3.3 Results of compliance rates of COS-STAD standards
The compliance rates of four criteria related to scope specification were greater than 95%. These included; ”research or practice setting(s) in which the COS is to be applied”, ”health condition covered by COS”, “the population covered by COS”, and “the intervention covered by COS”. Twenty-one studies (52.3%) were not clear whether stakeholders were involved in the COS development. Twenty-three studies (52.3%) clearly declared that health care professionals with experience of patients with the condition participated in the development of COS. Fourteen COSs (31.8%) clearly stated patients with the condition or their representatives were included in the process, but two COSs were not clear whether patients were involved in the study. Thirty-five studies (92.1%) did not consider the views of health care professionals and patients from literature reviews or interviews when compiling the initial list of outcomes. Twenty studies (60.5%) had no prior described scoring process, consensus definition, or criteria for including/dropping/adding outcomes. Besides, only twelve OG COSs (27.3%) had clear accessible registered details or published protocol. Forty-one studies (90%) were excluded to avoid ambiguity of language when COSs was used. (Fig.5) Table 4 shows there was no significant difference in total COS-STAR compliance standards of OG COSs between group one and group two. Compared with COSs without prior protocol or registered detailed, those studies with a priori protocol or registered details had greater compliance rates of the standard ”Priori describe scoring process”(OR=8.36, 95% CI:1.18,59.24, P=0.034), ”a consensus definition was described a priori” (OR=8.36, 95% CI:1.18,59.24, P=0.034), and ”criteria for including/dropping/adding outcomes were described a priori” (OR=8.36, 95% CI:1.18,59.24, P=0.034). COSs which involved a statistician, or epidemiologist authors had higher compliance rates on item 6 ”health care professionals with experience of patients with the condition involved with COS developed” (OR=0.82, 95% CI: 0.47-1.45, P= 0.512). Moreover, we observed significant differences between funding COSs and non-funding COSs related to the ”patients with the condition or their representatives” (OR= 3.35, 95% CI: 1.08 - 10.38, P= 0.036). (Table 5). Spearman’s correlation analysis revealed a statistically significant (p < 0.05) positive correlation between average citations per year and the compliance rates of COS-STAD for OG COSs. (Table 6).