COSTA study
Why are Core Outcome Sets important?
When an individual breaks their ankle, it can have a big impact on their daily life, physical functioning and wellbeing. Despite this, research and routine practice in ankle fracture recovery largely focuses on clinical details, resulting in limited consideration of patient experience, feelings, and management in daily life.
In further complication, when this research and routine practice is reported, different information, is reported by different groups, in different ways. This makes forming a clear conclusion about what might be most helpful in ankle fracture recovery very challenging.
Core Outcome Sets (COS) can help to address these inconsistencies. They do this by providing an agreed upon, standardised, set of outcomes which are important to patients, doctors, and medical staff. This will start to ensure outcomes important to both patients and professionals are reported.
The COSTA aims
A COS for ankle fracture does not currently exist so by working together with patients and clinicians as research partners, this study will aim to develop a COS for distal Tibia and Ankle fracture (COSTA).
We plan to reach consensus on this COS through:
- Exploration of existing evidence
- Extensive discussions with patients and professionals
- Working in collaboration with the wider research team
Project timeline
Key stages in COS development include:
- Defining what to measure (core domain set) – i.e., identifying aspects of health that matter to key stakeholders
- Determining how to measure (core measurement set)
- Recommending a final core outcome set
The development work for this study (COSTA1) was completed between November 2019 and March 2022, which involved detailed systematic evidence reviews, interviews with patients, and an international e-Delphi to identify a short-list of preliminary outcome domains for the core domain set. The current study (COSTA2) aims to complete the development process:
April 2024 – February 2025
Stage 1: Confirming what to measure: reducing and refining the core domain set (CDS)
April 2024 – September 2025
Stage 2: Determining how to measure (core measurement set (CMS)): reviewing the quality and acceptability of measurement approaches with which to measure the short-listed domains.
September 2025 – February 2026
Stage 3: Finalising the COSTA: achieve consensus on the core domain and measurement sets and endorse the COSTA guidance.
COSTA academic publications
Understanding patient experience of distal tibia or ankle fracture: a qualitative systematic review
This project is funded by AO via the AO Trauma Research Network and its Clinical Priority Program on Patient Outcomes. AO is a medically-guided, not-for-profit organisation, with the mission to promote excellence in patient care and outcomes in trauma and musculoskeletal disorders.
Further information about the AO Clinical Priority Program can be found here.
Contact details
Professor Kirstie Haywood (COSTA Chief Investigator) – k.l.haywood@warwick.ac.uk
Dr Sofie Power (COSTA Research Fellow) – sofie.power@warwick.ac.uk
Social media
Follow us on X @COSTA_study