Improving core outcome set uptake in trials


Awareness is growing of problems with the choice of outcomes to measure and report in trials, and the waste that this is causing. These include inconsistencies in what and how outcomes are measured across clinical trials; selective reporting of outcomes in some trials; and differences between the outcomes measured in trials and the outcomes that patients consider important. One solution to these problems that is beginning to take hold is for clinical trialists in a particular topic area to measure and report, as a minimum, a core outcome set (COS). A COS is an agreed standardised collection of outcomes that should be measured and reported in a specific area of health.

This reduction in waste will only be realised however if researchers choosing outcomes for randomised controlled trials include COS in their studies. The continuous development of COS, without uptake, could itself result in research waste. Recent work has shown that uptake of COS is variable but generally still low1-3. Research is needed to improve the uptake of COS.

The student will gain an understanding of the area through an update of the earlier review of COS uptake projects2, and may undertake a quantitative analysis of factors affecting uptake. They will conduct a survey or interviews with: (i) trialists – to understand how they arrived at the COMET database, and what influenced their decision to consider a COS; and (ii) stakeholders in the wider evidence ecosystem, including systematic reviewers, patients and patient organisations, clinical guideline and health technology assessment organisations – to explore what they could do within their organisation to promote COS uptake.

Various issues may emerge, providing the student with options for further research depending on their interest and experience. These may include: the development and testing of interventions with funders to improve uptake; educational interventions through trial registries and research ethics committees; development and evaluation of a system-level framework with UK and international organisations; exploring how industry researchers choose outcomes for study; exploring how patients can be involved in promoting COS uptake.


Paula Williamson and Mike Clarke are experienced COS developers. Bridget Young is experienced in mixed methods research. Ian Saldanha is an experienced systematic reviewer. All are experienced COS methods researchers.

Further Opportunities

Opportunities exist for placements at NICE and Roche, with these organisations providing letters of support. We will explore opportunities with Cochrane, NIHR and HRA. The COMET PoPPIE (People and Patients Participation, Involvement and Engagement) Coordinator, Heather Barrington, will be a research collaborator.


You are applying for a PhD studentship from the MRC TMRP DTP. A list of potential projects and the application form is available online at:

Please complete the form fully. Incomplete forms will not be considered. CVs will not be accepted for this scheme.

Please apply giving details for your first choice project. You can provide details of up to two other TMRP DTP projects you may be interested in at section B of the application form.

Before making an application, applicants should contact the project supervisor to find out more about the project and to discuss their interests in the research before 09 January 2023.

The deadline for applications is 4pm (GMT) 16 January 2023. Late applications will not be considered.

Completed application forms must be returned to: 

Informal enquiries may be made to Prof Williamson - 




Open to students worldwide

Funding information

Funded studentship

Studentships are funded by the Medical Research Council (MRC) for 3 years. Funding will cover tuition fees at the UK rate only, a Research Training and Support Grant (RTSG) and stipend. We aim to support the most outstanding applicants from outside the UK and are able to offer a limited number of bursaries that will enable full studentships to be awarded to international applicants. These full studentships will only be awarded to exceptional quality candidates, due to the competitive nature of this scheme.



1 Williamson PR, Barrington H, Blazeby JM, Clarke M, Gargon E, Gorst S, Saldanha IJ, Tunis S. (2022) Review finds core outcome set uptake in new studies and systematic reviews needs improvement. JCE 150: 154-164
2 Hughes KL, Clarke M, Williamson PR. (2020) A systematic review finds core outcome set uptake varies widely across different areas of health. Journal of Clinical Epidemiology, doi:
3 Hughes KL, Kirkham JJ, Clarke M, Williamson PR (2019). Assessing the impact of a research funder’s recommendation to consider core outcome sets. PLoS ONE 14(9): e0222418.