{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:43:31Z","timestamp":1767908611631,"version":"3.49.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["DRF-2015-08-023"],"award-info":[{"award-number":["DRF-2015-08-023"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>International stakeholder participation is important in the development of core outcome sets (COS). Stakeholders from varying regions may value health outcomes differently. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a COS for gastric cancer surgery trials (the GASTROS study).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>952 participants from 55 countries participating in a Delphi survey during COS development were eligible for inclusion. Recruits were grouped according to region (East or West), country income classification (high and low-to-middle income) and other characteristics (e.g. patients; age, sex, time since surgery, mode of treatment, surgical approach and healthcare professionals; clinical experience). Groups were compared with respect to how they categorised 56 outcomes identified as potentially important to include in the final COS (\u2018consensus in\u2019, \u2018consensus out\u2019, \u2018no consensus\u2019). Outcomes categorised as \u2018consensus in\u2019 or \u2018consensus out\u2019 by all 3 stakeholder groups would be automatically included in or excluded from the COS respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>In total, 13 outcomes were categorised \u2018consensus in\u2019 (disease-free survival, disease-specific survival, surgery-related death, recurrence of cancer, completeness of tumour removal, overall quality of life, nutritional effects, all-cause complications, intraoperative complications, anaesthetic complications, anastomotic complications, multiple organ failure, and bleeding), 13 \u2018consensus out\u2019 and 31 \u2018no consensus\u2019. There was little variation in prioritisation of outcomes by stakeholders from Eastern or Western countries and high or low-to-middle income countries. There was little variation in outcome prioritisation within either health professional or patient groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our study suggests that there is little variation in opinion within stakeholder groups when participant region and other characteristics are considered. This finding may help COS developers when designing their Delphi surveys and recruitment strategies. Further work across other clinical fields is needed before broad recommendations can be made.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0261937","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T18:39:09Z","timestamp":1640975949000},"page":"e0261937","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["How are trial outcomes prioritised by stakeholders from different regions? Analysis of an international Delphi survey to develop a core outcome set in gastric cancer surgery"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5751-1846","authenticated-orcid":true,"given":"Bilal","family":"Alkhaffaf","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9871-5167","authenticated-orcid":true,"given":"Aleksandra","family":"Metryka","sequence":"additional","affiliation":[]},{"given":"Jane M.","family":"Blazeby","sequence":"additional","affiliation":[]},{"given":"Anne-Marie","family":"Glenny","sequence":"additional","affiliation":[]},{"given":"Paula R.","family":"Williamson","sequence":"additional","affiliation":[]},{"given":"Iain A.","family":"Bruce","sequence":"additional","affiliation":[]},{"name":"on behalf of the GASTROS International Working Group","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"issue":"S3","key":"pone.0261937.ref001","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1186\/s13063-017-1978-4","article-title":"The COMET Handbook: version 1.0","volume":"18","author":"P. R. Williamson","year":"2017","journal-title":"Trials"},{"issue":"1","key":"pone.0261937.ref002","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1186\/s13063-017-2100-7","article-title":"Standardising the Reporting of Outcomes in Gastric Cancer Surgery Trials: Protocol for the Development of a Core Outcome Set and Accompanying Outcome Measurement Instrument Set (The GASTROS Study)","volume":"18","author":"B. Alkhaffaf","year":"2017","journal-title":"Trials"},{"issue":"10","key":"pone.0261937.ref003","doi-asserted-by":"crossref","first-page":"e021796","DOI":"10.1136\/bmjopen-2018-021796","article-title":"Reporting of outcomes in gastric cancer surgery trials: a systematic review","volume":"8","author":"B. Alkhaffaf","year":"2018","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0261937.ref004","doi-asserted-by":"crossref","first-page":"e034782","DOI":"10.1136\/bmjopen-2019-034782","article-title":"Patient priorities in relation to surgery for gastric cancer: qualitative interviews with gastric cancer surgery patients to inform the development of a core outcome set","volume":"10","author":"B. Alkhaffaf","year":"2020","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0261937.ref005","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/1745-6215-13-132","article-title":"Developing core outcome sets for clinical trials: issues to consider","volume":"13","author":"P. R. Williamson","year":"2012","journal-title":"Trials"},{"issue":"1","key":"pone.0261937.