O111 Defining humanitarian surgery: an international Delphi process

Abstract Introduction Over the last decade there has been an exponential increase in the terms “global surgery” and “humanitarian surgery”. However, the terms are often used interchangeably and there is no fixed definition of ‘humanitarian surgery’. This makes it difficult to compare interventions, outcomes and cost effectiveness since a wide variety of activities are included in these global or humanitarian surgery programmes. Methods A Delphi process was used over 3 rounds using online software to facilitate responses. A core set of academics and global surgery leaders were invited by targeted email and a snowball sampling effect was used to target responses form Low/Middle Income Countries. Predetermined inclusion criteria were used to ensure the validity of respondents. A Likert scale of 1-6 was used, group agreement was indicated by a median of 3 4 and group consensus was indicated by an interquartile range of £ 2. Intraclass correlation was used to assess stability of response. Results Round 1 generated 25 statements, across 4 themes: Who, What, Where and When. Of these, 10 reached agreement and consensus after Rounds 2 and 3. These 10 statements were then used as the basis for the definition of ‘Humanitarian Surgery’. Conclusion By agreeing the definition of ‘Humanitarian Surgery’, this will allow comparison of activities within the field to ensure they are appropriate, provide a high quality of care and are cost effective. Debate should now move to focus on ensuring Humanitarian Surgery is delivered to the highest possible standard wherever and whenever it is required.