ^{[1
]}

机构：

[1] Manchester Royal Infirm, Dept Otolaryngol, Manchester, England

[2] Manchester Royal Infirm, Dept Microbiol, Manchester, England

[3] Manchester Royal Infirm, Dept Radiol, Manchester, England

[4] Wythenshawe Hosp, Dept Microbiol, Manchester, England

[5] Preston Royal Hosp, Dept Radiol, Preston, England

[6] Sheffield Teaching Hosp, Dept Otolaryngol, Sheffield, England

[7] Sheffield Teaching Hosp, Dept Microbiol, Sheffield, England

[8] Hull Univ Teaching Hosp, Dept Otolaryngol, Kingston Upon Hull, England

[9] Hull Univ Teaching Hosp, Dept Microbiol, Kingston Upon Hull, England

[10] Hull Univ Teaching Hosp, Dept Radiol, Kingston Upon Hull, England

[11] Newcastle Upon Tyne NHS Hosp, Dept Otolaryngol, Newcastle Upon Tyne, England

[12] Newcastle Upon Tyne NHS Hosp, Dept Radiol, Newcastle Upon Tyne, England

[13] Sunderland Royal Hosp, Dept Otolaryngol, Sunderland, England

[14] Sunderland Royal Hosp, Dept Microbiol, Sunderland, England

[15] Sunderland Royal Infirm, Dept Radiol, Sunderland, England

[16] Doncaster Royal Infirm, Dept Otolaryngol, Doncaster, England

[17] Doncaster Royal Infirm, Dept Microbiol, Doncaster, England

[18] York Hosp, Dept Otolaryngol, York, England

[19] York Hosp, Dept Microbiol, York, England

[20] York Hosp, Dept Radiol, York, England

[21] Stepping Hill Hosp, Dept Otolaryngol, Stockport, England

[22] Stepping Hill Hosp, Dept Microbiol, Stockport, England

[23] St Johns Hosp, Dept Otolaryngol, Livingston, Scotland

[24] Univ Manchester, Dept Otolaryngol, Manchester, England

[25] Univ Sheffield, Dept Otolaryngol, Sheffield, England

[26] Preston Royal Hosp, Dept Otolaryngol, Preston, England

来源：

JOURNAL OF LARYNGOLOGY AND OTOLOGY | 2024年 / 138卷 / 09期

关键词：

Otitis externa; osteomyelitis; diabetes mellitus; immunosuppression therapy; OSTEOMYELITIS; MANAGEMENT; MORBIDITY;

D O I：

10.1017/S0022215124000513

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Objective Evidence for necrotising otitis externa (NOE) diagnosis and management is limited, and outcome reporting is heterogeneous. International best practice guidelines were used to develop consensus diagnostic criteria and a core outcome set (COS).Methods The study was pre-registered on the Core Outcome Measures in Effectiveness Trials (COMET) database. Systematic literature review identified candidate items. Patient-centred items were identified via a qualitative study. Items and their definitions were refined by multidisciplinary stakeholders in a two-round Delphi exercise and subsequent consensus meeting.Results The final COS incorporates 36 items within 12 themes: Signs and symptoms; Pain; Advanced Disease Indicators; Complications; Survival; Antibiotic regimes and side effects; Patient comorbidities; Non-antibiotic treatments; Patient compliance; Duration and cessation of treatment; Relapse and readmission; Multidisciplinary team management. Consensus diagnostic criteria include 12 items within 6 themes: Signs and symptoms (oedema, otorrhoea, granulation); Pain (otalgia, nocturnal otalgia); Investigations (microbiology [does not have to be positive], histology [malignancy excluded], positive CT and MRI); Persistent symptoms despite local and/or systemic treatment for at least two weeks; At least one risk factor for impaired immune response; Indicators of advanced disease (not obligatory but mut be reported when present at diagnosis). Stakeholders were unanimous that there is no role for secondary, graded, or optional diagnostic items. The consensus meeting identified themes for future research.Results The final COS incorporates 36 items within 12 themes: Signs and symptoms; Pain; Advanced Disease Indicators; Complications; Survival; Antibiotic regimes and side effects; Patient comorbidities; Non-antibiotic treatments; Patient compliance; Duration and cessation of treatment; Relapse and readmission; Multidisciplinary team management. Consensus diagnostic criteria include 12 items within 6 themes: Signs and symptoms (oedema, otorrhoea, granulation); Pain (otalgia, nocturnal otalgia); Investigations (microbiology [does not have to be positive], histology [malignancy excluded], positive CT and MRI); Persistent symptoms despite local and/or systemic treatment for at least two weeks; At least one risk factor for impaired immune response; Indicators of advanced disease (not obligatory but mut be reported when present at diagnosis). Stakeholders were unanimous that there is no role for secondary, graded, or optional diagnostic items. The consensus meeting identified themes for future research.Conclusion The adoption of consensus-defined diagnostic criteria and COS facilitates standardised research reporting and robust data synthesis. Inclusion of patient and professional perspectives ensures best practice stakeholder engagement.

引用

页码：913 / 920

页数：8

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