Academic Journal
Clinician and Patient Stakeholders Prioritize Rectal Prolapse Research Themes Through an International Delphi Process.
| Τίτλος: | Clinician and Patient Stakeholders Prioritize Rectal Prolapse Research Themes Through an International Delphi Process. |
|---|---|
| Συγγραφείς: | Gurland BH; Department of General Surgery, Stanford University School of Medicine, Stanford, California., Au Hoy S; Department of General Surgery, Stanford University School of Medicine, Stanford, California., Bordeianou L; Department of Surgery, Pelvic Floor Disorders Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts., Hainsworth AJ; GSTT Pelvic Floor Unit, Guy's and St. Thomas' Hospital, London, England, United Kingdom., Thorsen AJ; Department of Surgery, University of Minnesota, Minneapolis, Minnesota., Ratto C; Isola Tiberina, Gemelli Isola Hospital, Catholic University, Rome, Italy., Basilio PC; Department of Colorectal Surgery, Copa Star Hospital, Rio de Janeiro, Brazil., Oliveira LCC; Casa de Saude Sao Jose, Rio de Janeiro, Brazil., Murphy M; Orlando Health Colorectal Institute, Florida State University, Orlando, Florida., Ding S; Northwestern Health Science University, Bloomington, Minnesota., King JM; Department of General Surgery, Stanford University School of Medicine, Stanford, California., Olson CH; Department of Surgery, Baylor Scott and White Medical Center, Texas A&M University, Temple, Texas. |
| Συλλογικό Έργο: | Pelvic Floor Consortium Volunteers Workgroup 2024 of the American Society of Colon and Rectal Surgeons |
| Πηγή: | Diseases of the colon and rectum [Dis Colon Rectum] 2026 Jun 01; Vol. 69 (6), pp. 1722-1731. Date of Electronic Publication: 2026 Mar 25. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Lippincott Country of Publication: United States NLM ID: 0372764 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1530-0358 (Electronic) Linking ISSN: 00123706 NLM ISO Abbreviation: Dis Colon Rectum Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia. Lippincott |
| Ιατρικοί όροι (MeSH): | Rectal Prolapse*/therapy , Biomedical Research* , Stakeholder Participation*, Humans ; Delphi Technique ; Female ; Consensus ; Surveys and Questionnaires ; Middle Aged ; Male ; Pelvic Organ Prolapse |
| Περίληψη: | Background: There is limited understanding on how to focus research and resources to enhance care for individuals with rectal prolapse. Objective: This study aimed to identify and prioritize clinical research themes for rectal prolapse with and without pelvic organ prolapse based on the perspective of clinician and patient stakeholders. Design: This Institutional Review Board-approved study (No. 73560) used the Delphi method (higher than 70% consensus) with an initial open-response survey followed by 3 subsequent iterative clinician survey rounds. A patient survey was adapted from the final consensus themes. Settings: Secure electronic data capture platform was used for online survey collection and an in-person consensus meeting was held at the 2024 Pelvic Floor Consortium. Participants: Surveys were distributed through the Pelvic Floor Consortium volunteer list. Main Outcome Measures: Three hundred seventy-two clinicians completed the first round and response rates were 69% and 64% for the second and third rounds, respectively. Results: The majority of respondents were colorectal surgeons (67%). Fifty-six percent of clinician responders reported 10 or more years in practice and 47% had academic affiliations. Clinician responders were primarily from the United States (54%) and Europe (18%). Round 1 included 45 themes, and 19 themes reached consensus at the end of round 3. The consensus meeting included 146 clinician attendees, and 13 themes were reconsidered during the meeting, 3 of which reached consensus. The final consensus comprised 22 themes, which were adapted into a patient survey; 26 women (older than 50 years) from the United States completed the survey. Ten themes reached consensus with all stakeholders, with long-term functional outcomes reaching nearly unanimous agreement. Limitations: Limitations include potential