Developing a core outcome set for distal tibia and ankle fractures (COSTA)

Accurate assessment of important outcomes provides essential evidence for judging the value and effectiveness of care. However, in distal tibia and ankle fractures, there is limited outcome reporting guidance. Heterogeneity in reporting and limited consideration of important patient outcomes undermines data synthesis and impedes the developing evidence base. The aim of this project is to develop a core outcome set for distal tibia and ankle fractures (COSTA).

The study will be supported by an interdisciplinary research team, wider international advisory group and a patient research partner group. Methods will include:
1. Systematic reviews of outcome reporting
2. Reviews of qualitative literature
3. Semi-structured interviews with patients
4. Focus groups with patients and professionals to generate outcome statements.
This will support the identification formulation of a list of potential outcome domains. The domains will then be prioritised through an international e-Delphi process with multiple stakeholders.


Kirstie Haywood (Principal Investigator)
Nathan Pearson
Elizabeth Tutton
Stephen Gwilym
Alexander Joeris

Further Study Information

Current Stage: Ongoing
Date: November 2019 - December 2021
Funding source(s): AO Foundation

Health Area

Disease Category: Orthopaedics & trauma

Disease Name: Distal tibia and ankle fractures

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Not specified

Stakeholders Involved

- Clinical experts
- Consumers (patients)
- Journal editors
- Methodologists
- Patient/ support group representatives
- Researchers
- Service providers
- Service users

Study Type

- COS for clinical trials or clinical research
- COS for practice


- Delphi process
- Focus group(s)
- Interview
- Nominal group technique (NGT)
- Systematic review