Abstract

PurposeFaecal incontinence (FI) is estimated to affect around 7.7% of people. There is a lack of uniformity in outcome definitions, measurement and reporting in FI studies. Until now, there is no general consensus on which outcomes should be assessed and reported in FI research. This complicates comparison between studies and evidence synthesis, potentially leading to recommendations not evidence-based enough to guide physicians in selecting an FI therapy. A solution for this lack of uniformity in reporting of outcomes is the development of a Core Outcome Set (COS) for FI. This paper describes the protocol for the development of a European COS for FI.MethodsPatient interviews and a systematic review of the literature will be performed to identify patient-, physician- and researcher-oriented outcomes. The outcomes will be categorised using the COMET taxonomy and put forward to a group of patients, physicians (i.e. colorectal surgeons, gastroenterologists and general practitioners) and researchers in a Delphi consensus exercise. This exercise will consist of up to three web-based rounds in which participants will prioritise and condense the list of outcomes, which is expected to result in consensus. A consensus meeting with participants from all stakeholder groups will take place to reach a final agreement on the COS.DiscussionThis study protocol describes the development of a European COS to improve reliability and consistency of outcome reporting in FI studies, thereby improving evidence synthesis and patient care.Trial registrationThis project has been registered in the COMET database on the 1st of April 2020, available at http://www.comet-initiative.org/Studies/Details/1554. The systematic review has been registered on the PROSPERO database on the 31st of August 2020, available at https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=202020&VersionID=1381336.

Highlights

  • Faecal incontinence (FI) is a common anorectal problem which is defined by the ROME IV criteria as having recurrent uncontrolled passage of faecal matter for a minimum of 3Other contributors: United European Gastroenterology (UEG), European Society of Coloproctology (ESCP), European Society of Neurogastroenterology (ESNM), European Society for Primary Care Gastroenterology (ESPCG)Extended author information available on the last page of the article months [1]

  • This paper describes the protocol for the development of a Core Outcome Set (COS) which can be used in interventional studies for FI, evaluating treatment effectiveness

  • A consistent set of outcomes in all FI intervention studies will enhance comparison between studies which will simplify the assessment of the effectiveness of therapeutic modalities

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Summary

Introduction

Faecal incontinence (FI) is a common anorectal problem which is defined by the ROME IV criteria as having recurrent uncontrolled passage of faecal matter for a minimum of 3Other contributors: United European Gastroenterology (UEG), European Society of Coloproctology (ESCP), European Society of Neurogastroenterology (ESNM), European Society for Primary Care Gastroenterology (ESPCG)Extended author information available on the last page of the article months [1]. The most important risk factors for developing FI include advanced age, previous rectoanal or obstetric surgery, obstetric trauma and/or neurological disorders [1]. These risk factors may result in a failure in the interaction between stool consistency, function of the rectal reservoir, stability of the pelvic floor, function of the anal sphincter complex and neurological function, resulting in FI [3]. Faecal incontinence can cause the development of secondary medical morbidities such as skin deterioration and has a negative impact on a person’s quality of life (QoL) [4, 5]. FI can result in embarrassment, low self-esteem, social isolation, avoidance of activities and depression and can have a negative impact on intimate relationships [5,6,7]

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