for clinician bias and lack of patient participation in the initial open-response survey design. Conclusions: Through an iterative process, we have identified a list of themes that can guide international collaboration on outcomes research during the next decade. See Video Abstract . Los Mdicos Y Los Pacientes Priorizan Los Temas De Investigacin Sobre El Prolapso Rectal a Travs De Un Proceso Delphi Internacional: ANTECEDENTES:Existe un conocimiento limitado sobre cómo enfocar la investigación y los recursos para mejorar la atención a las personas con prolapso rectal.OBJETIVO:Este estudio tuvo como objetivo identificar y priorizar temas de investigación clínica para el prolapso rectal, con y sin prolapso de órganos pélvicos, desde la perspectiva de profesionales clínicos y pacientes.DISEÑO:Este estudio, aprobado por el Comité de Revisión Institucional (73560), utilizó el método Delphi (consenso superior al 70 %) con una encuesta inicial de respuesta abierta, seguida de tres rondas iterativas de encuestas para profesionales clínicos. Se adaptó una encuesta para pacientes a partir de los temas de consenso finales.CONFIGURACIÓN:Se utilizó una plataforma electrónica segura de captura de datos para la recopilación de encuestas en línea y se celebró una reunión de consenso presencial en el Consorcio de Suelo Pélvico 2024.PARTICIPANTES:Las encuestas se distribuyeron a través de la lista de voluntarios del Consorcio de Suelo Pélvico. PRINCIPALES MEDIDAS DE RESULTADOS: Trescientos setenta y dos médicos clínicos completaron la primera ronda y las tasas de respuesta fueron del 69% y el 64% para la segunda y la tercera ronda, respectivamente.RESULTADOS:La mayoría de los encuestados eran cirujanos colorrectales (67%). El 56% de los médicos clínicos que respondieron reportaron 10 o más años de práctica y el 47% tenía afiliaciones académicas. Los médicos clínicos que respondieron provenían principalmente de Estados Unidos (54%) y Europa (18%). La primera ronda incluyó 45 temas, 19 de los cuales alcanzaron consenso al final de la tercera ronda. La reunión de consenso incluyó a 146 médicos clínicos asistentes y 13 temas se reconsideraron durante la reunión, tres de los cuales alcanzaron consenso. El consenso final comprendió 22 temas que se adaptaron a una encuesta para pacientes; veintiséis mujeres (> 50 años) de Estados Unidos completaron la encuesta. Diez temas alcanzaron consenso con todas las partes interesadas, y los resultados funcionales a largo plazo alcanzaron un acuerdo casi unánime.LIMITACIONES:Entre las limitaciones se incluyen el posible sesgo clínico y la falta de participación de los pacientes en el diseño inicial de la encuesta de respuesta abierta.CONCLUSIONES:Mediante un proceso iterativo, hemos identificado una lista de temas que pueden orientar la colaboración internacional en la investigación de resultados durante la próxima década. ( AI-generated translation ). (Copyright © The ASCRS 2026.) |
| References: | Bordeianou LG, Anger JT, Boutros M, et al; members of the Pelvic Floor Disorders Consortium Working Groups on Patient-Reported Outcomes. Measuring Pelvic Floor Disorder Symptoms Using Patient-Reported Instruments: Proceedings of the Consensus Meeting of the Pelvic Floor Consortium of the American Society of Colon and Rectal Surgeons, the International Continence Society, the American Urogynecologic Society, and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction. Dis Colon Rectum. 2020;63:6–23. Lammers K, Lince SL, Spath MA, et al. Pelvic organ prolapse and collagen-associated disorders. Int Urogynecol J. 2012;23:313–319. McNevin MS. Evaluation and management of rectal prolapse. Surg Clin North Am. 2024;104:557–564. Lee A, Kin C, Syan R, Morris A, Gurland B. Surgical decision-making for rectal prolapse: one size does not fit all. Postgrad Med. 2020;132:256–262. Gurland BH, Olson CH, McCarthy MS, Bordeianou LG; Pelvic Floor Disorders Consortium Work Group. Core descriptor sets for rectal prolapse outcomes research using a modified Delphi consensus. Dis Colon Rectum. 