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The COMBAT project: study protocol for the development of a core outcome set for morbidity following surgery in paediatric brain tumour patients

The COMBAT project: study protocol for the development of a core outcome set for morbidity following surgery in paediatric brain tumour patients
The COMBAT project: study protocol for the development of a core outcome set for morbidity following surgery in paediatric brain tumour patients

Background: central nervous system tumours affecting the brain and spine are the most common solid tumour site in the paediatric population and the most common causes of cancer death in children and young people. They are associated with high morbidity both from the tumour and the interventions used to treat them. Postoperative morbidity reporting following surgery for paediatric brain tumours is poor. This is due to variability of outcomes measured and reported and the lack of a common language when reporting adverse outcomes. One solution is to develop a core outcome set which will stipulate the minimum postoperative outcomes that should be reported. The COMBAT (Core Postoperative Morbidity Set for Paediatric Brain Tumours) Project will develop a core set of adverse outcomes that can be applied to paediatric brain tumour patients undergoing surgery.

Methods and anlysis: this protocol has been developed using the COS-STAD (Core Outcome Set-Standards for Development) recommendations and the COS-STAP (Core Outcome Set-STAndardised Protocol Items) statement. A systematic review will identify adverse outcomes reported in the literature and how they are measured. Outcomes of importance to patients and their carers will be identified from semi-structured qualitative interviews with patients and their carers from Alder Hey Children's Hospital, Liverpool, UK. Consensus on the most important harms will be sought using a two-round eDelphi survey completed by national and international participants including health professionals, researchers, patients and their carers. Results of the eDelphi survey will be assessed against a pre-defined definition of consensus and discussed at an international consensus meeting attended by participants of the eDelphi survey.

Discussion: there is a clear need for a common language to harmonise measurement and reporting of morbidity following surgery for paediatric brain tumour patients. This project will define postoperative adverse outcomes that are of critical importance to key stakeholders. It will standardise surgical morbidity outcome measurement and reporting in both research studies and routine clinical practice, enabling comparison across different trials, studies and clinical services. It will lay the groundwork for future research in paediatric brain tumour surgical morbidity.

Studt registration: this study is registered with the COMET database as Study 1968 ( https://www.comet-initiative.org/Studies/Details/1968 ), registration date: 26/10/2021.

Brain Neoplasms/surgery, Child, Endpoint Determination/standards, Humans, Morbidity, Neurosurgical Procedures/adverse effects, Postoperative Complications/epidemiology, Systematic Reviews as Topic, Treatment Outcome, Paediatric, Brain tumour, Central nervous system, Neuro-oncology, Neurosurgery, Core outcome set, Surgery, Adverse outcome
1745-6215
Trichinopoly Krishna, Sandhya
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Harman, Nicola
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Mallucci, Conor
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Pizer, Barry
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Jenkinson, Michael D.
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Aquilina, Kristian
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Bull, Kim
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Foss-Skiftesvik, Jon
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Hartley, Helen
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Hayden, James
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Kennedy, Colin
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Thomale, Ulrich W.
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Wilne, Sophie
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Wisoff, Jeffrey H
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Bouaouiche, Faris
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Hull, Liz
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Robinson, John
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Vickers, Hannah L.
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Gamble, Carrol
6d685bb2-1ec5-4e38-a8d4-3cf6f6e625ac
Trichinopoly Krishna, Sandhya
302a327c-e6b9-4649-8ac1-ff91744a1066
Harman, Nicola
aef76cab-2d65-4083-b555-f49594051ee4
Mallucci, Conor
23a9b7a7-40e0-4f0d-b85d-014861f4bb77
Pizer, Barry
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Jenkinson, Michael D.
ca6c7774-ebce-4084-a22e-19a341081f56
Aquilina, Kristian
de54e04c-1190-40a0-926f-55f8d6171e73
Bull, Kim
751f8b25-29ba-4d4f-96e2-6c339a83a47f
Foss-Skiftesvik, Jon
3331514b-825b-4b98-b476-adea4627746a
Hartley, Helen
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Hayden, James
6b71d115-c182-43d6-a527-55444824e696
Kennedy, Colin
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Thomale, Ulrich W.
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Wilne, Sophie
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Wisoff, Jeffrey H
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Bouaouiche, Faris
95261a8b-5a0a-4c21-a9d4-af047c460226
Hull, Liz
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Robinson, John
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Vickers, Hannah L.
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Gamble, Carrol
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Trichinopoly Krishna, Sandhya, Harman, Nicola, Mallucci, Conor, Pizer, Barry, Jenkinson, Michael D., Aquilina, Kristian, Bull, Kim, Foss-Skiftesvik, Jon, Hartley, Helen, Hayden, James, Kennedy, Colin, Thomale, Ulrich W., Wilne, Sophie, Wisoff, Jeffrey H, Bouaouiche, Faris, Hull, Liz, Robinson, John, Vickers, Hannah L. and Gamble, Carrol (2025) The COMBAT project: study protocol for the development of a core outcome set for morbidity following surgery in paediatric brain tumour patients. Trials, 26 (1), [286]. (doi:10.1186/s13063-025-09004-4).

