4.3 Methodological standards of included COSs
For COS-STAD checklist, more than 95% of COSs met all four standards
for scope specification. In addition, most clearly described the
research or practice setting in which COS was applied, and the health
condition, population, and intervention covered by the COS. The decision
as to which outcomes are core to measure, and why is an important
process. Fourteen COSs (31.8%) met all the three standards for the
domain of stakeholders involved; based on the author affiliations or
participant lists, twenty-four (54.5%) of COSs were developed by people
intending to use the COS in research, and health care professionals with
experience of patients with the condition; sixteen COSs (36.4%) did not
describe the inclusion of patients with the condition or their
representatives. All the stakeholders involved in the COS development
should be reported to ascertain whether the COS fully reflects the views
of important outcomes for the target population in the forthcoming
research. This would be conducive to the utilization and promotion of
the COS.23 Given the difficulty to judge the standards
of COS-STAD in the consensus process that was set in advance, we
determined whether the studies that met this standard rely on the
registration information and published protocol.19Only 27.3% of COSs priori described a consensus protocol, and some
registration information was inadequately reported, making it difficult
to judge whether some standards were set prior. We suggest that the
registration platform could improve the standards for COS registration,
thereby promoting the integrity and transparency of COS developed.
92.1% of COSs did not report whether the patient representatives
received a glossary of terms before completing the survey, which may
cause ambiguity of language. Compared with COSs without prior protocol
or registered detailed, those studies with a priori protocol or
registered detailed had higher compliance rates of “describe consensus
definition” and “criteria for including/dropping/adding outcomes
consensus process in advance.” Besides, we found that COSs developed
with statistical or epidemiologist authors incorporated the views of
healthcare professionals on important outcomes. Compared to cancer COSs,
OG COSs similarly had a high compliance rate for standards in the scope
domain, and low compliance rates for the standards in the field of
stakeholders involved and consensus process.19