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Development of the Residual Lesion Score for congenital heart surgery: the RAND Delphi methodology

Published online by Cambridge University Press:  23 December 2022

Meena Nathan*
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Department of Surgery, Harvard Medical School, Boston, MA, USA
Jane W. Newburger
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Margaret Bell
Affiliation:
Department of Cardiac Psychiatry Research Program, Massachusetts General Hospital, Boston, MA, USA
Alexander Tang
Affiliation:
Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
Russell Gongwer
Affiliation:
HealthCore, Watertown, MA, USA
Carolyn Dunbar-Masterson
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA
Andrew M. Atz
Affiliation:
Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
Emile Bacha
Affiliation:
Division of Cardiothoracic Surgery, New York-Presbyterian/Morgan Stanley Children’s Hospital, Columbia University Irving Medical Center, New York, NY, USA
Steven Colan
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
J. William Gaynor
Affiliation:
Division of Cardiac Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Kirk Kanter
Affiliation:
Division of Pediatric Cardiac Surgery, Emory University School of Medicine, Atlanta, GA, USA
Jami C. Levine
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Richard Ohye
Affiliation:
Division of Pediatric Cardiac Surgery, C. S. Mott Children’s Hospital, Ann Arbor, MI, USA
Christian Pizarro
Affiliation:
Division of Cardiac Surgery, Nemours Cardiac Center, Alfred I duPont Hospital for Children, Wilmington, DE, USA
Steven Schwartz
Affiliation:
Division of Cardiac Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
Girish Shirali
Affiliation:
Heart Center, Children’s Mercy Hospital, Kansas City, MO, USA
Lloyd Tani
Affiliation:
Division of Pediatric Cardiology, University of Utah and Primary Children’s Hospital, Salt Lake City, UT, USA
James Tweddell
Affiliation:
Division of Pediatric Cardiac Thoracic Surgery, Cincinnati Children’s Hospital and Medical Center (Posthumous), Cincinnati, OH, USA
Michelle Gurvitz
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA Department of Pediatrics, Harvard Medical School, Boston, MA, USA
*
Author for correspondence: Meena Nathan MD, MPH, Department of Cardiac Surgery, Bader 273, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA. Tel: +1 617 355 7932; Fax: +1 617 730 0214. E-mail: meena.nathan@cardio.chboston.org

Abstract

Background and Objective:

The Residual Lesion Score is a novel tool for assessing the achievement of surgical objectives in congenital heart surgery based on widely available clinical and echocardiographic characteristics. This article describes the methodology used to develop the Residual Lesion Score from the previously developed Technical Performance Score for five common congenital cardiac procedures using the RAND Delphi methodology.

Methods:

A panel of 11 experts from the field of paediatric and congenital cardiology and cardiac surgery, 2 co-chairs, and a consultant were assembled to review and comment on validity and feasibility of measuring the sub-components of intraoperative and discharge Residual Lesion Score for five congenital cardiac procedures. In the first email round, the panel reviewed and commented on the Residual Lesion Score and provided validity and feasibility scores for sub-components of each of the five procedures. In the second in-person round, email comments and scores were reviewed and the Residual Lesion Score revised. The modified Residual Lesion Score was scored independently by each panellist for validity and feasibility and used to develop the “final” Residual Lesion Score.

Results:

The Residual Lesion Score sub-components with a median validity score of ≥7 and median feasibility score of ≥4 that were scored without disagreement and with low absolute deviation from the median were included in the “final” Residual Lesion Score.

Conclusion:

Using the RAND Delphi methodology, we were able to develop Residual Lesion Score modules for five important congenital cardiac procedures for the Pediatric Heart Network’s Residual Lesion Score study.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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