American Society for Peripheral Nerve

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Ipluto - International Plexus Outcome Study Group: First Results
Willem Pondaag, MD, PhD; Martijn Malessy, MD, PhD
Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands

Background: It is difficult to assess from the available literature optimal treatment strategies for children with a neonatal brachial plexus palsy (NBPP) - or ‘obstetric brachial plexus lesion’. Comparison of outcome data presented by different centers is impossible due to the use of 1) many different outcome measures to evaluate results; 2) different follow-up periods after interventions and 3) different patient ages at the time of assessment.
Objective: The goal of the iPLUTO study group is to define a universal dataset to evaluate upper limb function of NBPP children. This dataset will allow for comparison of results between different clinics if prospectively used. The iPluto dataset should be regarded as the basic information that should be minimally be collected. The goal is to create an international minimal standard for evaluation and expression of results of treatment. Standardized time points for the collection of data should be used.
Methods: The main tool to reach consensus on the datasets is internet surveys in four rounds. A Delphi-derived technique will be applied. The first round of the internet surveys will use open end questions to record the methods that clinicians currently use. The second round will use the results of the first round. Participants will be asked to rate the different evaluation methods on validity and applicability using a Likert scale. In the third round, results of the second round will be revealed for each question, and participants are asked to rate the items again. In this way feedback from the second round will narrow the ratings of items during the third round. Participants will be asked if an item should be part of the minimal or extended dataset. After the third round, results will be analyzed whether a consensus is reached on the validity and applicability of specific items. Depending on the analysis, a fourth round may be necessary for specific items if consensus is not reached in the third round.
Results: The detailed results from the internet surveys will be presented at the meeting. The panel’s opinion on the use of passive range of motion, active range of motion, force, Active Movement Scale, a variety of scoring systems, and Patient Reported Outcome Measures will be discussed.


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