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J Invest Dermatol. 2019 May;139(5):1045-1053. doi: 10.1016/j.jid.2018.11.019. Epub 2018 Dec 5.

Cochrane Reviews and Dermatological Trials Outcome Concordance: Why Core Outcome Sets Could Make Trial Results More Usable.

Author information

1
Center for Evidence-Based Healthcare, Medical Facults Carl Gustav Carus, Technische Universität Dresden, Dresden Germany. Electronic address: Jochen.Schmitt@uniklinikum-dresden.de.
2
Center for Evidence-Based Healthcare, Medical Facults Carl Gustav Carus, Technische Universität Dresden, Dresden Germany.
3
Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
4
Department of Epidemiology and Biostatistics, Amsterdam Universitair Medische Centra, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
5
Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt/Main, Germany; Working Group Evidence-Based Medicine Frankfurt, Institute for General Practice, Goethe University Frankfurt, Frankfurt/Main, Germany.
6
Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
7
Working Group Evidence-Based Medicine Frankfurt, Institute for General Practice, Goethe University Frankfurt, Frankfurt/Main, Germany.
8
Centre for Evidence-Based Dermatology, University of Nottingham, Nottingham, UK.
9
Department of Dermatology, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands.
10
Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.

Abstract

Evidence-based health care requires that relevant outcomes for patients are included in clinical trials investigating treatment effects, allowing subsequent systematic reviews to summarize all relevant evidence to guide clinical practice. Currently, no gold standard of outcome choice for dermatology trials and reviews exists. We systematically assessed concordance between efficacy outcomes in a random sample of 10 Cochrane Skin systematic reviews and the 220 dermatology trials included. Reviews did not include 742 (68%) of the 1,086 trial outcomes. Of the 60 outcomes the reviews sought, 17 (28%) were not reported in any trial, while 12 were assessed in <50% of trials. For 11 of 23 (48%) primary review outcomes, meta-analysis was impossible, because trial outcomes were absent or unclear. This small overlap of review/trial outcomes could suggest that trials are not measuring the outcomes perceived to be the most important by patients, clinicians, systematic reviewers, and trialists. The lack of standardized outcome measures, poor reporting of outcomes in trials, and low concordance of outcomes between reviews and primary studies could be improved by the development and implementation of Core Outcome Sets. These are an agreed-upon minimum set of key outcomes, for specified conditions, to be reported in all trials.

PMID:
30528825
DOI:
10.1016/j.jid.2018.11.019

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