International consensus definition of low anterior resection syndrome
International consensus definition of low anterior resection syndrome
AIM: Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders.
METHOD: This international patient-provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of LARS.
RESULTS: Three hundred twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this.
CONCLUSION: This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.
Consensus definition, low anterior resection syndrome, patient-reported, rectal resection
331-341
Keane, C.
6929845f-f722-4aaa-ac74-bc87db06133b
Fearnhead, N.S.
39468f9f-bb98-4c77-ae75-315bdbad27f7
Bordeianou, L.
8c5472a4-1372-48e7-bb78-9bfc702e9481
Christensen, P.
6f9621a8-7478-4e90-8737-b01d8a839a59
Espin Basany, E.
8dd2b1f9-6407-4661-b20b-36b5121a419e
Laurberg, S.
a122913a-1c40-496c-997d-48c12d0fa107
Mellgren, A.
e35466d2-eff9-41e8-ad9b-e54f09d5eb47
Messick, C.
29cd31de-2f19-459c-9ce4-abda51970512
Orangio, G.R.
c4c01c8d-fc19-412b-a378-13ae2abe1d53
Verjee, A.
efd93989-8f72-4e98-adab-406847647fa7
Wing, K.
4c7aa7f8-1b9c-4b9b-a240-0898f3f2ce77
Bissett, I.
58a20594-1d22-4899-b0f1-cc048b247d80
Nugent, Karen.
79fcb89d-6ff2-47b8-ac2c-2afb24954456
LARS International Collaborative Group
1 March 2020
Keane, C.
6929845f-f722-4aaa-ac74-bc87db06133b
Fearnhead, N.S.
39468f9f-bb98-4c77-ae75-315bdbad27f7
Bordeianou, L.
8c5472a4-1372-48e7-bb78-9bfc702e9481
Christensen, P.
6f9621a8-7478-4e90-8737-b01d8a839a59
Espin Basany, E.
8dd2b1f9-6407-4661-b20b-36b5121a419e
Laurberg, S.
a122913a-1c40-496c-997d-48c12d0fa107
Mellgren, A.
e35466d2-eff9-41e8-ad9b-e54f09d5eb47
Messick, C.
29cd31de-2f19-459c-9ce4-abda51970512
Orangio, G.R.
c4c01c8d-fc19-412b-a378-13ae2abe1d53
Verjee, A.
efd93989-8f72-4e98-adab-406847647fa7
Wing, K.
4c7aa7f8-1b9c-4b9b-a240-0898f3f2ce77
Bissett, I.
58a20594-1d22-4899-b0f1-cc048b247d80
Nugent, Karen.
79fcb89d-6ff2-47b8-ac2c-2afb24954456
Keane, C., Fearnhead, N.S., Bordeianou, L., Christensen, P., Espin Basany, E., Laurberg, S., Mellgren, A., Messick, C., Orangio, G.R., Verjee, A., Wing, K. and Bissett, I.
,
LARS International Collaborative Group
(2020)
International consensus definition of low anterior resection syndrome.
Colorectal Disease, 22 (3), .
(doi:10.1111/codi.14957).
Abstract
AIM: Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders.
METHOD: This international patient-provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of LARS.
RESULTS: Three hundred twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this.
CONCLUSION: This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.
Text
codi.14957
- Version of Record
More information
Accepted/In Press date: 23 August 2019
e-pub ahead of print date: 10 February 2020
Published date: 1 March 2020
Keywords:
Consensus definition, low anterior resection syndrome, patient-reported, rectal resection
Identifiers
Local EPrints ID: 443372
URI: http://eprints.soton.ac.uk/id/eprint/443372
ISSN: 1462-8910
PURE UUID: 43a319bf-7999-4a61-abd3-62e4af293a44
Catalogue record
Date deposited: 21 Aug 2020 16:31
Last modified: 16 Mar 2024 09:00
Export record
Altmetrics
Contributors
Author:
C. Keane
Author:
N.S. Fearnhead
Author:
L. Bordeianou
Author:
P. Christensen
Author:
E. Espin Basany
Author:
S. Laurberg
Author:
A. Mellgren
Author:
C. Messick
Author:
G.R. Orangio
Author:
A. Verjee
Author:
K. Wing
Author:
I. Bissett
Corporate Author: LARS International Collaborative Group
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics