SynthesisBMJ global health2024
Core outcome sets for trials of interventions to prevent and to treat multimorbidity in adults in low and middle-income countries: the COSMOS study.
Synthesis in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effectiveness and Implementation of Digital Health Interventions on Physiological, Psychological, and Functional Outcomes in Adults With Multimorbidity: Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of medical Internet research · 2026Pooled it
- Quality of life and multiple long-term conditions in Southeast Asia: a systematic review and meta-analysis.Nature communications · 2026Pooled it
- Global landscape, research hotspots, and evolutionary trends in childhood adversity and chronic disease research: a bibliometric analysis based on three databases.Frontiers in public health · 2026Pooled it
- Clarity in Reporting Multiple Long-Term Conditions in Research: The Need for Consistency and Consensus.Diabetes, obesity & metabolism · 2026Article
- Outcome measurement for multiple long-term conditions research across health-care settings - an overview of reviews.BMC medicine · 2026Review
- WHF Roadmap for Integrated Care in People Living with - or at Risk of - Cardiovascular Disease and Multiple Long-Term Conditions.Global heart · 2026Review
- Article
- Variations in quantifying patient reported outcome measures to estimate treatment effect.World journal of methodology · 2025Review
- Global Trends in Prevalence and Future Projections of Pelvic Organ Prolapse: A 30-year Epidemiological Study.International urogynecology journal · 2025Article
- Multimorbidity-associated emergency hospital admissions: a "screen and link" strategy to improve outcomes for high-risk patients in sub-Saharan Africa: a prospective multicentre cohort study protocol.NIHR open research · 2024Article
- Protocol for the development and validation of a Core Set for exercise-based rehabilitation of adults with multiple long-term conditions (multimorbidity) based on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework.Journal of multimorbidity and comorbidityArticle
- Challenges for the design of randomised trials for interventions for people with multiple long-term conditions: Recruitment and outcome selection.Journal of multimorbidity and comorbidityArticle
Corrections and comments
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Authors and funding
61 authors.
Funding
Abstract
introductionThe burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs.
methodsTo generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS. REGISTRATION: https://www.comet-initiative.org/Studies/Details/1580.
resultsThe systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life.
conclusionFollowing established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs. PROSPERO REGISTRATION NUMBER: CRD42020197293.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.