Standardising outcomes in Cochrane Pregnancy Childbirth Systematic Reviews

Article type
Year
Authors
Jones L1, Hampson L1, Kellie F1, Bridson J2, Alfirevic Z1
1Cochrane Pregnancy and Childbirth Group, UK
2University of Liverpool, UK
Abstract
Background: Cochrane Pregnancy and Childbirth (CPC) are currently looking at ways to improve the consistency of outcomes in their reviews. One way to achieve this could be through the adoption of core outcome sets (COS).

The first step is to map out COS development in pregnancy and childbirth. The Core Outcome Measures in Effectiveness Trials (COMET) database is the most comprehensive source of information relating to COS in healthcare. One of the aims of the COMET initiative is to link development and use of COS with the outcomes specified and reported in Cochrane Reviews.

Objectives: To identify existing/planned COS in pregnancy and childbirth. To conduct a survey of current CPC reviews to identify whether COS are used as a basis for defining outcomes in the methods or in the 'Summary of findings' (SoF) table.

Methods: We searched the COMET database (24 January 2016) to identify COS in pregnancy and childbirth. We summarised the number of published or ongoing COS. We undertook a descriptive survey of current CPC reviews and examined how many used a COS to inform the outcomes of the review and those in the SoF table.

Results: Out of all records in the COMET database 4% (30/723) relate to pregnancy and childbirth. Forty per cent (12/30) of this work is completed and 60% (18/30) is ongoing. In nearly half of all work identified, a CPC editor or author is involved in its development. Only 2% of reviews (12/522) reported that they used a COS in determining which outcomes to specify in the methods of the review. None of the CPC reviews stated specifically that they used a COS to guide selection of outcomes to present in the SoF table.

Conclusions: Clearly work is ongoing in the development of COS within pregnancy and childbirth. However, CPC systematic reviews rarely refer to a COS as a source for determining outcomes. None refer to their use in determining outcomes in the SoF table. A key final stage in COS development is implementation. It is imperative that once developed, COS are used by CPC systematic reviews. We propose a number of ways in which implementation could be achieved.