National consensus to develop core outcomes for the evaluation of complications from excess weight (CEW) clinics: results of a national Delphi process

Philippa Anna Stilwell; Billy White; Catherine Graham; Emma Rigby; Julian P H Shield; Rachael Brandreth; Sophie Solti; Richard Owen; Simon Kenny; CEW Delphi Collaborators; CEW Delphi collaborators

doi:10.1136/archdischild-2022-324550

National consensus to develop core outcomes for the evaluation of complications from excess weight (CEW) clinics: results of a national Delphi process

Arch Dis Child. 2023 Apr;108(4):296-299. doi: 10.1136/archdischild-2022-324550. Epub 2023 Jan 4.

Authors

Philippa Anna Stilwell^{1

2}, Billy White³, Catherine Graham⁴, Emma Rigby⁵, Julian P H Shield^{6

7}, Rachael Brandreth^{4

8}, Sophie Solti⁴, Richard Owen⁴, Simon Kenny^{4

9

10}; CEW Delphi Collaborators; CEW Delphi collaborators

Collaborators

James Law, Pooja Sachdev, Laura Stewart, Peter Green, Elizabeth Nash, Nikki Davis, Louisa Ells, Dasha Nicholls, Jo Searles, Natalie Selby, Birgit Westphal, Rhian Augustus, Senthil Senniappan, Martha Ford Adams, Ken Ong, Emma Webb, Neil Wright, Thomas Carrol, Gin Thian Peh

Affiliations

¹ NHS England and NHS Improvement London, London, UK [email protected].
² Paediatrics, Evelina London Children's Healthcare, London, UK.
³ University College London Hospital-Great Ormond Street Obesity Service, University College London Hospitals NHS Foundation Trust, London, UK.
⁴ NHS England and NHS Improvement London, London, UK.
⁵ Association for Young People's Health, London, UK.
⁶ NIHR Bristol Biomedical Research Centre, University Hospitals of Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
⁷ Institute of Child Health, University of Bristol, Bristol, UK.
⁸ Dietetics, Royal Cornwall Hospitals Trust, Cornwall, UK.
⁹ Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
¹⁰ School of Life Sciences, University of Liverpool, Liverpool, England.

PMID: 36599626
DOI: 10.1136/archdischild-2022-324550

Abstract

Objective: In 2021, centres across all seven NHS-England regions were selected to develop pilot clinics with the aim of treating children and young people (CYP) living with complications relating to excess weight (CEW). We led a process to develop core outcomes to enable the evaluation of these clinics.

Methods: A two-round Delphi process, virtual steering group meetings and two patient representation workshops were used to agree the most important outcomes for both clinicians/allied professionals and representative prospective service users.

Results: A total of 119 clinicians/allied professionals were invited to contribute to the Delphi process: 62 (52%) agreed and completed round 1 and 47 of these (76%) went on to complete round 2. Six young people (age range 13-17 years) and six parents were involved in two patient representation workshops and their experiences fed into virtual steering group meetings, via a representative.There were 44 outcomes assessed in round 1 and 21 outcomes assessed in round 2. There were 16 core outcomes selected: anthropometric, glucose tolerance/insulin resistance/type 2 diabetes, blood pressure, lipid profile, breathing problems, identification of aetiology, non-alcoholic fatty liver disease, idiopathic intracranial hypertension, anxiety, depression, self-esteem, quality of life, school attendance, dietary habits including disordered eating, exercise and activity habits.

Conclusions: Use of an online Delphi process, patient representation workshops and virtual steering group meetings has enabled the development of core outcomes for clinical obesity services with eight physical health, five mental health and three self-management outcomes. Further work is needed to develop outcome measures to complete a core outcome set. These will be used to guide the evaluation of novel regional clinics for the treatment of complications of excess weight.

Keywords: child health; health services research.

MeSH terms

Adolescent
Child
Consensus
Delphi Technique
Diabetes Mellitus, Type 2*
Humans
Outcome Assessment, Health Care
Prospective Studies
Quality of Life
Research Design
Treatment Outcome