The COMET initiative database: progress and activities update (2014)

The COMET Initiative database is a repository of studies relevant to the development of core outcome sets (COS). Use of the website continues to increase, with more than 16,500 visits in 2014 (36 % increase over 2013), 12,257 unique visitors (47 % increase), 9780 new visitors (43 % increase) and a rise in the proportion of visits from outside the UK (8565 visits; 51 % of all visits). By December 2014, a total of 6588 searches had been completed, with 2383 in 2014 alone (11 % increase). The growing awareness of the need for COS is reflected in the website and database usage figures.


Background
The Core Outcome Measures in Effectiveness Trials (COMET) website and database were launched in August 2011, and the progress and activities up to 31 December 2013 were reported in Trials last year [1]. This letter outlines subsequent progress in 2014 (Source of data usage: Google Analytics). It provides data on the value and use of the COMET materials and on the interest in core outcome sets (COS) above and beyond what might be gleaned through, for example, data on the citation of key articles. COS represent the minimum outcomes that should be measured and reported in all clinical trials of a specific condition and may also be suitable for use in other types of research and clinical audit [2].

Activity and content
On 31 December 2014, 567 studies relevant to the development of COS were included in the COMET database, up from 306 at the end of 2013. These included a total of 80 planned and ongoing studies, and the database had been boosted considerably by the addition of studies identified through a systematic review of core outcome sets that identified 198 published COS [3].  Table 1. There was a 38 % increase in page views from 2013 to 2014 (53,226 to 73,617 page views). By December 2014, a total of 6588 searches of the database had been run ( Fig. 1), with 2383 in 2014 alone. The sustained growth in use suggests that the COMET website and database are continuing to gain interest and prominence and that they are an effective resource for people interested in core outcome set development.
As in previous years, most visits to the website were direct or via a search engine. Thirteen percent of all visits in 2014 were referrals, including Twitter (15 %), The Italian Cochrane Centre (6 %), MRC Network of Hubs for Trials Methodology Research (6 %), The University of Liverpool (5 %), BJOG: An International Journal of Obstetrics and Gynaecology (5 %), and Nature (4 %). The COMET IV meeting was jointly hosted by the Italian Cochrane Centre in Rome in November 2014, which reflects the large group of referrals from the Italian Cochrane Centre website; demonstrating how effective collaborative efforts can promote COMET. The Nature referrals can be explained by an editorial in Nature Medicine in August 2014 [4], demonstrating the impact of this type of high profile exposure.
Analyses of the COMET website data show that 57 % of visitors went beyond the page on which they landed. As in previous years, the most common first interaction was to complete a search in the COMET database. Other first interactions included moving to the page providing an overview of the COMET Initiative, accessing the database but without completing a search, and visiting the pages containing details of the COMET IV meeting or the COMET resources page. The Core Resource Pack is the second most highly accessed resource on the website (after the database), with 1064 page views in 2014, compared to 780 in 2013.  The content of the website continues to be updated regularly. In 2014, we extended the patient and public involvement resources beyond the Plain Language Summary that was available. There is now a Delphi Process Plain Language Summary, along with a Public Involvement Strategy outlining the COMET public involvement objectives and plans. In 2014, the plain language summary page was visited 301 times, and the Public Involvement page was visited 138 times since it was launched in August to December 2014.
The  Table 2 shows the ten countries with the most visits to the COMET website from 2012 to 2014. The presence of Japan in 2013 and India in 2014 reflects where COMET activities were undertaken, including the COMET workshop in Kyoto (2013) and the presence of the Cochrane Colloquium in Hyderabad (2014) [4]. This highlights the importance of international dissemination, but it is worth noting that all content and materials are provided in the English language only at the moment, and there are no immediate plans for translation.
As noted above, 6588 searches have been completed in the database since its launch in August 2011 to December 2014, with 2383 in 2014. The search allows the user to take a structured approach to finding COS, and the most frequently used search criteria in 2014 were consistent with previous years. Disease category (74 %) was the most frequently used, followed by disease name (47 %), study type (30 %), type of intervention (26 %), methods used (25 %), and stakeholders involved (24 %). The most commonly searched terms were 'cancer' (n = 129), 'mental health' (n = 116), 'pregnancy and childbirth' (n = 86), and 'neurology' (n = 82).

Plans for the future
An update of our systematic review of core outcome sets [2] is planned for early 2015. This will help to keep the database up to date and ensure that it is an effective resource for users. As before, we continue to identify and include studies in an ad hoc way to keep the database current. A pop-up survey is planned for 2015 to gather information from users in order to evaluate how and why people are using the database. This will allow us, for example, to consider ways to improve the search functions available. Other activities for 2015 include the first COMET meeting (COMET V) to be held outside of Europe, in Calgary, Canada, in May. Finally, we plan to expand the patient and public involvement resources available on the website, and this will be a priority for the newly formed COMET Patient and Public Involvement (PPI) working group.
The COMET website and database usage figures will continue to be monitored and assessed annually.