Record type: Article

Abstract

Background: central nervous system tumours affecting the brain and spine are the most common solid tumour site in the paediatric population and the most common causes of cancer death in children and young people. They are associated with high morbidity both from the tumour and the interventions used to treat them. Postoperative morbidity reporting following surgery for paediatric brain tumours is poor. This is due to variability of outcomes measured and reported and the lack of a common language when reporting adverse outcomes. One solution is to develop a core outcome set which will stipulate the minimum postoperative outcomes that should be reported. The COMBAT (Core Postoperative Morbidity Set for Paediatric Brain Tumours) Project will develop a core set of adverse outcomes that can be applied to paediatric brain tumour patients undergoing surgery.

Methods and anlysis: this protocol has been developed using the COS-STAD (Core Outcome Set-Standards for Development) recommendations and the COS-STAP (Core Outcome Set-STAndardised Protocol Items) statement. A systematic review will identify adverse outcomes reported in the literature and how they are measured. Outcomes of importance to patients and their carers will be identified from semi-structured qualitative interviews with patients and their carers from Alder Hey Children's Hospital, Liverpool, UK. Consensus on the most important harms will be sought using a two-round eDelphi survey completed by national and international participants including health professionals, researchers, patients and their carers. Results of the eDelphi survey will be assessed against a pre-defined definition of consensus and discussed at an international consensus meeting attended by participants of the eDelphi survey.

Discussion: there is a clear need for a common language to harmonise measurement and reporting of morbidity following surgery for paediatric brain tumour patients. This project will define postoperative adverse outcomes that are of critical importance to key stakeholders. It will standardise surgical morbidity outcome measurement and reporting in both research studies and routine clinical practice, enabling comparison across different trials, studies and clinical services. It will lay the groundwork for future research in paediatric brain tumour surgical morbidity.

Studt registration: this study is registered with the COMET database as Study 1968 ( https://www.comet-initiative.org/Studies/Details/1968 ), registration date: 26/10/2021.

Text
s13063-025-09004-4 - Version of Record
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e-pub ahead of print date: 11 August 2025
Published date: 11 August 2025
Keywords: Brain Neoplasms/surgery, Child, Endpoint Determination/standards, Humans, Morbidity, Neurosurgical Procedures/adverse effects, Postoperative Complications/epidemiology, Systematic Reviews as Topic, Treatment Outcome, Paediatric, Brain tumour, Central nervous system, Neuro-oncology, Neurosurgery, Core outcome set, Surgery, Adverse outcome

Identifiers

Local EPrints ID: 505414
URI: http://eprints.soton.ac.uk/id/eprint/505414
ISSN: 1745-6215
PURE UUID: a2f9540f-0b0c-46d8-982b-e9e0224dc749
ORCID for Kim Bull: ORCID iD orcid.org/0000-0002-5541-4556

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Date deposited: 07 Oct 2025 17:19
Last modified: 08 Oct 2025 01:37

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Contributors

Author: Sandhya Trichinopoly Krishna
Author: Nicola Harman
Author: Conor Mallucci
Author: Barry Pizer
Author: Michael D. Jenkinson
Author: Kristian Aquilina
Author: Kim Bull ORCID iD
Author: Jon Foss-Skiftesvik
Author: Helen Hartley
Author: James Hayden
Author: Colin Kennedy
Author: Ulrich W. Thomale
Author: Sophie Wilne
Author: Jeffrey H Wisoff
Author: Faris Bouaouiche
Author: Liz Hull
Author: John Robinson
Author: Hannah L. Vickers
Author: Carrol Gamble

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