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Toronto Outcomes Research in Child Health (TORCH) is an inter-disciplinary paediatric collaborative led by scientists and divisional representatives at The Hospital for Sick Children. TORCH facilitates the use of rigorous outcomes in child health research and in bedside care by focusing on the methodology behind the selection, measurement, analysis, benchmarking, and reporting of child health outcomes.
TORCH was founded in 2015 by Dr. Martin Offringa, Senior Scientist in the Child Health Evaluative Sciences (CHES) program. It serves as a local paediatric outcomes platform that advances outcome selection and reporting in paediatric health research and health system evaluation through the networking and collaboration with other established outcome groups and stakeholders in Canada and across the world.
- Director (2015-Present): Martin Offringa, MD, PhD
- Research Lead (2017-Present): Nancy Butcher, PhD
- Project Manager (2019-Present): Andrea Monsour, MPH
Ongoing collaborations with organizations and initiatives include:
- COMET Initiative (The Core Outcome Measures in Effectiveness Trials Initiative)
- COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments)
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health (CAMH)
- EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research)
- ICHOM (The International Consortium for Health Outcomes Measurement)
- neoEPOCH (Neonatal Electronic health record data for Point Of Care Health)
- PROMIS (Patient-Reported Outcomes Measurement Information System)
- Cochrane Neonatal
To enhance child health by ensuring children are given safe and effective treatments based on evidence that addresses relevant and accurate child health research and health system performance outcomes.
To create and seize opportunities to improve paediatric research and health system performance outcomes by:
- Raising awareness on the importance of meaningful outcome selection, measurement, and reporting in children;
- Providing methodology to select, measure, and report truthful, discriminative, and feasible outcomes in child health research; and
- Supporting engagement with research ethics boards, funders, journal editors, regulators, and health system administrators to critically appraise outcome selection, measurement, and reporting.
1. Raise awareness:
- of the importance of selecting and measuring Core Outcome Sets in child health;
- of the importance of completely and transparently describing outcomes in clinical trials protocols and publications.
2. Provide methodology:
- develop Core Outcome Sets for a range of pediatric diseases (“what” and “how” to measure outcomes);
- improve clinical trial outcome reporting through the generation and implementation of CONSORT and SPIRIT-Outcomes Extensions (see below).
3. Support engagement:
- translate new insights to research and health system evaluation practice in collaboration with child health research stakeholders including research ethics boards, funders, regulators, journal editors, governments, and health system administrators;
- promote uptake and use of Core Outcome Set selection and measurement methods in paediatric clinical trials and healthy system evaluation;
- network with existing outcome and research organizations and initiatives.
Core Outcome Sets
Core Outcome Sets represent the minimum outcomes that should be measured and reported in all clinical trials of a specific health condition and are also suitable for use in clinical audit or research other than randomised trials. The development and implementation of a Core Outcome Set makes it easier for trial results to be compared, contrasted and combined, ultimately improving patient and health system outcomes and reducing research waste.
Sets in development:
- Adolescent depression
- Paediatric appendicitis
- Rare metabolic diseases (MCAD and PKU)
Recently developed sets:
- Children with feeding tubes and neurological impairment
- Neonatal opioid abstinence syndrome
- ICHOM Overall Paediatric Standard Set
Reviews of Core Outcome Sets:
- From research to practice: the importance of outcome selection, measurement, and reporting in pediatric mental health research (Monga et al 2020)
- Counting what counts: the case for harmonized outcomes in child and youth mental health research (Szatmari et al 2019)
InsPECT: SPIRIT-Outcomes & CONSORT-Outcomes
Inadequate outcome reporting in clinical trials is a well-documented problem that impedes the ability of researchers to evaluate, replicate, and build upon study findings, which in turn impacts evidence-based clinical and policy decision making.
To facilitate harmonized reporting of outcomes in published trial protocols and reports, TORCH is leading the development of new outcome-specific reporting extensions to the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and CONSORT (Consolidated Standards of Reporting Trials) reporting guidelines, known as the SPIRIT-Outcomes and CONSORT-Outcomes reporting guidelines, respectively.
The SPIRIT and CONSORT-Outcomes reporting extensions will provide the first evidence-informed and consensus-based standards focused on outcome reporting in clinical trials that can be applied across diverse disease areas, populations, and outcome types. They have the potential to benefit trialists, systematic reviewers, journal editors, medical writers, and patient groups.
- Study protocol: Butcher et al 2019
- Literature review protocol: Butcher et al 2019
- Literature review: Butcher et al 2020
As part of the InsPECT project, we are also assessing the current standard of outcome reporting in published clinical trials and cohort studies: