Protocol for CAMUS Delphi Study: A Consensus on Comprehensive Reporting and Grading of Complications after Urological Surgery.

Background: Reproducible assessment of postoperative complications is essential for reliable evaluation of quality of care to enable comparison between healthcare centres and ensure transparent patient counselling. Currently, significant discrepancies exist in complication reporting and grading due to heterogeneous definitions and methodolo-gies. Objective: To develop a standardised and reproducible assessment of perioperative com-plications and overall associated morbidity, to allow for the construction of a uniform language for complication reporting and grading. Design, setting, and participants: The 12-part REDCap-based Delphi survey was devel-oped in conjunction with methodologist review and experienced urologist opinion. International urologists, anaesthetists, and intensive care unit specialists will be included. A minimum sample size of 750 participants (500 urologists and 250 critical care specialities) is targeted. Outcome measurements and statistical analysis: The survey assesses participant demo-graphics, opinion on complication reporting and the proposed Complications After Major & Minor Urological Surgery (CAMUS) reporting recommendations, grading of interven-tion events using the existing Clavien-Dindo classification and the proposed CAMUS classification, and rating of various clinical scenarios. Consensus will be defined as >= 75% majority agreement. If consensus is not reached, then subsequent Delphi rounds will be performed under steering committee guidance. Results and limitations: Twenty-one participants completed the draft survey. The med-ian survey completion time was 128 min (interquartile range 88-135). The survey revealed that 90% of participants believe that the current complication classification systems are useful but inaccurate, while 100% of participants believe that there is a uni-versal demand for reporting consensus. Several amendments were made following feed-back. Limitations include complexity of the proposed supplemental grades and time to completion of the survey. Conclusions: To ensure comprehensive and comparable complication reporting and grading across centres worldwide, a conclusive uniform language for complication reporting must be created. We intend to address shortcomings of the current complica-tion reporting and classification systems with a new CAMUS classification system devel-oped through multidisciplinary expert consensus obtained through a Delphi survey. Ultimately, standardisation of urological complication reporting and grading may improve patient counselling and quality of care. Patient summary: The reporting and grading of operative complications that occur dur-ing or after an operation and associated costs provide a means to stratify quality of patient care. Current complication reporting and classification systems are not standard-ised and somewhat inaccurate, and thus significantly underestimate patient morbidity and surgical risk. This Delphi survey will provide the basis for the creation of a uniform complication reporting and grading system. Our new system may allow improved reporting and grading between centres, and ultimately improve patient counselling and care. (c) 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.