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. 2020 Jun 25;21(1):570.
doi: 10.1186/s13063-020-04403-1.

Core outcome sets through the healthcare ecosystem: the case of type 2 diabetes mellitus

Susanna Dodd  1 , Nicola Harman  2 , Nichole Taske  3 , Mark Minchin  3 , Toni Tan  3 , Paula R Williamson  2
Affiliations

Core outcome sets through the healthcare ecosystem: the case of type 2 diabetes mellitus

Susanna Dodd et al. Trials. .

Abstract

Background: It is increasingly accepted that insufficient attention has been given to the patient health outcomes that are important to measure in comparative effectiveness research that will inform decision-making. The relationship between outcomes chosen for comparative effectiveness research, outcomes used in decision-making in routine care, and outcome data recorded in electronic health records (EHR) is also poorly understood. The COMET Initiative (http://www.comet-initiative.org/. Accessed 3 Apr 2020) supports and encourages the development and use of 'core outcome sets' (COS), which represent the minimum set of patient health outcomes that should be measured and reported for a specific condition. There is growing interest in identifying how COS might fit into the different stages of the healthcare research and delivery ecosystem, and whether inclusion in the EHR might facilitate this.

Methods: We sought to determine the degree of overlap between outcomes within COS for research and routine care, EMA, FDA and NICE guidelines, NICE quality statements/indicators, EHR and a point-of-care randomised clinical trial, using type 2 diabetes (T2D) as a case study.

Results: There is substantial agreement about important patient outcomes for T2D for research and healthcare, with associated coverage within the UK general practice EHR.

Conclusions: This case study has demonstrated the potential for efficient research and value-based healthcare when the EHR can include COS for both research and care, where the COS comprises outcomes of importance to all relevant stakeholders. However, this concordance may not hold more generally, as the focus on patient-centred outcomes may well be greater in T2D than in other conditions. Work is ongoing to examine other clinical areas, in order to highlight any current inefficiencies when health outcomes in research and healthcare do not agree with core outcomes identified by patients, clinicians and other key stakeholders.

Keywords: Clinical guidelines; Core outcome sets; Electronic health records; Quality indicators; Quality standards.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Healthcare research ecosystem (adapted from NICE Connect)
See this image and copyright information in PMC

References

    1. COMET Initiative. Core outcome measures in effectiveness trials. http://www.comet-initiative.org/. Accessed 3 Apr 2020.
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    1. Gargon E. Choosing important health outcomes for comparative effectiveness research: a systematic review. PLoS One. 2014;9:e99111. doi: 10.1371/journal.pone.0099111. - DOI - PMC - PubMed

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