STIMULATE-ICP-Delphi (Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways Delphi): Study protocol

  1. Christina M. van der Feltz-Cornelis
  2. Jennifer Sweetman
  3. Gail Allsopp
  4. Emily Attree
  5. Michael G. Crooks
  6. Daniel J. Cuthbertson
  7. Denise Forshaw
  8. Mark Gabbay
  9. Angela Green
  10. Melissa Heightman
  11. Toby Hillman
  12. Lyth Hishmeh
  13. Kamlesh Khunti
  14. Gregory Y. H. Lip
  15. Paula Lorgelly
  16. Hugh Montgomery
  17. W. David Strain
  18. Emma Wall
  19. Caroline Watkins
  20. Nefyn Williams
  21. Dan G. Wootton
  22. Amitava Banerjee
  23. for the STIMULATE-ICP Consortium

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Abstract

As mortality rates from COVID-19 disease fall, the high prevalence of long-term sequelae (Long COVID) is becoming increasingly widespread, challenging healthcare systems globally. Traditional pathways of care for Long Term Conditions (LTCs) have tended to be managed by disease-specific specialties, an approach that has been ineffective in delivering care for patients with multi-morbidity. The multi-system nature of Long COVID and its impact on physical and psychological health demands a more effective model of holistic, integrated care. The evolution of integrated care systems (ICSs) in the UK presents an important opportunity to explore areas of mutual benefit to LTC, multi-morbidity and Long COVID care. There may be benefits in comparing and contrasting ICPs for Long COVID with ICPs for other LTCs.

Methods and analysis

This study aims to evaluate health services requirements for ICPs for Long COVID and their applicability to other LTCs including multi-morbidity and the overlap with medically not yet explained symptoms (MNYES). The study will follow a Delphi design and involve an expert panel of stakeholders including people with lived experience, as well as clinicians with expertise in Long COVID and other LTCs. Study processes will include expert panel and moderator panel meetings, surveys, and interviews. The Delphi process is part of the overall STIMULATE-ICP programme, aimed at improving integrated care for people with Long COVID.

Ethics and dissemination

Ethical approval for this Delphi study has been obtained (Research Governance Board of the University of York) as have approvals for the other STIMULATE-ICP studies. Study outcomes are likely to inform policy for ICPs across LTCs. Results will be disseminated through scientific publication, conference presentation and communications with patients and stakeholders involved in care of other LTCs and Long COVID.

Registration

Researchregistry: https://www.researchregistry.com/browse-the-registry#home/registrationdetails/6246bfeeeaaed6001f08dadc/ .

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  1. Version published to 10.1371/journal.pone.0277936
  2. Version published to 10.1101/2022.04.06.22273514v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2022.04.06.22273514: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Participants from Survey 1, willing and able to provide informed consent, will be invited (using a separate survey link) to express interest in participating in an interview to discuss their experiences of healthcare relating to Long COVID and/or LTCs.
    Sex as a biological variablenot detected.
    RandomizationStudy design and procedures: This STIMULATE-ICP-DELPHI sub-study of the STIMULATE-ICP project (Symptoms, Trajectory, Inequalities and Management: Understanding Long COVID to Address and Transform Existing Integrated Care Pathways).(33) (Figure 1) STIMULATE-ICP is funded by the National Institute for Health Research (NIHR: COV-LT2-0043)(34) and combines clinical epidemiological studies, a complex randomised trial exploring the benefit of an ICP for Long COVID (IRAS: 1004698), and mixed methods studies exploring inequalities of care and transferability of the ICP to other LTCs (IRAS: 303958).
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The Delphi approach is a structured method for collecting opinions of experts concerning a subject of their expertise, reaching consensus over a number of rounds.
    Delphi
    suggested: (DelPhi, RRID:SCR_008669)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2022.04.06.22273514v1 on medRxiv