Patient research partners in core outcome set development: a systematic review

A core outcome set (COS) is a minimal set of outcomes that clinical trials in a specific health or health-care area should report. Patient research partners (PRPs) should engage in all stages of COS development (coleading and codeveloping the COS). PRPs contribute the lived experience of a condition, and this perspective can improve the quality and uptake of COSs. However, there is variability in PRP responsibilities, which can impede meaningful involvement in COS development. The study aims to systematically review the roles of PRPs in COS development studies and compare their involvement strategies with available guidance.

We included ongoing and completed COS development studies published in English that involved PRPs. We searched Medline, Embase, and Web of Science on September 15, 2023. We applied COS-Standards for Development to assess the quality of the COS. We extracted, tabulated, and described details of the COS development studies.

Our searches identified 2261 unique records, of which we included 94 articles describing 64 COS development studies. The earliest publication was in 2014. Forty-one (64%) studies cited the Core Outcome Measures in Effectiveness Trials (COMET) Handbook when designing patient engagement for COS development. Among research team members, the proportion who was PRPs was similar in studies that cited the COMET Handbook (17%) and in those that did not (17%). Sixty-nine percent of studies included PRPs but did not specifically include this nomenclature, and 31% also involved PRPs in other activities, such as Delphi studies and interviews. The studies described various PRP tasks, the most frequent of which were guiding the process (70%) and designing questionnaires (64%).

This systematic review identified variations in PRP terminology, roles, and engagement across existing COS studies. We recommend that researchers refer to established guidelines, such as the COMET Handbook, for consistent PRP terminology and definitions. Such guidance can also help identify appropriate avenues for engaging patients as partners throughout the COS development process. These findings lay the foundation for future PRP involvement, aiming to balance meaningful engagement with feasibility in COS development.