ORBITAL core outcome set: international consensus on what to measure in alcohol brief intervention

What is it about?

Alcohol brief interventions (ABIs) are widely used to help people reduce risky drinking, but the field has been hampered by a fundamental problem: different trials measure different outcomes in different ways, making it impossible to compare results or combine findings in meta-analyses. The ORBITAL (Outcome Reporting in Brief Intervention Trials: Alcohol) project was established to solve this problem by developing a core outcome set (COS), a minimum agreed standard for what should be measured in all future ABI trials. The process drew on a companion systematic review that identified 2,641 outcomes measured across 401 trial articles using 1,560 different approaches, a two-round international e-Delphi study involving 150 participants from 19 countries, and a consensus meeting of key stakeholders. Ten outcomes were voted into the COS: typical frequency of drinking, typical quantity, frequency of heavy episodic drinking, a combined consumption measure, hazardous or harmful drinking classification, alcohol-related consequences, alcohol-related injury, quality of life, use of emergency healthcare services, and use of alcohol treatment services.

Featured Image

Why is it important?

This is the culmination of the ORBITAL project, representing several years of systematic methodological work to address one of the most significant obstacles to building a coherent evidence base for alcohol brief interventions. A COS carries genuine authority because it was developed through transparent, inclusive consensus processes involving researchers, policymakers, clinicians, patients and funders from 19 countries. Adoption of the ORBITAL COS by trial designers, ethics committees and funders means that future ABI trials will generate comparable, combinable evidence for the first time, directly improving the quality of future systematic reviews and meta-analyses. The paper has been widely cited as the standard reference for outcome selection in ABI trial design internationally and is being used in the field to set high standards in evaluation.