Inconsistencies in health research are well documented, affecting anyone trying to use this information to make a choice about healthcare or to cope with the abundance of data generated by researchers. Differences in how outcomes are defined and measured are common make it difficult, sometimes impossible, to synthesise research results and apply them in a meaningful way. To make a well informed choice, we need to be able to compare and contrast research findings on the basis of the same outcomes. Since the late 1970s, when the World Health Organisation published guidelines on the minimal requirements for reporting outcomes in cancer trials, initiatives in many areas have attempted to increase consistency by developing an agreed set of important outcomes that should be measured and reported by all studies of a specific condition. January 2010 saw the beginning of the COMET Initiative—an innovative project to bring together people with an interest in standardising outcomes for clinical trials and systematic reviews, with the aim of facilitating the development and application of core outcome sets . 180 days since the launch of the website, the COMET database provides an illustration of how it is helping to achieve this aim, and why this challenge needs to be met.
The COMET database is a publically available internet-based resource that collates knowledge about core outcome set development, and highlights the applied work that has been done across health. It makes it easier to find existing research, helping funders who may wish to fund work in this area to avoid duplication, and helping researchers who want to know what developments are underway. It includes planned and ongoing work as well as published papers about core outcome set development. 24 planned or ongoing studies in various areas of health are included already, with a further 29 in discussion, 133 published studies in various areas of health and healthcare have also been identified and there is systematic review underway.
The most recently added report was a review of the content and quality of 10,000 controlled trials in schizophrenia . It found that a shocking 2194 different scales had been used, meaning that a new rating instrument was introduced for every fifth trial. Understandably, the authors concluded that an increased effort is needed to develop and apply an agreed core set of outcomes in future trials. Papers like this highlight the importance of paying more attention to the choice of outcomes to be measured and reported in trials, and the importance of making this information available so that research in the future will be more consistent. The COMET database is one of the ways to achieve this, and 180 days after it was launched, we reached 2194 individual users, one for each of the scales in the schizophrenia trials. Many of these people use the resources that are presented to them directly on the website but many have run searches for core outcome sets and more than 900 such searches have been run to date. You can find out more about the COMET Initiative, and visit the database at http://www.cometinitiative.org/.
1. Williamson P, Altman D, Blazeby J, Clarke M, Gargon E. Driving up the quality and relevance of research through the use of agreed core outcomes. J Health Serv Res Policy. 2012;17(1):1-2.
2. Miyar J, Adams CE. Content and Quality of 10 000 Controlled Trials in Schizophrenia Over 60 Years. Schizophr Bull 2012;30:30.
Elizabeth Gargon is the COMET Project Coordinator.