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13063-016-1591-y","article-title":"Exploring methods the for selection and integration of stakeholder views in the development of core outcome sets: A case study in reconstructive breast surgery","volume":"17","author":"S. Potter","year":"2016","journal-title":"Trials"},{"issue":"6","key":"pone.0261937.ref007","doi-asserted-by":"crossref","first-page":"e99111","DOI":"10.1371\/journal.pone.0099111","article-title":"Choosing Important Health Outcomes for Comparative Effectiveness Research: A Systematic Review","volume":"9","author":"E. Gargon","year":"2014","journal-title":"PLoS One"},{"key":"pone.0261937.ref008","unstructured":"\u201cWorld Bank Country and Lending Groups\u2013World Bank Data Help Desk.\u201d [Online]. Available: https:\/\/datahelpdesk.worldbank.org\/knowledgebase\/articles\/906519-world-bank-country-and-lending-groups. [Accessed: 05-May-2020]."},{"key":"pone.0261937.ref009","unstructured":"\u201cFar East\u2014Wikipedia.\u201d [Online]. Available: https:\/\/en.wikipedia.org\/wiki\/Far_East. [Accessed: 28-Jun-2020]."},{"key":"pone.0261937.ref010","unstructured":"\u201cWestern world\u2014Wikipedia.\u201d [Online]. Available: https:\/\/en.wikipedia.org\/wiki\/Western_world. [Accessed: 28-Jun-2020]."},{"issue":"1","key":"pone.0261937.ref011","first-page":"79","article-title":"Surgical management of gastric cancer: The East vs. West perspective","volume":"6","author":"M. Yamamoto","year":"2015","journal-title":"Journal of Gastrointestinal Oncology"},{"issue":"8","key":"pone.0261937.ref012","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.clon.2019.05.012","article-title":"Gastric Cancer\u2013From Aetiology to Management: Differences Between the East and the West","volume":"31","author":"W. L. Chan","year":"2019","journal-title":"Clin. Oncol."},{"key":"pone.0261937.ref013","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jclinepi.2017.12.020","article-title":"A taxonomy has been developed for outcomes in medical research to help improve knowledge discovery","volume":"96","author":"S. Dodd","year":"2018","journal-title":"J. Clin. Epidemiol."},{"issue":"11","key":"pone.0261937.ref014","doi-asserted-by":"crossref","first-page":"2738","DOI":"10.1007\/s11695-016-2186-0","article-title":"A Comparison of Health Professionals\u2019 and Patients\u2019 Views of the Importance of Outcomes of Bariatric Surgery","volume":"26","author":"K. D. Coulman","year":"2016","journal-title":"Obes. Surg."},{"key":"pone.0261937.ref015","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jclinepi.2019.07.007","article-title":"Industry funding was associated with increased use of core outcome sets","volume":"115","author":"J. J. Kirkham","year":"2019","journal-title":"J. Clin. Epidemiol."},{"issue":"1","key":"pone.0261937.ref016","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/ajco.12112","article-title":"Registry of gastric cancer treatment evaluation (REGATE): I baseline disease characteristics","volume":"10","author":"Y.-J. Bang","year":"2014","journal-title":"Asia. Pac. J. Clin. Oncol"},{"issue":"1","key":"pone.0261937.ref017","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.ejso.2015.09.017","article-title":"\u201cVariations among 5 European countries for curative treatment of resectable oesophageal and gastric cancer: A survey from the EURECCA Upper GI Group (EUropean REgistration of Cancer CAre)","volume":"42","author":"M. Messager","year":"2016","journal-title":"Eur. J. Surg. Oncol"},{"key":"pone.0261937.ref018","article-title":"Commissioned by Healthcare Quality Improvement Partnership National Oesophago-Gastric Cancer Audit 2018 An audit of the care received by people with Oesophago-Gastric Cancer in England and Wales 2018 Annual Report","author":"J. Michalowski","year":"2018"},{"key":"pone.0261937.ref019","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jclinepi.2020.09.028","article-title":"\u2018Vicarious thinking\u2019 was a key driver of score change in Delphi surveys for COS development and is facilitated by feedback of results","volume":"128","author":"R. Fish","year":"2020","journal-title":"J. Clin. Epidemiol."},{"issue":"1","key":"pone.0261937.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12874-020-01197-3","article-title":"Methodology in core outcome set (COS) development: the impact of patient interviews and using a 5-point versus a 9-point Delphi rating scale on core outcome selection in a COS development study","volume":"21","author":"A. Remus","year":"2021","journal-title":"BMC Med. Res. Methodol."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261937","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T18:40:44Z","timestamp":1640976044000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261937"}},"subtitle":[],"editor":[{"given":"Sandro","family":"Pasquali","sequence":"first","affiliation":[]}],"short-title":[],"issued":{"date-parts":[[2021,12,31]]},"references-count":20,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0261937","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,31]]}}}