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Core outcome measurement set for clinical trials in dengue: an international Delphi consensus study (DEN-CORE)

  • Sophie Yacoub*
  • , Anastasia Demidova
  • , Xin Hui S. Chan
  • , Ali Ajam
  • , Dina Baimukhambetova
  • , Andreij Horn
  • , Evgeniia Kakotkina
  • , Mark Kosenko
  • , Aigun Mursalova
  • , Jennifer Ilo van Nuil
  • , Chi Le Phuong
  • , Lin Xiao
  • , Sudeep Adhikari
  • , Juan David Alzate Alvarez
  • , Kathryn B. Anderson
  • , Panisadee Avirutnan
  • , Stephanie Buchholz
  • , Richa Chandra
  • , Aileen Y. Chang
  • , Ho Quang Chanh
  • M. nika Patricia Consuegra Rodríguez, Vanessa Daniel, Janet V. Diaz, Claudia Figueiredo-Mello, Rosa Margarita Gelvez-Ramírez, Tran Bang Huyen, Evelyne Kestelyn, Phung Khanh Lam, Stije J. Leopold, Ruobing Li, Tran Luu, David Chien Boon Lye, Angela McBride, Isabelle Meyer-Andrieux, Nathaniel J. Moorman, Nguyet Minh Nguyen, Sharifah Faridah Syed Omar, Hang Cheng Ong, Eng Eong Ooi, Ekaterina Pazukhina, Sarah L. Pett, Diego Bastos Porto, Giri S. Rajahram, Marc Rogers, Elsa Rojas, James Rosen, Jamie Rylance, William H. K. Schilling, Andre M. Siqueira, Peter Sjö, Alfonso Sucerquia-Hernandez, Dong Thi Hoai Tam, Mauro Martins Teixeira, Andreas Tietz, Huynh Trung Trieu, Annalise Unsworth, Luis Villar, Adam Tully Waickman, James A. Watson, Bridget A. Wills, Po Ying Chia, Patricia Brasil, Thomas Jaenisch, Lucy Lum, Gathsaurie Neelika Malavige, Steven McGloughlin, Bharath Kumar Tirupakuzhi Vijayaraghavan, Laura Merson, Daniel Munblit*, DEN-CORE Study Group
*Corresponding author for this work
  • University of Oxford
  • Sechenov First Moscow State Medical University
  • Medical University of Vienna
  • Princess Marina Hospital
  • George Washington University
  • SUNY Upstate Medical University
  • Mahidol University
  • European Medicines Agency
  • Federal Institute for Drugs and Medical Devices
  • Novartis
  • Centro de Atención y Diagnóstico de Enfermedades Infecciosas
  • Drugs for Neglected Diseases initiative
  • World Health Organization
  • Instituto de Infectologia Emílio Ribas
  • National University of Singapore
  • Mahidol Oxford Tropical Medicine Research Unit
  • Novartis (China) Biomedical Research
  • National Centre for Infectious Diseases
  • Tan Tock Seng Hospital
  • Lee Kong Chian School of Medicine
  • University of North Carolina at Chapel Hill
  • University of Malaya
  • Duke-National University of Singapore Medical School
  • Queen Mary University of London
  • University College London
  • Universidade Federal do Ceará
  • Kementerian Kesihatan Malaysia
  • Rapidly Emerging Antiviral Drug Discovery Initiative
  • Fundação Oswaldo Cruz
  • Universidade Federal de Minas Gerais
  • University College London Hospitals NHS Foundation Trust
  • Westmead Hospital
  • Infectious Diseases Data Observatory
  • Heidelberg University 
  • Colorado School of Public Health
  • University of Sri Jayewardenepura
  • Monash University
  • Apollo Hospitals Group
  • The George Institute for Global Health
  • University of Edinburgh
  • Institut Pasteur de Dakar
  • King's College London

Research output: Contribution to journalReview articleAcademicpeer-review

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Abstract

Dengue, caused by any one of four distinct virus serotypes, is the most rapidly spreading mosquito-borne viral disease worldwide. It is a primary arboviral infection with increasing global incidence, driven by climate change, urbanisation, and the expanding range of Aedes mosquito vectors. Despite growing research interest, outcome and measurement instrument heterogeneity in dengue clinical trials remains high, limiting comparability and evidence synthesis. This project aimed to develop a globally relevant Core Outcome Measurement Set (COMS) for use in dengue clinical trials through international consensus. This consensus study followed core outcome measures in effectiveness trials and Core Outcome Set-Standards for Development (COS-STAD) guidelines and was conducted in two phases. Phase 1 focused on developing a Core Outcome Set (COS) through four steps: (1) a systematic literature review; (2) qualitative interviews with people with lived experience of dengue; (3) review by the management group and steering committee; (4) a two-round modified Delphi survey and structured online consensus meetings to finalise the COS for hospitalised and early stages of dengue disease. Input from critical care experts informed recommendations for the intensive care unit (ICU) and high dependency unit COS. Phase 2 consisted of a further two steps: (1) targeted review of outcome measurement instruments; and (2) a hybrid international consensus workshop to finalise the COMS. The agreed COMS for hospitalised dengue included seven outcomes; the early stage dengue COS included these outcomes plus four more. For critical care trials, use of existing ICU-specific COS was recommended. Unified definitions were developed for nine clinician-reported outcomes. The DEN-CORE COMS provides a consensus-based framework for harmonising outcome selection and measurement in dengue trials, improving comparability and supporting policy and clinical decision making.
Original languageEnglish
JournalThe Lancet Infectious Diseases
Early online date2025
DOIs
Publication statusE-pub ahead of print - 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being
  2. SDG 11 - Sustainable Cities and Communities
    SDG 11 Sustainable Cities and Communities
  3. SDG 13 - Climate Action
    SDG 13 Climate Action

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