International Position Paper on Outcome Selection After Aneurysmal Subarachnoid Hemorrhage

BACKGROUND: The health outcomes currently reported in aneurysmal subarachnoid hemorrhage (aSAH) research lack consistency and do not sufficiently reflect what is important to people most affected. The objective of this article was to establish consensus on the aspects of health (domains) clinicians and researchers should measure in aSAH research. METHODS: Informed by 2 international prioritizing surveys (involving 239 participants from over 25 countries and 6 continents), we used established consensus methodology in a hybrid in-person/online consensus meeting to establish which domains of health researchers should measure in aSAH research. Sixty-nine participants with lived experience with aSAH (35%), clinical and research leaders (62%), or from aSAH-related charity (3%) took part. International multidisciplinary working groups established consensus definitions for each domain. RESULTS: Consensus (>70% endorsement) was sought on a proposed group of 6 domains of health, and failing that, each domain individually. The 6 domains which reached consensus and were formally defined are (1) health-related quality of life, (2) survival, (3) cognition and executive function, (4) functional outcome, (5) delayed cerebral ischemia and cerebral infarction, and (6) rebleeding and aneurysm obliteration. CONCLUSIONS: This International Position Statement reports the consensus process undertaken and the core domain set established to guide the choice of outcomes for evaluating new treatments for aSAH. It will ultimately help shape the future aSAH research agenda.