Clarifying the ORBITAL core outcome set: a response to comments from the field

What is it about?

This brief correspondence is a direct response from Shorter and the ORBITAL team to a critical commentary by de Bejczy and colleagues published in the same issue of the Journal of Studies on Alcohol and Drugs, which raised questions about the ORBITAL core outcome set for alcohol brief intervention trials. The response addresses the specific concerns raised about the scope, applicability and measurement approach of the ORBITAL COS, clarifying the rationale behind key decisions in the consensus process, defending the representativeness of the international Delphi panel, and explaining how the COS is intended to function as a minimum standard rather than an exhaustive or restrictive outcome framework. The letter also addresses concerns about alcohol dependence outcomes and the relationship between the COS and clinical versus population-level research contexts.

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Why is it important?

Methodological correspondence of this kind is an important part of the scientific process, particularly for a core outcome set whose value depends entirely on broad adoption by the research community. Critiques and formal responses help clarify the scope, limitations and intended use of the ORBITAL COS for potential adopters, including trial designers, funders and ethics committees. The exchange also illustrates that the ORBITAL project was sufficiently prominent by 2022 to attract substantive methodological debate in a leading international journal, reflecting its influence on the alcohol brief intervention field. The published response strengthens the credibility and transparency of the consensus process that underpins the COS.