The first Core Outcome Measures in Effectiveness Trials (COMET) workshop in Japan took place, in April 2013, at Kyoto University, stimulating debate about how the Japanese research and practice community might engage with this international initiative and make use of core outcome sets. Toshiaki Furukawa (Professor and Chair, Department of Health Promotion and Human Behaviour Professor, Department of Clinical Epidemiology, Kyoto University) and Rintaro Mori (Head, Department of Health Policy National Centre for Child Health and Development, Tokyo), worked with three of the COMET team (Paula Williamson, Liz Gargon, and Mike Clarke) to deliver the workshop. I attended, along with 80 others from across Japan, including researchers, trialists, systematic reviewers, statisticians, healthcare providers, and clinicians. There were small group activities to discuss the problems with outcomes and the need for a more scientific approach to outcomes, how core outcome sets could help, and how we might develop and use core outcome sets in Japan. These discussions were informed by an introduction to the COMET Initiative and their activities.
The concept of a core outcome set was new to many in the workshop, but it was well received and understood over the course of the day. A recurring theme was undertaking an international approach to core outcome set development, and participants identified particular challenging issues for Japan, such as the variability between healthcare systems and differences in language. There are further questions as well, about how to involve and integrate all stakeholders, especially, policymakers, regulatory, and patients.
This is a new era in Japan of evidence based medicine and health policy, and of increasing international cooperation. Japanese researchers are collaborating more with researchers around the world and making important contributions to the evidence for global healthcare. For example, in relation to outcomes, Japanese researchers have recently contributed to a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, and the pharmaceutical industry) to determine core outcome domains for atopic eczema trials . The Japanese satellite of the Cochrane pregnancy and childbirth group established in June 2012 by Professor Mori, and supported by the Cochrane Centres in Australia, the UK, and the USA, is another shining example of Japanese researchers’ growing contribution to global evidence. Furthermore, the satellite was set up not only to share research and editorial responsibility with the pregnancy and childbirth group, but also to provide support for Japanese Cochrane authors in all areas of Japan and nearby countries.
Participants in the workshop strongly agreed with the idea of core outcome sets for use in clinical trials and systematic reviews, and the need to continue to develop the methods for preparing and using core outcome sets. On top of the success of the workshop, it highlighted the next challenge, that is, how Japanese researchers can get more involved and collaborate in work on core outcome sets. We look forward to building on this enthusiasm and for opportunities for Japanese collaborators to get involved in the development of core outcome sets and future COMET activities, and to start to implement these in their own research and practice. This is an important initiative to help overcome waste in science and research when studies cannot be compared and contrasted, and to help doctors and healthcare providers make better informed decisions, which will ultimately lead to improved health and healthcare.
1) Schmitt J, Spuls P, et al. (2012). “Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.” Allergy 67(9): 1111-1117.
Naohiro Yonemoto is a section in chief of Department of Epidemiology and Biostatistics, Translational Medical Center, National Center of Neurology and Psychiatry, Japan.