{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:54:56Z","timestamp":1793796896254,"version":"4.6.1"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"unspecified","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2026,2,5]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Liver trauma management has evolved over recent decades, shifting from primarily operative to algorithmic approaches incorporating initial non-operative management alongside operative intervention for severe injuries. Inconsistent core outcome measures between studies hamper meaningful clinical research and evidence synthesis. This study aimed to develop a core outcome set (COS) for liver trauma research to standardize outcome reporting and improve study comparability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified Delphi consensus methodology after COMET (Core Outcome Measures in Effectiveness Trials) and COS-STAD (Core Outcome Set-Standards for Development) guidelines was employed and twenty trauma surgery experts were recruited through purposive sampling of high-impact publications and professional networks. Round 1 collected free-text outcome suggestions. Round 2 used a 9-point Likert scale rating of those previously identified outcomes. Consensus was defined as \u226570% rating outcomes as critically important (7\u20139) and \u226415% as unimportant (1\u20133). Intraclass correlation (ICC) assessed agreement. Round 3 involved reprioritization of non-consensus outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 20 experts completed three rounds (95% response rate). From 102 initial suggestions, 41 unique outcomes were identified. By consensus, 12 outcomes were prioritized spanning four domains: operative decision-making, non-operative management success, hepatic complications, and healthcare utilization-related outcomes. The ICC was 0.89 (95% CI 0.84 to 0.94), indicating strong inter-rater reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This rigorously developed COS for liver trauma provides standardized outcomes to guide future research and improve cross-study comparability. Adoption of these outcomes may enhance reporting consistency and facilitate evidence synthesis in liver trauma research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study type<\/jats:title>\n                    <jats:p>Consensus development study (modified Delphi)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>V.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tsaco-2025-002164","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T14:35:17Z","timestamp":1772116517000},"page":"e002164","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Core outcome set for liver trauma: a consensus approach using modified Delphi methodology"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1257-935X","authenticated-orcid":false,"given":"Christian Damone","family":"Cain","sequence":"first","affiliation":[{"name":"R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1467-2380","authenticated-orcid":false,"given":"Saskya","family":"Byerly","sequence":"additional","affiliation":[{"name":"Surgery, UTHSC COM, Memphis, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole A","family":"Stassen","sequence":"additional","affiliation":[{"name":"Surgery, University of Rochester Medical Center, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1136-7238","authenticated-orcid":false,"given":"David","family":"Efron","sequence":"additional","affiliation":[{"name":"R Adams Cowley Shock 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