Practical considerations
The COR Tool is not intended to replace currently available ROB
assessment tools, but rather, is intended to be used alongside these
tools, to assess the completeness of outcome reporting in any trial. ROB
tools tend to focus on study design, conduct and analysis, placing
emphasis on identifying aspects that may lead to bias. For example, the
six domains assessed in the Cochrane ROB tool are (1) random sequence
generation, (2) allocation concealment, (3) blinding of participants and
personnel, (4) blinding of outcome assessment, (5) incomplete outcome
data, and (6) selective reporting – none of which directly assess the
comprehensiveness of the outcomes that are chosen to be
measured.12 To address bias related to outcome
reporting, Cochrane recommends the use of COS, introduced by the Core
Outcome Measures in Effectiveness Trials (COMET) initiative in
2012,27 and endorsed by the Core Outcomes in Women’s
and Newborn Health (CrOWN) group.32 By creating
standards for reporting, COS are effective at facilitating more
applicable and transparent comparisons between interventions and across
studies, an important of ensuring standardization of outcomes across
studies.33 However, the focus on ensuring a ‘core’ or
‘minimum’ set of outcomes, becomes a barrier to ensuring
comprehensiveness of outcome reporting, as we have recently shown.
Utilizing the COR Tool in conjunction with COS would ensure that all
relevant outcome areas are covered while still ensuring the interests of
all stakeholders are considered in current health research.