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International consensus recommendations on face transplantation: A 2-step Delphi study.

ABSTRACT: Face transplantation is a viable reconstructive approach for severe craniofacial defects. Despite the evolution witnessed in the field, ethical aspects, clinical and psychosocial implications, public perception, and economic sustainability remain the subject of debate and unanswered questions. Furthermore, poor data reporting and sharing, the absence of standardized metrics for outcome evaluation, and the lack of consensus definitions of success and failure have hampered the development of a "transplantation culture" on a global scale. We completed a 2-round online modified Delphi process with 35 international face transplant stakeholders, including surgeons, clinicians, psychologists, psychiatrists, ethicists, policymakers, and researchers, with a representation of 10 of the 19 face transplant teams that had already performed the procedure and 73% of face transplants. Themes addressed included patient assessment and selection, indications, social support networks, clinical framework, surgical considerations, data on patient progress and outcomes, definitions of success and failure, public image and perception, and financial sustainability. The presented recommendations are the product of a shared commitment of face transplant teams to foster the development of face transplantation and are aimed at providing a gold standard of practice and policy.

SUBMITTER: Longo B

PROVIDER: S-EPMC10881406 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

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International consensus recommendations on face transplantation: A 2-step Delphi study.

Longo Benedetto B Alberti Fay Bound FB Pomahac Bohdan B Pribaz Julian Joseph JJ Meningaud Jean-Paul JP Lengelé Benoît B Özkan Ömer Ö Özkan Özlenen Ö Barret Juan Pere JP Lassus Patrik P Blondeel Phillip P Roche Nathalie N Gurunian Raffi R Infante-Cossio Pedro P Lindford Andrew A Brandacher Gerald G Giovanoli Pietro P Plock Jan J Gorantla Vijay S VS Herrington Emily Ruppel ER Saleh Daniel D Natalwala Ibrahim I Cardillo Massimo M Jowsey-Gregoire Sheila S La Padula Simone S Manas Derek D Benedict James J Nuccitelli Gloria G Bosc Romain R Morello Roberto R Farías-Yapur Anneke A Giacalone Martina M Hall Sarah S D'Orsi Gennaro G Cervelli Valerio V

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 20230902 1

Face transplantation is a viable reconstructive approach for severe craniofacial defects. Despite the evolution witnessed in the field, ethical aspects, clinical and psychosocial implications, public perception, and economic sustainability remain the subject of debate and unanswered questions. Furthermore, poor data reporting and sharing, the absence of standardized metrics for outcome evaluation, and the lack of consensus definitions of success and failure have hampered the development of a "tr ...[more]

PMID: 37666457

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Project description:BackgroundTelehealth has emerged as an alternative model for treatment delivery and has become an important component of health service delivery. However, there is inconsistency in the use of terminologies and a lack of research priorities in telehealth in musculoskeletal pain. The purpose of this international, multidisciplinary expert panel assembled in a modified three-round e-Delphi survey is to achieve a consensus on research priorities and for the standard terminology for musculoskeletal pain telehealth practice.MethodsIn this international modified e-Delphi survey, we invited an expert panel consisting of researchers, clinicians, consumer representatives, industry partners, healthcare managers, and policymakers to participate in a three-round e-Delphi. Expert panels were identified through the Expertscape website, PubMed database, social media, and a snowball approach. In Round 1, potential research priorities and terminologies were presented to panel members. Panel members rated the agreement of each research priority on a 5-point Likert scale and an 11-point numerical scale, and each terminology on a 5-point Likert scale for the "telehealth in musculoskeletal pain " field over rounds. At least 80% of the panel members were required to agree to be deemed a consensus. We analyzed the data descriptively and assessed the stability of the results using the Wilcoxon matched-pairs signed rank test.ResultsWe performed an international e-Delphi survey from February to August 2022. Of 694 invited people, 160 panel members participated in the first round, 133 in the second round (83% retention), and 134 in the third round (84% retention). Most of the panel members were researchers 76 (47%), clinicians 57 (36%), and consumer representatives 9 (6%) of both genders especially from Brazil 31 (19%), India 22 (14%), and Australia 19 (12%) in the first round. The panel identified fourteen telehealth research priorities spanned topics including the development of strategies using information and communication technology, telehealth implementation services, the effectiveness and cost-effectiveness of telehealth interventions, equity of telehealth interventions, qualitative research and eHealth literacy in musculoskeletal pain conditions from an initial list of 20 research priorities. The consensus was reached for "digital health" and "telehealth" as standard terminologies from an initial list of 37 terminologies.ConclusionAn international, multidisciplinary expert consensus recommends that future research should consider the 14 research priorities for telehealth musculoskeletal pain reached. Additionally, the terms digital health and telehealth as the most appropriate terminologies to be used in musculoskeletal telehealth research.RegisterOpen Science Framework ( https://osf.io/tqmz2/ ).

Dataset Information

International consensus recommendations on face transplantation: A 2-step Delphi study.

Publications

International consensus recommendations on face transplantation: A 2-step Delphi study.

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