{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T13:25:20Z","timestamp":1765891520426,"version":"3.48.0"},"reference-count":45,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"PLANETS Cancer Charity","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Penguins Against Cancer","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/100018063","name":"Bowel Research UK","doi-asserted-by":"publisher","award":["BRUK_SG_23109"],"award-info":[{"award-number":["BRUK_SG_23109"]}],"id":[{"id":"10.13039\/100018063","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,12,20]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The empty pelvis syndrome is a significant source of morbidity following pelvic exenteration surgery. It remains poorly defined with research in this field being heterogeneous and of low quality. Furthermore, there has been minimal engagement with patient representatives following pelvic exenteration with respect to the empty pelvic syndrome. \u2018PelvEx\u2014Beating the empty pelvis syndrome\u2019 aims to engage both patient representatives and healthcare professionals to achieve an international consensus on a core outcome set, pathophysiology and mitigation of the empty pelvis syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A modified-Delphi approach will be followed with a three-stage study design. First, statements will be longlisted using a recent systematic review, healthcare professional event, patient and public engagement, and Delphi piloting. Second, statements will be shortlisted using up to three rounds of online modified Delphi. Third, statements will be confirmed and instruments for measurable statements selected using a virtual patient-representative consensus meeting, and finally a face-to-face healthcare professional consensus meeting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The University of Southampton Faculty of Medicine ethics committee has approved this protocol, which is registered as a study with the Core Outcome Measures in Effectiveness Trials Initiative. Publication of this study will increase the potential for comparative research to further understanding and prevent the empty pelvis syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05683795\">NCT05683795<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076538","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T22:31:11Z","timestamp":1707172271000},"page":"e076538","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Beating the empty pelvis syndrome: the PelvEx Collaborative core outcome set study protocol"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05683795","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05683795","registry":"10.18810\/clinical-trials-gov"}],"author":[{"name":"PelvEx Collaborative","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"2025121605210635000_14.2.e076538.1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/codi.15956","article-title":"Empty pelvis syndrome: a systematic review of reconstruction techniques and their associated complications","volume":"24","author":"Johnson","year":"2022","journal-title":"Colorectal Dis"},{"key":"2025121605210635000_14.2.e076538.2","unstructured":"Barber HRK , Johnson JC . Pelvic Exenteration. In: Nichols DH , ed. Gynecologic and obstetric surgery. 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