The Measurement and Reporting of Outcomes in Clinical Studies of Incidental and Untreated Meningioma Are Heterogeneous and Prevent Knowledge Progress: A Systematic Review

Abstract

Abstract AIMS There is increasing interest in the clinical management of patients with incidental and untreated intracranial meningioma. Determining balance between observation and intervention is a key research priority. However, heterogeneity of outcome measurement and reporting has hampered knowledge progress. This systematic review aimed to summarise the outcomes measured and reported in such studies. METHOD A systematic literature search was performed to identify published full-texts describing active monitoring of adult cohorts with incidental and untreated intracranial meningioma. Reported outcomes were extracted verbatim, along with an associated definition and method of measurement if provided. Deduplication, grouping, and classification of verbatim outcomes was performed to identify unique outcomes reported in the literature. RESULTS Thirty-three published articles and one ongoing study were included, describing 32 unique studies: retrospective n=27, cross-sectional n=3, prospective n=2. 271 verbatim outcomes were reported, of which 90 were defined. Following deduplication, 181 unique verbatim outcomes remained and were grouped into 53 unique ‘non-verbatim’ outcomes. Those reported most frequently included: volume of tumor n=18, growth of tumor n=30, absolute growth rate n=18, relative growth rate n=17, need for surgery n=21, and progression-free survival n=11. CONCLUSION Harmonisation of outcome measurement and reporting across clinical studies of incidental and untreated intracranial meningioma could facilitate knowledge progress for this priority research area. The unique outcomes identified from this systematic literature review will be prioritised through an eDelphi survey and consensus meeting of key stakeholders (including patients), in order to develop a Core Outcome Set (COS) for use in future clinical studies.