Clinical outcomes in hemophilia: Towards development of a core set of standardized outcome measures for research

• Main Authors: Saunya Dover, Victor S. Blanchette, Alok Srivastava, Kathelijn Fischer, Audrey Abad, Brian M. Feldman
• Format: Article
• Language: English
• Published: Wiley 2020-05-01
• Series: Research and Practice in Thrombosis and Haemostasis
• Subjects: core set; hemophilia; nominal groups process; outcome assessment (health care); outcome measure
• Online Access: https://doi.org/10.1002/rth2.12331

Abstract Introduction A lack of uniformity in the choice of outcome measurement in hemophilia care and research has led to studies with incomparable results. We identified a need to define core outcome measures for use in research and clinical care of persons with hemophilia. Objective To move toward a core set of outcome measures for the assessment of persons with hemophilia in research and practice. Methods A modified nominal groups process was conducted with an international group of hemophilia experts, including persons with hemophilia as follows. Step 1: item generation for all potential outcome measures. Step 2: survey where respondents voted on the relative importance and usefulness of each item. Steps 3/4: 2‐day meeting where attendees voted for items they valued, followed by open discussion and a second round of voting. Step 5: survey where respondents selected their top five items from those with >50% agreement at the meeting. Results The highest ranked items for the pediatric core set (% agreement) are treatment satisfaction (92.7%), joint health (83.3%), a measure of access to treatment (82.5%), a measure of treatment adherence (72.5%), and generic performance based physical function (72.1%). The highest ranked items for the adult core set (% agreement) are total bleeding events (88.1%), EuroQol five dimensions (85.4%), treatment adherence (82.1%), joint health (79.1%), and number/location of bleeds per unit time (78.6%). Conclusion This process generated a list of preferred outcome measures to consider for assessment in persons with hemophilia. This information now requires refinement to define optimal core sets for use in different clinical/research contexts.