About the COSMIN initiative

COSMIN develops methodology and practical tools for selecting the most suitable outcome measurement instrument.

COnsensus-based Standards for the selection of health Measurement INstruments

COSMIN is an initiative of an international multidisciplinary team of researchers with a background in epidemiology, psychometrics, medicine, qualitative research, and health care, who have expertise in the development and evaluation of outcome measurement instruments.

Mission statement

The mission of COSMIN is to improve the selection of outcome measurement instruments of health outcomes by developing and encouraging the use of transparent methodology and practical tools for selecting the most suitable outcome measurement instrument in research and clinical practice.

We aim to improve the quality of studies on measurement properties by developing methodology and practical tools for assessing measurement properties, and we call for standardization of outcomes and outcome measurement instruments by developing core outcome sets (COS).

Goals

  • Advance the science and application of health outcome measurement
  • Develop new and update existing methodology and practical tools for the selection and use of outcome measurement instruments for research and clinical practice
  • Monitor and maintain the scientific quality of COSMIN tools
  • Encourage widespread adoption of the COSMIN methodology
  • CAll for standardization of outcomes and outcome measurement instruments by developing Core Outcome Sets (COS) and COS methodology

Background information about COSMIN

The COSMIN initiative, founded in 2005, was inspired by a lack of clarity in the literature about terminology and definitions of measurement properties, a lack of evidence on the measurement properties of many outcome measurement instruments, and inconsistency in methods used to determine these measurement properties. Therefore, we developed a consensus-based taxonomy including definitions of the nine measurement properties, and consensus-based standards for assessing the quality of studies on measurement properties.

Numerous outcome measurement instruments exist; many instruments aim to measure the same construct and were developed for the same patient population, and still new ones are being developed. So researchers and clinicians have to choose the most suitable instrument for their application.

The process of selecting outcome measurement instruments for specific purposes is complex, because of various aspects. Choices involve conceptual considerations about the definition of the construct of interest; practical aspects about costs, and the burden for patients and other people involved; and quality aspects of measurement instruments (referring to nine different measurement properties clustered in the domains reliability, validity and responsiveness). Selecting unsuitable or insufficient quality outcome measurement instruments may introduce bias in the conclusions of studies. This may lead to a waste of resources and is unethical because participating patients contribute little or nothing to the body of evidence but still suffer from the burdens and risks of the study.

To enable evidence-based selection of the most suitable outcome measurement instrument COSMIN developed methodology for conducting systematic reviews of patient-reported outcome measures (PROMs).

COSMIN steering committee members

Two members of the steering committee (Wieneke and Caroline) are responsible for the day-to-day management of COSMIN.

Lidwine B. (Wieneke) Mokkink
Lidwine B. (Wieneke) MokkinkAssistant professor in Clinimetrics
Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands.

Dr. Wieneke Mokkink is epidemiologist by background and her focus of research is on clinimetrics; it is her aim to develop user-friendly tools to help researchers and clinicians by the selection of health measurement instruments. She is one of the founders of the COSMIN initiative and obtained her PhD degree on the  first COSMIN study (2010).

In 2016, she received a personal research grant from the Netherlands Organisation for Scientific Research (NWO) which allows her to perform a study aiming to adapt the COSMIN checklist to assess the methodological quality of studies on measurement properties of outcome measurement instruments other than PROMs, i.e. tests and instruments administered by health-care professionals. In addition, Wieneke is involved in studies on the development and evalution of PROMs, in systematic reviews on the quality of outcome measurement instruments, and in Delphi studies.

Caroline B Terwee
Caroline B TerweeAssociate professor in Measurement
Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands

Dr. Caroline B Terwee is head of the research group “Measurement” at VUmc. She is epidemiologist by background and her research focusses on methodology for the selection and standardization of outcome measures, for example through systematic reviews of outcome measures, Core Set development, and the validation and implementation of item banks. She is one of the founders of the COSMIN initiative and participates in international initiatives, such as COMET, OMERACT, and InsPECT. She is president of the PROMIS Health Organization who aims to developed, validate, and provide reliable, valid, and cost-effective measurement of relevant health outcomes to the greater scientific and clinical research community and to other health care organizations across the world.

Retired COSMIN steering committee members

Henrica CW de Vet
Henrica CW de VetProfessor of Clinimetrics
Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center

Prof.dr.ir. Henrica CW de Vet is clinical epidemiologist by training and her focus is on methodological research. She has special expertise on the development and improvement of measurement instruments. She has been involved in the development of internationally-accepted methodological standards of, among others, reporting of diagnostic studies (STARD initiative), the quality of measurement instruments (COSMIN) and economic evaluations (CHEC). In her research she focuses on the measurement of health status and quality of life of patients, but also on quality of health care. She has much expertise on the use of patient reported outcomes in health care research and clinical practice and is involved in the Dutch-Flemish PROMIS group promoting the use of IRT questionnaires in health care settings.

Lex M Bouter
Lex M BouterProfessor of Methodology and Integrity
Amsterdam Public Health research institute VU University and VU University Medical Center, Amsterdam, the Netherlands.

