VU medisch Centrum


EMGO institute for health and care research

Studies using the COSMIN checklist 

The COSMIN checklist has been used in more than 70 systematic reviews of measurement instruments. COSMIN has recently developed a searchable database of all published systematic reviews of health status outcome measurement instruments. the database contains more than 500 reviews. All reviews that have used COSMIN can be found using a specific search button for COSMIN reviews.


Update of the COSMIN checklist

Over the years, some suggestions for improvement have been defined. Based on user experiences the COSMIN checklist is currently being revised. More emphasis will be put on content validity and more attention will be paid to the use of IRT methods.


Also the protocol for performing systematic reviews will be further developed and published.


Currently, new boxes for assessing content validity (including face validity) of outcome measurement instruments are under development.

Face and content validity are considered to be the most important measurement properties of a measurement instrument, because they influence all other measurement properties. Therefore we recommend to evaluate face and content validity of the included measurement instruments first, before looking at the evidence for the other measurement properties.

The evaluation of face and content validity consists of a subjective judgment of the comprehension, relevance and comprehensiveness of the instrument, based on the research question of the systematic review, the development of the instrument, existing face and content validity studies and the reviewer’s own judgment of the content of the instrument.

The current COSMIN standards for evaluating the quality of studies on measurement properties consider whether the relevance and comprehensiveness of items of an instrument have been evaluated but it does not contain standards for the methodological quality of a content validity study, nor standards for the development of an instrument. COSMIN is currently working on an extension of the COSMIN standards for evaluating the quality of existing face and content validity.