Uptake of core outcome sets: A systematic review protocol

Core outcome sets (COS) have the potential to reduce waste in research by improving the consistency and relevance of outcomes measured in clinical trials for a specific health condition, thereby allowing evidence from trials to be synthesised and reducing outcome reporting bias. However, if researchers choosing outcomes for trials don’t apply COS, their continued development may contribute to, rather than reduce, research waste. Furthermore, patients, healthcare professionals and researchers will not realise the benefits that COS can offer.

It is important to assess uptake of COS to avoid waste through lack of implementation. An assessment of uptake can determine whether steps need to be taken to promote uptake or a review of the relevance of the COS is required. This systematic review will bring together studies that have assessed uptake of a particular COS by randomised controlled trials (RCTs) or systematic reviews (SRs) and investigate the level of uptake across difference areas of health.


1. To systematically identify all studies that have evaluated the uptake of a COS.
2. To explore the level of COS uptake across different areas of health.
3. To review the methods used to assess uptake of COS.


Karen Hughes PhD Student (1)
Paula Williamson Primary PhD Supervisor (1)
Mike Clarke Co-supervisor (2)


1 MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
2 Centre for Public Health, Institute of Clinical Sciences, Queen’s University Belfast, Royal Victoria Hospital, Belfast, United Kingdom

Further Study Information

Current Stage: Ongoing
Date: July 2018 - July 2020
Funding source(s): This work was supported by the MRC Network of Hubs for Trials Methodology Research (MR/L004933/1- Q30) and the MRC North West Hub for Trials Methodology Research (MR/K025635/1).

Health Area

Disease Category: Other

Disease Name: N/A

Target Population

Age Range: 0 - 120

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- None

Study Type

- Systematic review of COS uptake studies


- Systematic review

Information sources: Citation reports will be obtained via Scopus for all COS reports published between 1981 (year of the first COS report identified) and up to two years prior to the start of the search. The COS reports will be identified via systematic reviews published by the COMET Initiative. Weekly Scopus alerts will be set to identify studies of COS uptake that were published after the search cut-off date. No language restrictions will be applied to the search.
Inclusion criteria: Studies that have assessed uptake of the outcomes recommended by a particular COS developed for any condition, population or intervention. Studies will be included if they have assessed uptake of the COS outcomes, either individually or as a full set, by RCTs or SRs.
Study selection: The titles of articles that have cited a COS report will be searched for keywords relating to COS and uptake. Titles containing a keyword will be screened, followed by abstract screening. The full texts of potentially eligible studies will be assessed.
Data extraction: A data collection form will record:
• Disease category
• Disease name
• Scope of the uptake study
• Period covered by the assessment
• Number of RCTs/SRs assessed
• % RCTs/SRs that measured the full COS and/or % RCTs/SRs that measured each individual outcome in the COS
• Method used to assess uptake.

The results of the review will be presented descriptively using text and tables.

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