Before taking up the current position he was professor of Epidemiology and Rector of the Vrije Universiteit Amsterdam. Lex Bouter was involved in COSMIN from its inception and has still a keen interest in clinimetrics and systematic reviews. He is a member of the Steering Committee of the REWARD (REduce research Waste And Reward Diligence) Alliance. He is currently mainly involved in teaching and research regarding responsible conduct of research, questionable research practices and research misconduct. In 2017 he organized and co-chaired the 5th World Conference on Research Integrity in Amsterdam and became chair of the World Conferences on Research Integrity Foundation.

Cecilia A.C. (Sanna) Prinsen
Cecilia A.C. (Sanna) PrinsenAssistant professor in Clinimetrics
Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, the Netherlands.

Dr. C.A.C. Prinsen is a clinical epidemiologist by background and the focus of her research is on the standardization of outcome measurement in trials and clinical practice. Sanna has special expertise in the development of Core Outcome Sets (COS). She has been involved in the development of internationally-accepted methodology on COS development (COMET Handbook), in the development of a guideline on how to select outcome measurement instruments for outcomes included in a COS and in the development of a guideline for systematic reviews of patient-reported outcome measures. Sanna is involved in international initiatives: HOME QoL Working Group, and the Cochrane Skin Group Core Outcomes Set Initiative (CSG-COUSIN) Methods working group. Further, Sanna has co-founded the APH COS focus group initiative in 2017 and it is her mission to improve the quality and quantity of COS development among COS researchers in the Netherlands.

Donald L Patrick
Donald L PatrickProfessor of Health Services
Director of the Social and Behavioral Sciences Program at the University of Washington, Director of the Seattle Quality of Life Group, Seattle, US.

Donald Patrick has received international recognition as a leading developer and user of multiple patient-centered outcome measure measures in application to chronic diseases, adolescence, regulatory assessment, and health equity. He is active in research on health outcomes, health disparities, youth QoL, and people with disabilities. He was lead investigator of the Longitudinal Investigation of Depression Outcomes in six countries. He was a founding member of the WHO quality-of-life instrument development. He is involved in Task Forces and other work for both the International Society for Quality of Life Research, for which he was inaugural president, and the International Society for Pharmacoeconomics and Outcomes Research.  He is author of numerous articles and monographs, a classic book written with Pennifer Erickson entitled Health Status and Health Policy and a book with Richard Deyo entitled Hope or Hype: The Obession with Medical Advance and the High Cost of False Promises. He is an elected member of the National Academy of Medicine.

Jordi Alonso
Jordi AlonsoProfessor of Public Health and Head of the Health Services Research Group
Epidemiology and Public Health Program. Institut Municipal d’Investigació Mèdica (IMIM-Hospital del Mar), Barcelona, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain; Dept. Experimental and Health Sciences, Pompeu Fabra University (UPF), Barcelona, Spain.

Jordi Alonso, MD, PhD, is Director of the Program of Epidemiology and Public Health, IMIM (Hospital del Mar Medical Research Institute) and full professor of Public Health at the Pompeu Fabra University (UPF), Barcelona, and coordinator of the Program on Health Services Evaluation of the Spanish Research Network on Epidemiology & Public Health (CIBERESP).

His research focuses on the measurement of perceived health and its application to evaluate the need for and the effectiveness of mental health services. Dr. Alonso is the European coordinator of the project WHO World Mental Health (WMH) Surveys, a WHO promoted initiative to assess mental disorders and related global burden worldwide. Dr. Alonso is a member of the Board Directors of PROMIS (Patient-Reported Outcomes Measurement Information Systems) , where his committed with its international expansion. Dr. Alonso is the scientific co-director of BiblioPRO, an on-line repository for Patient Reported Outcomes in Spanish, being currently a member of its scientific committee.

Dirk L Knol, Statistician, Department of Epidemiology and Biostatistics, Emgo Institute for Health and Care Research, VU University Medical Center

Paul W Stratford, Professor School of Rehabilitation Science, Faculty of Health Sciences, and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.

Collaboration

Funding

The first Delphi study on the taxonomy and COSMIN checklist (2005-2010), i.e. the study ‘COSMIN: development and evaluation of a checklist to assess the methodological quality of studies on measurement properties’, was financially supported by the EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands.

We are grateful to ZonMW for their support to develop this website (project number 29385041).

The Delphi study on content validity (2014-2017), the study of the development of the COSMIN Risk of Bias checklist, and the development of the COSMIN Study Design checklist was financially supported by the department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands.

The development of the guideline on how to select outcome measurement instruments for outcomes included in COS has received funding from the European Union’s Seventh Framework Programme [FP7/2007-2013] under grant agreement n° [305081].

The study on the development of the COSMIN checklist for clinician-reported and performance-based outcome measures (2017-2020) is financially supported by ZonMW VENI grant: ‘Measurement in Medicine: choosing and using the best outcome measure’  (dossiernummer 016.176.098).

The project on the development of the COSMIN reporting checklist (2017-2019) will be performed in participation with the University of Michigan, and is financially supported by the Patient-Centered Outcomes Research Institute (PCORI): ‘Development of reporting guidelines for psychometric research on PROMs’ (ME-1606-35556).