Discussion
Main findings
This comprehensive systematic review goes someway to update the previous
work of Duffy et al.,6 which included three completed
core outcome sets relevant to maternal health. Our multi-faceted search
strategy identified 32 unique citations relating to 26 core outcome
sets: 17 maternal and 9 neonatal COS. Almost half the COS included in
the current review had not been included in previous reviews (n = 12)
indicating significant progress in COS development. Recently developed
COS-STAD criteria were applied to evaluate each COS against minimum
standards.8 No COS met all the minimum standards.
While scope was well addressed in all COS, patient participation in both
stakeholder group and initial outcome generation are areas in need of
greater attention. Our findings further indicated greater attention is
needed to improve the methods used and reporting of the consensus
process. Our findings indicate that standards of COS development have
improved from 2018 onwards compared to those prior to 2018 (median
standards 6.5 vs 10) likely reflecting the use of COMET
guidelines,7 COS-STAD minimum
standards,8 and COS-STAR reporting
guidelines.18
It is important to acknowledge our findings relate to two distinct
groups of COS: those specifically designed as core outcome sets and
those that determined outcomes in studies with wider study aims. It is
also important to acknowledge that almost half of the included COS
pre-date recent methodological guidance.