Presentation (CTI)

OBJECTIVES: In 2024, the EU Member State Coordination Group on HTA issued ‘Guidance on outcomes for joint clinical assessments’ referencing consideration of core outcome sets (COS). A COS is an agreed standardised set of outcomes, developed with representation from key stakeholders (patients, clinicians, researchers, policymakers, payers), which should be reported as a minimum for all research in a specific health condition. In 2025 NICE consulted about a disease-specific reference case extension on the management of overweight and obesity in adults, to try to standardise aspects of health economic modelling. Here we review how COS informs this reference case extension and HTA more generally.
METHODS: The COMET database was searched for obesity-related COS. Included COS were applicable to treatments for the management of overweight or obesity for adults and reduction of weight-related comorbidities. Exclusion criteria were: COS for the prevention of overweight or obesity in people of normal weight; COS related to obesity in children; COS for diabetes and cardiovascular conditions. The quality of the COS development process was assessed using the Core Outcome Set-STAndards for Development (COS-STAD) criteria. Core outcomes were extracted from each COS and classified according to the COMET outcome taxonomy.
RESULTS: Eight COS were identified applicable to any intervention (n=1), bariatric surgery (n=3), drugs (n=1), self-management (n=1), exercise (n=1), and behavioural weight management (n=1). Patients and/or public representatives were included in the development of five COS; one study included 90 individuals, the rest less than 10. Across the eight COS, three outcomes were recommended by the majority for measurement in obesity research and/or clinical practice.
CONCLUSIONS: This review of COS recommends that weight, cardiovascular risk and quality of life be included in the obesity reference case extension and associated health economic assessments, to inform HTA and clinical guidelines.