Delphi study to develop a core outcome set for inpatient pain assessment after cesarean delivery

S Ciechanowicz; B Carvalho; J Berger; P Duch; P Flood; R Ffrench-O'Carroll; H Sviggum; S Hakimi; D Jethava; M Mieszkowski; A Merriam; S Osmundson; U Ituk; J Wagner Kovacec; P Sultan

doi:10.1016/j.accpm.2025.101556

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Delphi study to develop a core outcome set for inpatient pain assessment after cesarean delivery

Journal article

Peer reviewed

Delphi study to develop a core outcome set for inpatient pain assessment after cesarean delivery

S Ciechanowicz, B Carvalho, J Berger, P Duch, P Flood, R Ffrench-O'Carroll, H Sviggum, S Hakimi, D Jethava, M Mieszkowski, …

Anaesthesia critical care & pain medicine, Vol.44(5), 101556

09/2025

DOI: 10.1016/j.accpm.2025.101556

PMID: 40441486

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Abstract

Studies of cesarean delivery pain report different outcomes, restricting data pooling. The study aimed to develop a core outcome set for inpatient postoperative pain assessment after cesarean delivery to use for research and clinical practice, using the Delphi consensus methodology. A scoping review identified 37 initial outcomes, with 2 additional outcomes developed from a focus group. These were rated in a two-round Delphi survey completed by the focus group consisting of authors of studies from the scoping review (n = 9), supplemented with other experts (n = 5) and patients with recent lived experience (n = 7). Scores were on a 1-5 Likert scale, 1-2 being 'critical for inclusion'; 3 being 'important but not critical', and 4-5 of 'limited importance/invalid'. Outcomes were included if recommended by ≥70% of stakeholders after voting. A third-round virtual meeting determined domains, and several further rounds of online surveys, the specific measures. Round one included 14 experts and 7 patients. Round two included 12 experts and 4 patients (76% response). The virtual meeting was attended by 11 experts and 3 patients (67%), and the 4 online surveys were completed by 67%, 52%, 67%, and 76% of the focus group. The final domains included pain intensity: at rest, movement-evoked, and pain relief; pain interference; total consumption of opioids; and maternal adverse effects. 12 measures for domains were agreed upon. Getting out of a hospital bed was selected as the most relevant functional activity for movement-evoked pain after cesarean delivery. This core outcome set may be applied to future research and clinical practice.

Cesarean delivery

Postoperative pain

Core outcome set

Delphi

Details

Title: Subtitle: Delphi study to develop a core outcome set for inpatient pain assessment after cesarean delivery
Creators: S Ciechanowicz - Stanford University
B Carvalho - Stanford University
J Berger - George Washington University
P Duch - Zealand University Hospital
P Flood - Stanford University
R Ffrench-O'Carroll - Children's Health Ireland at Crumlin
H Sviggum - Mayo Clinic Hospital
S Hakimi - Ege University
D Jethava - Mahatma Gandhi Mission Medical College and Hospital
M Mieszkowski - University of Warmia and Mazury in Olsztyn
A Merriam - Yale University
S Osmundson - Vanderbilt University Medical Center
U Ituk - University of Iowa
J Wagner Kovacec - University Clinical Centre Maribor
P Sultan - Stanford University
Resource Type: Journal article
Publication Details: Anaesthesia critical care & pain medicine, Vol.44(5), 101556
DOI: 10.1016/j.accpm.2025.101556
PMID: 40441486
NLM abbreviation: Anaesth Crit Care Pain Med
ISSN: 2352-5568
eISSN: 2352-5568
Publisher: ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
Grant note: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University
Funding Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, grant funding of Prof Pervez Sultan.
Language: English
Electronic publication date: 05/27/2025
Date published: 09/2025
Academic Unit: Anesthesia
Record Identifier: 9984827332902771

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