Outcomes in intervention research on snakebite envenomation: a systematic review

Soumyadeep Bhaumik; Deepti Beri; Jyoti Tyagi; Mike Clarke; Sanjib Kumar Sharma; Paula R Williamson; Jagnoor Jagnoor

doi:10.12688/f1000research.122116.1

Outcomes in intervention research on snakebite envenomation: a systematic review

F1000Res. 2022 Jun 8:11:628. doi: 10.12688/f1000research.122116.1. eCollection 2022.

Authors

Soumyadeep Bhaumik^{1

2

3}, Deepti Beri², Jyoti Tyagi³, Mike Clarke⁴, Sanjib Kumar Sharma⁵, Paula R Williamson⁶, Jagnoor Jagnoor^{1

2}

Affiliations

¹ Injury Division, The George Institute for Global Health, Faculty of Medicine, University of New South Wales,, Sydney, New South Wales, 2042, Australia.
² Injury Division, The George Institute for Global Health, New Delhi, Delhi, 110025, India.
³ Meta-research and Evidence Synthesis Unit, George Institute for Global Health, New Delhi, Delhi, 110025, India.
⁴ Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
⁵ Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
⁶ Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK.

Abstract

Introduction: A core outcome set (COS) is a minimal list of consensus outcomes that should be used in all intervention research in a specific domain. COS enhance the ability to undertake meaningful comparisons and to understand the benefits or harms of different treatments. A first step in developing a COS is to identify outcomes that have been used previously. We did this global systematic review to provide the foundation for development of a region-specific COS for snakebite envenomation. Methods: We searched 15 electronic databases, eight trial registries, and reference lists of included studies to identify reports of relevant trials, protocols, registry records and systematic reviews. We extracted verbatim data on outcomes, their definitions, measures, and time-points. Outcomes were classified as per an existing outcome taxonomy, and we identified unique outcomes based on similarities in the definition and measurement of the verbatim outcomes.

Results: We included 107 records for 97 studies which met our inclusion criteria. These reported 538 outcomes, with a wide variety of outcome measures, definitions, and time points for measurement. We consolidated these into 88 unique outcomes, which we classified into core areas of mortality (1, 1.14 %), life impact (6, 6.82%), resource use (15, 17.05%), adverse events (7, 7.95%), physiological/clinical (51, 57.95%), and composite (8, 9.09%) outcomes. The types of outcomes varied by the type of intervention, and by geographic region. Only 15 of the 97 trials (17.04%) listed Patient Related Outcome Measures (PROMS).

Conclusion: Trials evaluating interventions for snakebite demonstrate heterogeneity on outcomes and often omit important information related to outcome measurement (definitions, instruments, and time points). Developing high quality, region-specific COS for snakebite could inform the design of future trials and improve outcome reporting. Measurement of PROMS, resource use and life impact outcomes in trials on snakebite remains a gap.

Keywords: Clinical Trials; Outcome Assessment; Patient Reported Outcome Measures; Snakebite; Systematic Review; Treatment Outcome.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Databases, Factual
Humans
Registries
Snake Bites* / therapy

Associated data

figshare/10.6084/m9.figshare.19777921.v1

Grants and funding

SB is supported by the University International Postgraduate Award (UIPA) by University of New South Wales (UNSW), Sydney, Australia. No external funding was received. The George Institute for Global Health invests internal resources for research on snakebite and on meta-research.