(1) Determination of Outcome Areas
We used an updated and most comprehensive taxonomy of outcomes developed
for use in medical research, encouraging consistency across clinical
trials to promote more effective categorization, reporting, and
searching of outcomes in the literature.3 Having
undergone numerous iterations to account for advancements within the
field, the system evolved from a 12-category system, to now include 38
categories, representing as many outcomes as can possibly be reported in
health-related studies.3, 17 These outcomes are
grouped under five core areas – (1) mortality/survival outcomes; (2)
system-specific morbidity (physiological/clinical) outcomes; (3)
functioning or life-impact outcomes; (4) resource-use outcomes and (5)
adverse events/effects.3 This taxonomy was employed as
the foundation of the COR Tool, with minor modifications. For example,
we separated the outcome domain ‘delivery of care’ from within the
outcome areas ‘functioning/ life-impact’, as it was deemed to be a
distinct entity, encompassing its own unique sub-divisions. We therefore
identified six distinct outcome areas for the COR tool. Further, because
obstetrics involves two individuals – mother and fetus, each of these
six distinct outcome areas are considered individually for both, leading
to a total of twelve outcome categories.