COSMYC: a Core Outcome Set for MYopia clinical trials with Children and young people
In brief
Experts agree on ten core outcomes for pediatric myopia intervention trials
A three-phase COMET consensus process involving children, parents, eye-care professionals and researchers identified ten essential outcomes-such as axial length, visual acuity, eye health and quality of life-for myopia trials in youth. The study also produced stakeholder-endorsed recommendations for how each outcome should be measured, aiming to standardize future research and improve comparability.
- Journal
- The British journal of ophthalmology (Q1)
- Published
- 18 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Annegret Dahlmann-Noor, Megan Jacobson, Lily Islam, Sarah Gorst, Helen Baker, Nick Freemantle, et al.
- PMID
- 42760103
- DOI
- 10.1136/bjo-2026-330475
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 20 September 2026): High-quality evidence in a top journal
Abstract
BACKGROUND/AIMS: Childhood myopia is an increasing public health concern, with earlier onset, faster progression and greater severity than in previous generations, increasing the risk of sight-threatening complications in adulthood. Randomised controlled trials (RCTs) of myopia interventions report heterogeneous outcomes and may not address priorities of all stakeholders. We aimed to develop a core outcome set (COS) and recommendations for outcome measurement instruments (OMIs) for myopia intervention trials in children and young people (CYP). METHODS: Using Core Outcome Measures in Effectiveness Trials (COMET) methodology, we undertook a three-phase consensus process. Phase 1 comprised a systematic literature review, workshops with CYP and parents/caregivers, and interviews with eye care professionals (ECPs) and myopia researchers to identify candidate outcomes and OMIs. Phase 2 used a two-round Delphi process and consensus meeting involving CYP, parents/caregivers, ECPs and researchers to agree on core outcomes. Phase 3 involved literature review, content-validity assessment and stakeholder consensus to develop OMI recommendations. RESULTS: Phase 1 identified 308 verbatim outcomes from randomised trials and qualitative work, from which 21 outcomes were retained for consensus. In Phase 2, stakeholders reached consensus on 10 core outcomes: axial length, spectacle prescription, visual acuity, eye health, eye comfort/discomfort, quality of life, adherence, treatment satisfaction, ocular adverse effects and systemic adverse effects. Phase 3 produced stakeholder-informed recommendations for OMIs for each core outcome. CONCLUSION: Core Outcome Set for MYopia clinical trials with Children and young people (COSMYC) provides the first stakeholder-informed COS and OMI recommendations for paediatric myopia intervention trials. Adoption and international ratification of COSMYC may improve consistency, comparability and relevance of future myopia research.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.