Protocol for the development of a core indicator set for reporting burn wound infection in trials: Icon-b study

Anna Davies, Louise Teare, Sian Falder, Karen Coy, Jo C. Dumville, Declan Collins, Luke Moore, Baljit Dheansa, A. Toby A. Jenkins, Simon Booth, Riaz Agha, Mamta Shah, Karen Marlow, Amber Young

Research output: Contribution to journalArticlepeer-review

5 Citations (SciVal)

Abstract

Introduction Systematic reviews of high-quality randomised controlled trials are necessary to identify effective interventions to impact burn wound infection (BWI) outcomes. Evidence synthesis requires that BWI is reported in a consistent manner. Cochrane reviews investigating interventions for burns report that the indicators used to diagnose BWI are variable or not described, indicating a need to standardise reporting. BWI is complex and diagnosed by clinician judgement, informed by patient-reported symptoms, clinical signs, serum markers of inflammation and bacteria in the wound. Indicators for reporting BWI should be important for diagnosis, frequently observed in patients with BWI and assessed as part of routine healthcare. A minimum (core) set of indicators of BWI, reported consistently, will facilitate evidence synthesis and support clinical decision-making. Aims The Infection Consensus in Burns study aims to identify a core indicator set for reporting the diagnosis of BWI in research studies. Methods (1) Evidence review: a systematic review of indicators used in trials and observational studies reporting BWI outcomes to identify a long list of candidate indicators; (2) refinement of the long list into a smaller set of survey questions with an expert steering group; (3) a two-round Delphi survey with 100 multidisciplinary expert stakeholders, to achieve consensus on a short list of indicators; (4) a consensus meeting with expert stakeholders to agree on the BWI core indicator set. Ethics and dissemination Participants will be recruited through professional bodies, such that ethical approval from the National Health Service (NHS) Health Research Authority (HRA) is not needed. The core indicator set will be disseminated through peer-reviewed publication, co-production with journal editors, research funders and professional bodies, and presentation at national conferences. PROSPERO registration number CRD42018096647.

Original languageEnglish
Article number026056
Pages (from-to)1-6
Number of pages6
JournalBMJ Open
Volume9
Issue number5
Early online date14 May 2019
DOIs
Publication statusPublished - 14 May 2019

Funding

1Centre for Academic Child Health, University of Bristol, Bristol, UK 2Department of Microbiology, Chelmsford Hospital, Chelmsford, UK 3Burns and Plastic Surgery, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK 4Centre for Children’s Burns Research, University Hospitals Bristol NHS Foundation Trust, Bristol, UK 5Division of Nursing, Midwifery and Social work, The University of Manchester, Manchester, UK 6Department of Plastic Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK 7Department of Surgery and Cancer, Imperial College London, London, UK 8Department of Microbiology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK 9National Institute for Health Research Health Protection Research Unit, Imperial College London, London, UK 10Department of Plastic Surgery and Burns, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK 11Department of Chemistry, University of Bath, Bath, UK 12School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK 13Department of Plastic Surgery, Royal Free Hospital NHS Foundation Trust, London, UK 14Department of Plastic Surgery, Royal Manchester Children’s Hospital, Manchester, UK 15Centre for Children's Burns Research, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK 16Bristol Centre for Surgical Research, University of Bristol, Bristol, UK Contributors AY and AD wrote the paper and conceived the project. LT, ATAJ and LM provided microbiological expertise. SF, KC, DC, BD, SB, RA, MS and KM provided clinical and nursing expertise relating to wound infection diagnosis. JCD provided methodological expertise. All authors critically reviewed, contributed to, and have read and approved the manuscript. Funding This work was supported by an Engineering and Physical Sciences Research Council (EPSRC) Grant, reference: EP/R51164X/1

Keywords

  • Burn wound infection
  • Burns
  • Delphi survey
  • Diagnostic indicators
  • Systematic review

ASJC Scopus subject areas

  • General Medicine

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