COMET IV meeting summary

On two sunny days in Rome in November 2014, more than 200 people with an interest in core outcome sets (COS) from around the world gathered at The Pontificia Università Lateranense for the fourth meeting of the COMET Initiative. They came from 14 countries: Austria, Canada, Denmark, France, Germany, Ireland, Italy, Netherlands, Poland, Portugal, Romania, Switzerland, UK and USA. The programme was introduced by Liz Gargon (COMET Project Coordinator) and a summary of the coming days was provided by the chair of the COMET Management Group (Paula Williamson). Paula also presented the COMET strategic plan and provided a general update and progress report since the last meeting in Manchester in June 2013. Over the two days, the invited plenary talks were complemented by three workshops, 52 posters (50% more than the number at the 2013 meeting) and four contributed presentations. On 19 November, Roberto D’Amico (University of Modena) talked about the need for core outcome sets to improve evidence synthesis, and Silvio Garattini (IRCCSIstituto di Ricerche farmacologiche Mario Negri) followed him by discussing the use of surrogate and composite endpoints. He underlined the differences between core sets and these end points and explained how the latter did not always examine the outcomes most important to patients. This became a prominent theme throughout the meeting and was the focus of a dedicated session on 20 November focussing on patient engagement and involvement in COS development. A patient representative (Rosemary Humphreys – HOME Initiative) emphasised why core outcome sets are so important to patients, highlighting how patients looking for information on their conditions on the internet and elsewhere are confronted not only by the challenges of finding reliable information but, when they do, they might find themselves looking at trials that did not compare the same outcomes. She also stressed how doctors might know about the condition, while patients know about the impact. We also heard about the potential challenges of public involvement from the perspective of a COS developer (Iain Bruce, Royal Manchester Children’s Hospital). Iain spoke about the practical, but essential, aspects of arranging face to face meetings and ensuring comprehensive involvement from all sections of a patient group or society, including ‘hard to reach’ groups. Heather Bagley, COMET Patient and Public Involvement (PPI) coordinator, concluded this session with a presentation on ‘Involving people and the COMET PPI strategy’, which outlines COMET’s public involvement objectives and initial plans for public involvement activities. This report is available at http://www.comet-initiative.org/resources/ publicinvolvement. In a session designed to turn the generalities of developing COS, into the specifics of individual projects, we also heard from three COS developers (Christian Apfelbacher, University of Regensburg; Finn Gottrup, Copenhagen Wound Healing Center, Bispebjerg University Hospital, and Alessandro Chiarotto, VU University) about the methods used and their experiences of developing COS. Discussion included the importance of defining the scope of the COS from the outset and thinking about implementation early on in the process. This provided the foundation for later sessions, including one on COS development methodology (Sara Brookes, University of Bristol, and Sanna Prinsen, VU University). We also learned more about the relevance of COS to systematic reviews, in particular Cochrane Reviews. Holger Schünemann (McMaster University) highlighted the links to the GRADE summary of findings tables, suggesting that COS can help reviewers decide on the important outcomes to present in their tables. Valerie Smith (Trinity College Dublin) presented a survey of outcomes in Cochrane Reviews, emphasising that consistency of reporting of outcomes across and between Cochrane Review groups is a challenge and that Cochrane needs to play its part by using COS in their reviews to help overcome this. The example of pain as an * Correspondence: [email protected] University of Liverpool, Department of Biostatistics, Liverpool, UK Full list of author information is available at the end of the article Gargon et al. Trials 2015, 16(Suppl 1):M1 http://www.trialsjournal.com/content/16/S1/M1 TRIALS