Maximising the impact of research effort by standardising outcomes in hearing research: "More bang for your buck"
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21 November 2016
Presenter(s): Professor Iain Bruce
Time: 13.00 -14.00
Location: NHBRU, Meeting Room 1
A recent editorial in the British Medical Journal has emphasised the critical importance of “establishing and requiring core outcomes to enable combination of data from multiple studies” under the banner of promoting the benefits of ‘big data’. Ultimately, it is envisaged that “…studies that are designed, conducted, and reported using a common language will have a greater scientific value because the datasets can be truthfully combined" (Koroshetz 2015). Heterogeneity of choice of outcome measurement between studies significantly lessens the ability to combine the results of studies in a clinical meaningful manner. If effectiveness studies do not report consistent outcome measures using agreed definitions and corresponding measurement instruments, their results cannot be combined and/or contrasted. Heterogeneity makes data synthesis in systematic reviews inherently difficult. Outcome reporting bias (ORB) occurs when only a selection of the 'significant' or 'positive' findings are reported resulting in a biased representation of the trial results. A solution to this problem is the standardisation of outcome measurement through the development of ‘core outcome sets’ (COS). A COS is an agreed minimum set of outcomes that should be measured and reported in all trials in a specific condition. The ideal COS would combine both patient/parent/carer and clinician opinion and could be used in the design of all subsequent clinical studies in the field. A COS is a recommendation of ‘what’ should be measured and reported in all trials in a specific area ( http://www.comet-initiative.org). Accompanying the domains in the COS should be an appropriate method to quantify the outcome (the ‘measurement instrument’ set) - ‘how’ - in addition to a recommendation for the timing of its use - ‘when’. Ultimately, standardizing ‘what’, ‘how’ and ‘when’ outcomes should be measured in research would significantly improve overall trial design and enable more reliable synthesis of evidence, in order to produce robust recommendations for optimal clinical practice.
Iain has worked as a Consultant Paediatric Otolaryngologist at the Royal Manchester Children’s Hospital since 2009 and is the Honorary Professor of Paediatric Otolaryngology, MAHSC, University of Manchester. He is a member of the Standing Scientific Committee of the ESPO and the council of the British Association of Paediatric Otolaryngology (BAPO). He is an Associate Director of the NIHR/Wellcome Manchester Children's CRF. His research interests complement his clinical sub-specialisations, focusing on childhood hearing loss, implantable hearing aids and airway obstruction in children. He is an assistant editor for Cochlear Implants International and member of the International Editorial Board for Clinical Otolaryngology.