A core outcome set for cranioplasty following stroke or traumatic brain injury - The COAST study
Bibliographic record
Abstract
Introduction: There is substantial heterogeneity in the reporting of outcomes in the global cranioplasty literature. This study aimed to establish a core outcome set (COS) for cranioplasty after decompressive craniectomy for stroke or traumatic brain injury. Methodology: The scope was defined according to the criteria recommended by the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Phase 1 focused on outcome gathering through a systematic review and a qualitative study. Phase 2 focused on consolidation and consensus of outcomes through a two-round Delphi survey and consensus meeting. Participants from the four stakeholder groups (1. patients and/or relatives; 2. Surgeons, 3. physicians (non-surgeons), 4. Nurses, allied health professionals, and researchers) individually scored all outcomes on a 9-point Likert scale. Variables that did not reach the predefined consensus threshold for COS inclusion or exclusion were voted upon at the final consensus meeting. Results: In total, 208 verbatim outcomes were consolidated into 56 domains. A total of 153 participants completed round 1, with 45 additional outcomes suggested for inclusion. Following rationalisation, four were included in round 2. A total of 109/153 participants (71 %) from 16 countries completed Round 2 and re-scored all 60 outcomes (56 original + 4 additional). Nine outcomes were voted in, and 12 were excluded from the Delphi. The remaining 39 were discussed at a consensus meeting with 11 voted in. The final COS included 20 outcomes (12 + 8) across four domains: life impact, pathophysiological manifestations, resource use/economic impact, and mortality. Conclusion: COAST COS covers key cranioplasty outcomes, as assessed by international stakeholders, including surgical, medical, rehabilitation, and nursing professionals, as well as patients and their relatives. Future implementation will aid in the standardisation of outcomes and facilitate the development of cranioplasty-specific outcome measures, aiding between-study comparisons and improving the relevance of trial findings to healthcare professionals and patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.079 | 0.114 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.005 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".