Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries

OBJECTIVE: To compare the views of participants from different income-status countries on outcome selection for a burn care Core Outcome Set (COS). METHODS: A retrospective analysis of data collected during a two round Delphi survey to prioritise the most important outcomes in burn care research. RESULTS: There was considerable agreement between participants from low- and middle-income countries (LMICs) and high-income countries (HICs) across outcomes. The groups agreed on 91% of 88 outcomes in round 1 and 92% of 100 in round 2. In cases of discordance, the consensus of participants from LMICs was to include the outcome and for participants from HICs to exclude. There was also considerable agreement between the groups for the top-ten ranking outcomes. Discordance in outcome prioritisation gives an insight into the different values clinicians from LMICs place on outcomes compared to those from HICs. Limitations of the study were that outcome rankings from international patients were not available. Healthcare professionals from LMICs were not involved in the final consensus meeting. CONCLUSION: COS developers should consider the need for a COS to be global at protocol stage. Global COS should include equal representation from both LMICs and HICs at all stages of development.