Barriers to uptake of the hip fracture core outcome set: an international survey of 80 hip fracture trialists.

INTRODUCTION: Core outcome sets (COS) are an agreed recommendation to inform the selection of outcome measures in clinical trials. There has been low uptake of the 2014 hip fracture COS. The reasons for this remain unclear. The aim of this study was to understand the reasons for the non-adoption and approaches to increase adoption of the hip fracture COS. METHODS: Randomised controlled trials (RCTs) from Pubmed (2017-2019) and ClinicalTrials.gov (2015-2019) were identified. Corresponding authors for each identified trial (n=302) were surveyed using five questions on: awareness of the hip fracture COS; reasons for non-adoption; and approaches to increase adoption. Data were analysed descriptively using frequencies, mean and standard deviations. RESULTS: Fifty-four percent of respondents (n=43) were aware of the concept of COS. Only 15% (n=12) based outcome measure selection on the 2014 hip fracture COS. Key reasons for non-adoption included: authors being unaware and perceived inappropriateness to their trial design. Eighty-six percent (n=69) of respondents agreed the need for increased awareness of COS through research training, academic and clinical journal requirements and funding or publication stipulations. Eighty-eight percent (n=70) of respondents indicated the current COS required revision to focus on trials investigating: people with cognitive impairment, caregivers, rehabilitation, surgical interventions and anaesthetic trial designs. CONCLUSIONS: Barriers to the adopted of the hip fracture COS centre on education, awareness of the COS and applicability to the breath of hip fracture trial designs. Further consideration should be made to address these, to improve the harmonisation of outcome measures across hip fracture trials.