Developing a Consensus-Based Core Set of Outcome Measures for Ulnar Nerve Surgery: A Delphi Study With Focus on the Supercharged End-to-Side Anterior Interosseous Nerve to Ulnar Nerve Transfer
Bibliographic record
Abstract
Purpose: The supercharged end-to-side (SETS) anterior interosseous to ulnar nerve transfer is increasingly used to augment intrinsic muscle recovery in patients with severe ulnar neuropathy. However, there is a lack of standardized outcome measures to evaluate the effectiveness of this procedure. This study aimed to develop a consensus-based core set of outcome measures applicable to ulnar nerve surgery, with a specific focus on the SETS transfer. Methods: A two-round modified Delphi process was conducted involving 15 multidisciplinary experts in hand surgery and upper limb rehabilitation. The initial survey was informed by a comprehensive literature review and expert opinion. Participants ranked outcome domains and corresponding measurement tools based on their relevance in both clinical and research settings. Consensus was defined as ≥75% agreement. A second-round survey was conducted to refine the results and focus specifically on outcomes applicable to SETS procedures. Results: In Round 1, experts reached consensus on several key domains including motor function, functional ability, quality of life, pain, dexterity, and sensory evaluation. In Round 2, a refined core outcome set for SETS procedures was established. Lateral pinch strength and daily living function self-assessment were prioritized across both settings. Validated tools endorsed included the Patient-Rated Ulnar Nerve Evaluation, Short Form-12, visual analog scale, nine-hole peg test, and two-point discrimination. Conclusions: This Delphi study established a consensus-based core outcome set for evaluating surgical outcomes following ulnar nerve reconstruction, with specific application to SETS procedures. The proposed framework integrates patient-reported and clinician-rated measures and may support standardization in future research and clinical practice. Clinical relevance: The lack of standardized outcomes for ulnar nerve transfers limits cross-study comparisons and evidence synthesis. This study provides a structured outcome set to support consistent evaluation and improve decision making in patients undergoing SETS or related procedures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".