In a landmark international collaboration published in The Lancet’s eClinicalMedicine, researchers have, for the first time, defined a globally standardized set of patient-centered outcome measures for adults with major injury. This initiative was developed by the International Consortium for Health Outcomes Measurement (ICHOM) Major Injury Working Group and included vital contributions from members of CNTR’s Injury Research Engagement Panel (IREP)—notably Kelly Lang, Candi Diaz, and Debra Marvel, whose lived experience as trauma survivors informed every stage of this consensus process. CNTR member organizations, the American Trauma Society and Trauma Survivors Network, were acknowledged for their support as well.

Toward a Common Global Language for Trauma Outcomes

Major injury remains one of the world’s leading causes of death and disability, yet measuring patient outcomes has long been inconsistent across regions and systems. To address this, ICHOM convened 28 multidisciplinary experts and patient representatives from 11 countries—spanning Australia, South Africa, the Netherlands, Saudi Arabia, Japan, and the U.S.—to establish a shared set of measures for benchmarking care quality and advancing value-based trauma care.

Using a rigorous, Delphi-based consensus process, the team reviewed nearly two decades of global research and conducted multiple surveys among trauma clinicians, researchers, and patients. Their efforts culminated in a Major Injury Outcome Set consisting of 26 outcomes (22 patient-reported and 4 clinician-reported) across four key domains:

1. Patient-reported health status
2. Functioning
3. Psychological well-being and mental health
4. Clinical outcomes

Validated outcome tools—such as the EQ-5D-5L, PROMIS, and PC-PTSD scales—were endorsed to ensure consistency and practicality in clinical and research settings. The team also identified 30 case-mix variables (including demographic and clinical factors) and standardized follow-up intervals at baseline, six months, and one year.

The Patient Voice at the Center

What distinguishes this work is its integration of patient and survivor perspectives. Because the ICHOM Patient Advisory Group included patients, the working group ensured that the measures reflected what matters most to those recovering from trauma—such as pain, disability, return to function, mental health, and quality of life.

Lang, Diaz, and Marvel’s contributions underscore the transformative role of patient engagement in shaping research that not only measures outcomes but also drives improvements in recovery, rehabilitation, and survivorship.

Next Steps: From Consensus to Implementation

The Major Injury Set will now guide trauma systems, registries, and researchers worldwide in measuring and comparing outcomes consistently across settings—from high-income trauma centers to emerging systems in middle-income regions. The authors note that further work is needed to validate the set in low-resource environments to ensure global equity.

The full article, “Development of a set of patient-centered outcome measures for patients with major injury: Delphi-based consensus recommendations from the ICHOM Major Injury Working Group,” is available open-access via The Lancet’s eClinicalMedicine HERE.