2024;67:841–849. Olson CH, Bordeianou L, Perry WRG, et al.; On behalf of the Pelvic Floor Disorders Consortium. Development of a consensus-derived synoptic operative report for rectal prolapse: a report from the Pelvic Floor Disorders Consortium. Dis Colon Rectum. 2024;67:1169–1176. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: how to decide its appropriateness. World J Methodol. 2021;11:116–129. Cavallaro PM, Vogler SA, Hyman NH, et al.; New England Society of Colorectal Surgery and the Pelvic Floor Disorders Consortium Rectal Prolapse Quality Incentive Workgroup Participants. Preliminary report from the Pelvic Floor Disorders Consortium: large-scale data collection through quality improvement initiatives to provide data on functional outcomes after rectal prolapse repair. Dis Colon Rectum. 2021;64:986–994. van der Schans EM, Paulides TJC, Wijffels NA, Consten ECJ. Management of patients with rectal prolapse: the 2017 Dutch guidelines. Tech Coloproctol. 2018;22:589–596. Bungo CP, Kimura C, Adel H, Au Hoy SL, Mishra K, Gurland BH. Identifying current barriers in patient educational content surrounding rectal prolapse and rectocele: using animation to bridge the gaps. Dis Colon Rectum. 2024;67:1077–1084. Hicks CW, Weinstein M, Wakamatsu M, Savitt L, Pulliam S, Bordeianou L. In patients with rectoceles and obstructed defecation syndrome, surgery should be the option of last resort. Surgery. 2014;155:659–667. |
| Contributed Indexing: | Investigator: A Chandra; A Sang; A Pathak; A Wolthuis; A Gasior; A Fichera; A Garcea; A Ky; A Hawkins; A Snyder; A Traugott; A Halverson; A Warwick; A Zimmern; A Nordholm-Carstensen; A Marra; A Stuto; A Lowry; A Spivak; A Williams; A Sirany; A Lin; A Scanavini Neto; A Bortolami; A Ofshteyn; A Kulaylat; A Dulskas; A Gultekin; B Cosman; B Gulcu; C Harbaugh; C Grimes; C Ratto; C Peterson; C Bradley; C Leia; C Fleming; C Addington; C Benlice; C Varela; D Petersen; D Sarmiento; D Lubowski; D Mackrill; D Proud; D Lutrin; D Keller; D Nagle; E Arcia; E Itenberg; E Birnbaum; E Davidson; E Lukacz; E Steinhagen; E Pettke; E Zaremba; F D'Urso; F Fleming; F Brucchi; F Marinello; G Arroyo; G Poles; G Van Ramshorst; G Gallo; G Calini; G Pellino; G Marquini; G Sica; G Lee; G Rosato; HN Lakshmi; H Bonnette; HR Zentner; I Skinner; I Gecim; I Mohamed Ali; I Harm-Ernandes; I Le Leannec; J Mccormick; J Ogilvie; J Murphy; J Stijns; J Perez; J Scow; J Diyani; J Ayscue; J Davids; J Lowney; J Speranza; J Reyes; J Cohan; J Dubbs; J Khan; J Jongen; J Griffin; J Abelson; J Tarigo; J Bleier; J Cornish; K Ponce; K Weeks; K Propst; K Mishra; K Richard; K Perrone; K Ohman; K Gorissen; K Olortegui; K Ludwig; K Staller; L Xue; L Becker; L Neshatian; L Knoepp; L Chardalias; L Gottesman; L Savitt; L Maguire; L Ferrari; L Rogo-Gupta; L Murphy; L Oliveira; L Martinez; M Westfal; M Muhlmann; M Whiteford; M Boutros; M Kairaluoma; M Carmel; M Kelly; M Edgehouse; MM Cucchiara; M Sundberg; M Vega; M Kelly; M Von Papen; M Rubbini; M Olson; M Thomas; M Strauhal; M Younis; N Mantilla; N Salehomoum; N Sengul; N Foley; N Horesh; P Piccinini; P Levin; P De Nardi; P Shah; P Cavallaro; P Igualada-Martinez; P Bhat; P Basilio; P Kondylis; P Bernardi; P Sileri; P Zhu; P Chen; P Rajan; R Platte; R Steinhagen; R Wani; R Staniunas; R Shine; R Baucom; R Kotarinos; R Hollis; R O'Connell; R Collinson; R Rajan; S Guevara; S Eisenstein; S Diaz; S Fox; S Stringfield; S Badiani; S Hao; S Pittman; SF Arias; S Leventoglu; S Rizwan; S Ding; S Bekere; S Rapolla; S Murad-Regadas; T Raphaeli; T Shepherd; TS Saban; T Russell; T Hassinger; T Debeche-Adams; TP Olson; T Chase; T Pampiglione; T Dixon; T Toogood; T Mimura; T Hull; U Grossi; V Picello; V Bauer; V Hortian; V Poylin; V Simianu; V Bolshinsky; WJ Shao; W Lichliter; W Cirocco; W Kethman; W Perry; X Li; Y Xue; Y Maeda; Y Nasseri; Z Cui; Z Kutayli Keywords: Delphi survey; Pelvic organ prolapse; Rectal prolapse |
| Entry Date(s): | Date Created: 20260325 Date Completed: 20260713 Latest Revision: 20260713 |
| Update Code: | 20260714 |
| DOI: | 10.1097/DCR.0000000000004218 |
| PMID: | 41879064 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1530-0358 |
|---|---|
| DOI: | 10.1097/DCR.0000000000004218 |