If we want to choose the shortest of three routes between two towns, how would we cope if told that one is 10 kilometres and another is 8 miles? Doing that conversion between miles and kilometres might not be too much of a problem, but what if the third route was said to be 32 furlongs? Now, imagine that the measurements had all been taken in different ways. One came from walking the route with a measuring wheel, one from an estimate based on the time taken to ride a horse between the two towns and one from using a ruler on a map. To make a well informed choice we would want the distances to be available to us in the same units, measured in the same ways. Making decisions about health care should be no different. We want to compare and contrast research findings on the basis of the same outcomes, measured in the same ways.
Achieving this is not straightforward, but it is not impossible. Key steps are to decide on the core outcome measures and, in some cases, the core baseline variables, and for these to then be included in the conduct and reporting of research studies. One of the earliest examples is an initiative by the World Health Organisation in the late 1970s, relating to cancer trials. Meetings on the Standardization of Reporting Results of Cancer Treatment took place in Turin (1977) and in Brussels two years later. More than 30 representatives from cooperative groups doing randomised trials in cancer came together and their discussions led to a WHO Handbook of guidelines on the minimal requirements for data collection in cancer trials [7, 8].
OMERACT has also grown by trying to reach a consensus among major stakeholders in the field of rheumatology [1] and the IMMPACT recommendations for chronic pain trials have arisen in a similar way [9]. Other approaches have included the use of literature surveys to identify the variety of outcome measures that have been used and reported, followed by group discussion. This is the case with low back pain [10], colon cancer [11] and an e-Delhi survey in maternity care [12].
Having developed these lists of outcomes measures, researchers need to use them and systematic reviewers need to build their reviews around them. These sets of standardised outcomes measures are not meant to stifle the development and use of other outcomes. Rather, they provide a core set of outcome measures, which researchers should use routinely. Researchers wishing to add other outcome measures in the context of their own trial would continue to do so but, when reporting their trial, selective reporting should be avoided through the presentation of the findings for both the core set and all additional outcome measures they collected. Furthermore, the use of the outcome measures in these core sets should not be restricted to research studies. They are also relevant within routine practice. If they are collected within such practice, they would help the provider and the receiver of health care to assess their progress and facilitate their understanding of the relevance to them of the findings of research.
Journals such as Trials can help by highlighting initiatives such as those discussed in rheumatology [1] and ulcerative colitis [2]. They should encourage researchers to report their findings for the outcome measures in the core sets, and provide them with the space to do so. This will allow readers and systematic reviewers to make best use of the reported trials.