Having established “what” to measure in Degenerative Cervical Myelopathy (DCM) trials (the core outcome set), to ensure studies were comparable it is also important to standardise “how” these are measured.  This is called a Core Measurement Set.
As part of AO Spine RECODE-DCM, outcome tools used in DCM underwent a quality assessment using the COSMIN Criteria [1].  Recognising that current tools used in DCM cannot cover the entire breadth of the COS, and wanting both to avoid burdening researchers and ensure current studies can be compared to key historic data, it was agreed that the AO Spine RECODE-DCM CMS should focus on (1) outcome measures already in use within DCM and (2) aim for one outcome tool per outcome domain. 
Following a consensus process, the following four measurement tools were selected by consensus to be the Core Measurement Set. This have been integrated into template clinical research forms.  Please note the use of the SF-36 requires a licence.  This can be obtained from QualityMetric
The modified Japanese Orthopaedic Assessment Score (mJOA)
The SF-36 Life Impact Scale (Version 2)
The Neck Disability Index
The Spinal Adverse Events Severity System

These tools were felt to be the best options at present, but are not without their limitations.  For example they do not cover all outcomes in the Core Outcome Set.  The list of outcome tools that have been used in DCM, including the detailed analysis of their “quality” [2] can be found here.  We recognise that this is not an exhaustive list of all possible outcome tools, and did not consider those known to be in development. 
The ambition is that the CMS will be updated in the years to come.


None of this would have been possible without the support of AO Spine. We wholeheartedly thank them for kickstarting this important initiative.