{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:09:41Z","timestamp":1768313381141,"version":"3.49.0"},"reference-count":55,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp; Comm Disor"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The COnsensus\u2010based Standards for the selection of health Measurement INstruments (COSMIN) is an international initiative that offers standardized and validated tools to guide the appraisal of patient\u2010reported outcome measures in healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore the use of a new set of tools from the COSMIN to appraise studies on one outcome measure available to speech and language therapists (SLTs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>We used the COSMIN tools to appraise seven studies and a user manual that reported the measurement properties of the Focus on the Outcomes of Children Under Six (FOCUS), a validated measure of pre\u2010schoolers\u2019 communicative participation that is used in various contexts around the world.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Using COSMIN guidelines, the FOCUS was categorized as a \u2018category A\u2019 tool because there was a sufficient level of evidence to support its content validity and internal consistency. According to the COSMIN guidelines, this means that the FOCUS can be recommended for use. The quality of evidence supporting measurement properties of the FOCUS received a rating of \u2018moderate\u2019, meaning users can have moderate confidence in its measurement properties. Since these ratings from the COSMIN tools may be unclear to users of the FOCUS, we have provided more specific recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The COSMIN tools offer detailed standards to support the appraisal of outcome measures available to SLTs. However, several limitations were observed, and recommendations to support the application of the COSMIN tools are provided.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>\n<jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:caption><jats:title>What this paper adds<\/jats:title><\/jats:caption><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p>Collecting outcome data is essential to ensure speech and language therapy is effective. Until the development of COSMIN there was a lack of standards in the way the measurement properties of outcome measure instruments were appraised.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p>This paper used the FOCUS, a measure of pre\u2010schoolers\u2019 communicative participation outcomes in speech and language therapy, as a case example to illustrate the applications of the COSMIN tools. In doing so, the strengths and limitations of the current COSMIN tools in appraising the quality of outcome measure instruments are emphasized.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p>The COSMIN tools offer a step\u2010by\u2010step, standardized approach to appraise various measurement properties in outcome instruments. Due to existing limitations of the COSMIN tools, appraisal should provide clear and specific recommendations so users of outcome measures (e.g., SLTs, researchers) can identify the appropriate uses of each instrument.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12603","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T16:08:51Z","timestamp":1613318931000},"page":"313-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Strengths and challenges of the COSMIN tools in outcome measures appraisal: A case example for speech\u2013language therapy"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4893-2574","authenticated-orcid":false,"given":"Elaine Yuen Ling","family":"Kwok","sequence":"first","affiliation":[{"name":"CanChild McMaster University  Hamilton ON Canada"},{"name":"Department of Pediatrics McMaster University  Hamilton ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"CanChild McMaster University  Hamilton ON Canada"},{"name":"Department of Pediatrics McMaster University  Hamilton ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Thomas\u2010Stonell","sequence":"additional","affiliation":[{"name":"CanChild McMaster University  Hamilton ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara Jane","family":"Cunningham","sequence":"additional","affiliation":[{"name":"CanChild McMaster University  Hamilton ON Canada"},{"name":"School of Communication Sciences and Disorders Elborn College Western University  London ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Agency for Health Research and Quality 2011"},{"key":"e_1_2_8_3_1","unstructured":"Allied Health Professions (AHP) Outcome Measures UK Working Group 2019"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.12.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1044\/0161-1461(2012\/12-0093)"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13187"},{"key":"e_1_2_8_7_1","unstructured":"Consensus\u2010Based Standards for the Selection of Health Measurement Instruments 2020"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14665"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1044\/2016_JSLHR-L-15-0329"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"e_1_2_8_11_1","volume-title":"Therapy outcome measures for rehabilitation professionals","author":"Enderby P.","year":"2015"},{"key":"e_1_2_8_12_1","volume-title":"Therapy Outcome Measures theoretical underpinning and case studies","author":"Enderby P.","year":"2020"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24042"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02287427"},{"key":"e_1_2_8_15_1","article-title":"A Systematic Review of Behaviour\u2010Related Outcome Assessments for Children on the Autism Spectrum with Intellectual Disabilities in Education Settings","author":"Howell M.","year":"2020","journal-title":"Review Journal of Autism and Developmental Disorders"},{"key":"e_1_2_8_16_1","first-page":"10","article-title":"Standardized language test use: a Canadian survey utilisation","volume":"27","author":"Kerr M. 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