Nancy Medley

Choosing important health outcomes for comparative effectiveness research: a systematic review.

Background A core outcome set (COS) is a standardised set of outcomes which should be measured and reported, as a minimum, in all effectiveness trials for a specific health area. This will allow results of studies to be compared, contrasted and combined as appropriate, as well as ensuring that all trials contribute usable information. The COMET (Core Outcome Measures for Effectiveness Trials) Initiative aims to support the development, reporting and adoption of COS. Central to this is a publically accessible online resource, populated with all available COS. The aim of the review we report here was to identify studies that sought to determine which outcomes or domains to measure in all clinical trials in a specific condition and to describe the methodological techniques used in these studies. Methods We developed a multi-faceted search strategy for electronic databases (MEDLINE, SCOPUS, and Cochrane Methodology Register). We included studies that sought to determine which outcomes/domains to measure in all clinical trials in a specific condition. Results A total of 250 reports relating to 198 studies were judged eligible for inclusion in the review. Studies covered various areas of health, most commonly cancer, rheumatology, neurology, heart and circulation, and dentistry and oral health. A variety of methods have been used to develop COS, including semi-structured discussion, unstructured group discussion, the Delphi Technique, Consensus Development Conference, surveys and Nominal Group Technique. The most common groups involved were clinical experts and non-clinical research experts. Thirty-one (16%) studies reported that the public had been involved in the process. The geographic locations of participants were predominantly North America (n = 164; 83%) and Europe (n = 150; 76%). Conclusions This systematic review identified many health areas where a COS has been developed, but also highlights important gaps. It is a further step towards a comprehensive, up-to-date database of COS. In addition, it shows the need for methodological guidance, including how to engage key stakeholder groups, particularly members of the public.

Methods to induce labour: A systematic review, network meta-analysis and cost-effectiveness analysis

To compare the clinical effectiveness and cost‐effectiveness of labour induction methods.

Choosing Important Health Outcomes For Comparative Effectiveness Research: A Systematic Review.

Background: A core outcome set (COS) is a standardised set of outcomes which should be measured and reported, as a minimum, in all effectiveness trials for a specific health area. This will allow results of studies to be compared, contrasted and combined as appropriate, as well as ensuring that all trials contribute usable information. The COMET (Core Outcome Measures for Effectiveness Trials) Initiative aims to support the development, reporting and adoption of COS. Central to this is a publically accessible online resource, populated with all available COS. The aim of the review we report here was to identify studies that sought to determine which outcomes or domains to measure in all clinical trials in a specific condition and to describe the methodological techniques used in these studies. Methods: We developed a multi-faceted search strategy for electronic databases (MEDLINE, SCOPUS, and Cochrane Methodology Register). We included studies that sought to determine which outcomes/domains to measure in all clinical trials in a specific condition. Results: A total of 250 reports relating to 198 studies were judged eligible for inclusion in the review. Studies covered various areas of health, most commonly cancer, rheumatology, neurology, heart and circulation, and dentistry and oral health. A variety of methods have been used to develop COS, including semi-structured discussion, unstructured group discussion, the Delphi Technique, Consensus Development Conference, surveys and Nominal Group Technique. The most common groups involved were clinical experts and non-clinical research experts. Thirty-one (16%) studies reported that the public had been involved in the process. The geographic locations of participants were predominantly North America (n = 164; 83%) and Europe (n = 150; 76%). Conclusions: This systematic review identified many health areas where a COS has been developed, but also highlights important gaps. It is a further step towards a comprehensive, up-to-date database of COS. In addition, it shows the need for methodological guidance, including how to engage key stakeholder groups, particularly members of the public. Citation: Gargon E, Gurung B, Medley N, Altman DG, Blazeby JM, et al. (2014) Choosing Important Health Outcomes for Comparative Effectiveness Research: A Systematic Review. PLoS ONE 9(6): e99111. doi:10.1371/journal.pone.0099111 Editor: Roberta W. Scherer, Johns Hopkins Bloomberg School of Public Health, United States of America Received February 10, 2014; Accepted May 8, 2014; Published June 16, 2014 Copyright: 2014 Gargon et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work was funded by the MRC MRP (Medical Research Council Methodology Research Panel), grant number MR/J004847/1; and European Union Seventh Framework Programme ([FP7/2007-2013] [FP7/2007-2011]) under grant agreement nu 305081. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: DGA, JB, MC and PRW are members of the COMET Management Group and co-applicants on grants to support COMET and related work. EG is a member of the COMET Management Group and is the COMET Project Co-ordinator. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. * Email: e.gargon@liv.ac.uk

Clinical guidelines for prevention and management of preterm birth: a systematic review

Clinical practice guidelines (CPG) endorse multiple strategies to prevent or manage preterm birth (PTB).

Outcomes reported in trials of methods for the induction of labour

Background Labour inductions have increased steadily over the past two decades, with overall rates in many countries now exceeding 20% of all births. We have conducted a systematic review, network meta-analysis and cost-effectiveness analysis to determine which treatments for induction perform best on pre-specified safety and efficacy outcomes. This poster reports analysis of the outcomes reported in trials.

Interventions during pregnancy to prevent spontaneous preterm birth: an overview of Cochrane systematic reviews

This is a protocol for a Cochrane Review (Overview). The objectives are as follows: Our objective is to produce an overview of the evidence in the Cochrane Database of Systematic Reviews for antepartum interventions to prevent spontaneous preterm birth. We also aim to identify interventions with the potential to impact spontaneous preterm birth and to make recommendations for future systematic reviews and clinical research.