Reaching Consensus on Long Covid Symptoms and Patient-Reported Outcomes Across the Veterans Health Administration Using a Modified Hybrid Nominal Group-Delphi Approach

Bibliographic Data

ID9104353
AuthorsAmelia E Schlak (0000-0003-3078-6799, Department of Veterans Affairs, Health System Research Portfolio, Office of Research and Development, Washington, DC, corresponding author), Ilana Seidel (San Francisco VA Health Care System, San Francisco, CA), Omar Awan (Washington DC VA Medical Center, Washington, DC), Jacqueline Neal (Jesse Brown VA Medical Center, Chicago, IL), Mayuree Rao (0000-0002-0874-8238, VA Puget Sound Health Care System, Seattle, WA, corresponding author), Kristin Janssen (Department of Veteran Affairs, Clinical Services, Washington, DC), Kayla Janssen (Health Services Research & Development), Debra Warner (Department of Veteran Affairs, Clinical Services, Washington, DC), Debra A Warner (Health Services Research & Development), Kelli Lee (Department of Veteran Affairs, Clinical Services, Washington, DC), Angela Y S Park (0000-0003-3420-942X, Health Services Research & Development), Angela Park (Department of Veteran Affairs, Clinical Services, Washington, DC), Marian Adly (Department of Veterans Affairs, National Artificial Intelligence Institute, Office of Research and Development, Washington, DC), Elizabeth Brill (0000-0001-6182-3113, Department of Veteran Affairs, Clinical Services, Washington, DC), David Atkins (0000-0003-1381-6861, Washington DC VA Medical Center, Washington, DC), Barbara Jones (0000-0003-2717-6076, University of Utah), Barbara E Jones (0000-0001-9985-3860, Department of Veterans Affairs, Informatics Decision Enhancement and Analytic Sciences Center of Innovation, Salt Lake City, UT), Pandora L Wander (0000-0003-3671-1464, VA Puget Sound Health Care System, Seattle, WA, corresponding author)
Year2025
Volume63
Issue11
Pages842-850
Publication date2025-11-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002194
PMID41081723
OpenAlexW4415128488
LanguageEN
References cited14

BACKGROUND: A consistent approach to track Long COVID symptoms at the Veterans Health Administration (VHA) was lacking. OBJECTIVES: To reach consensus among clinical stakeholders on how long COVID symptoms should be assessed at VHA outpatient visits and recommend an assessment battery. RESEARCH DESIGN: Hybrid Delphi-Nominal Group approach. SUBJECTS: Members of the VHA Long COVID Field Advisory Board (FAB) and the VHA Long COVID Community of Practice (CoP) participated. Veteran stakeholders provided input. MEASURES: A literature review and clinician questionnaires identified 68 instruments across 14 symptom domains. In the first consensus round, FAB members excluded instruments with limited clinical usability. The remaining 25 instruments were ranked by CoP members. Multiple rounds of asynchronous voting were conducted until one instrument remained per domain. The top instruments were grouped into 3 batteries. Final consensus on a preferred battery was reached through additional voting. Veterans from the Los Angeles Veteran Engagement Panel assessed clarity, burden, and feasibility. RESULTS: The final battery included the Modified Yorkshire COVID-19 Rehabilitation Survey, VHA Whole Health Well-Being Signs, the Exercise Vital Signs Questionnaire, and the 2-Minute Step Test. Whole Health questions were also included to support the VHA's Whole Health System mission. Symptom-specific instruments already used in VHA routine care were not included in the final battery, as clinics already had access to them. CONCLUSIONS: A structured, rapid consensus process was used to identify a battery of symptom instruments to standardize Long COVID symptom assessment across VHA clinics

2019-20 coronavirus outbreak · Administration (probate law) · Coronavirus disease 2019 (COVID-19) · Coronavirus Infections · MEDLINE · Pandemic · Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) · Veterans Affairs · Chronic Obstructive Pulmonary Disease (COPD) Research · Intensive Care Unit Cognitive Disorders · Long-Term Effects of COVID-19

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