Protocol for developing a core outcome set for medicines safety at transitions of care: a systematic review, qualitative study and Delphi consensus
Bibliographic record
Abstract
INTRODUCTION: Medication-related problems at transitions of care are common and can lead to patient harm. Comparing results of studies that look at medication reconciliation and medication safety at transitions of care can be difficult as the outcomes reported in these studies are heterogeneous. Moreover, the outcomes measured often lack the patient's perspective. A core outcome set (COS) is a list of outcomes which should be measured and reported in studies in order to avoid heterogeneity between trials, measure outcomes relevant to stakeholders and ensure all trials report usable information. This study aims to develop a COS for medicines safety at transitions of care, through updating an existing systematic review and evaluating the perspectives of patients, carers and healthcare professionals. METHODS: This study is registered with the Core Outcome Measures in Effective Trials (COMET) initiative and the project will be conducted following the COS-STAR (Core Outcome Set-Standards for Reporting) guidelines for the design and reporting of COSs. A four-step process will be followed: (1) updating an existing systematic literature review; (2) semistructured interviews with patients and their caregivers; (3) Delphi survey preparation involving a project steering group to compile a list of potential outcomes; (4) a three-round Delphi consensus exercise involving patients, clinicians and policymakers to refine the final core list of outcomes. ANALYSIS: This will be the first COS for medicines safety at transitions of care and will address an unmet need in providing an essential measurement approach that incorporates patients', carers' and healthcare professionals' views. The findings apply to both quality improvement and research, ensuring the relevance and translation of future research findings. ETHICS AND DISSEMINATION: Ethical approval for the qualitative surveys and Delphi technique has been granted by the Irish College of General Practitioners Research Ethics Committee (Record ID: 2182). The findings of this project will be disseminated through peer-reviewed publications, conference presentations and registration with the COMET Initiative. Members of the Delphi panel will receive summaries of the outputs, and findings will also be shared with the patient and public involvement groups involved in the study through lay summaries. Engagement with professional societies, healthcare organisations and patient groups will ensure that the COS is widely accessible and adopted into future practice.
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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 | 0.283 | 0.231 |
| Meta-epidemiology (narrow) | 0.005 | 0.006 |
| Meta-epidemiology (broad) | 0.007 | 0.010 |
| Bibliometrics | 0.015 | 0.013 |
| Science and technology studies | 0.007 | 0.008 |
| Scholarly communication | 0.008 | 0.009 |
| Open science | 0.006 | 0.010 |
| Research integrity | 0.007 | 0.011 |
| Insufficient payload (model declined to judge) | 0.061 | 0.018 |
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".