Since the 1990’s, the Internet has gained importance in lives of youth and its intensive use adds to the list of classic risky behaviors such as alcohol and cannabis use [1]. People have acknowledged the fact that the Internet has been present in all aspects of our lives, as it has reached the role of informing, educating and entertaining all ages, especially teenagers [2]. The time spent on the Internet is increasing and it impacts health in various ways: sleep disorders, obesity, academic difficulties and vision problems [3, 4]. Data show that Internet use has a very important impact on society, individuals, society and health [5]. Over the past decade, studies have shown that the prevalence of Internet use among teenagers has been surprisingly high; In the United States and Japan, more than 90% of teenagers and 72% of Chinese teenagers use the Internet every day, while among high school students, the rate of Internet overuse has surpassed 20% in India and Iran [6–8]. Problematic internet use (PIU) is defined as “(a) Maladaptive preoccupation with the Internet experienced an irresistible use longer than expected, (b) remarkable distress resulting from behavior and (c) absence of other axis pathology that might explain the behavior, i.e., mania or hypomania” [9]. Compulsive or problematic Internet users will spend too much time on the Internet for fun and not for work, which may cause them to neglect other important areas of daily life or important work, such as work tasks or schoolwork, social relationships, food or rest [10–13]. There is no standardized name for PIU, so many synonyms are used in the literature, such as Internet addiction, compulsive use, pathological Internet use, and heavy Internet use. PIU can be defined as excessive and impulsive Internet use, inability to control one's Internet use time, affecting one's health or impairing daily life [14]. In recent years, PIU has become more and more obvious and common in young people [15, 16].
At present, there is no complete set of outcome indicators to evaluate PIU in clinical practice. The lack of consensus and the degree of difference lead to the inability to compare the results of individual RCTS, resulting in the diversification of outcome indicators and the lack of a complete evaluation system, which directly affects the effectiveness of research in informing patients and clinicians in clinical practice. The development of a core outcome set allows for standardization of outcome reporting and ultimately enables healthcare consumers to collaborate with healthcare professionals to make more informed healthcare decisions.
Core outcome sets (COSs) refer to the minimum results that should be measured and reported in clinical trials in a specific area of healthcare [17]. To facilitate future PIU studies, COS are required. Through standardization will report the results of specific areas, in addition to being able to form a set of standardized system, help clinical decision makers, can also reduce the waste and improve the effectiveness of randomized controlled trials, promote treatment comparison between different sources of evidence, and accelerate to generate systematic review and meta-analysis and evidence-based clinical guidelines [18, 19]. These core outcomes will standardize PIU outcome measures through a variety of means, including measurement and reporting, enabling key stakeholders-including individuals with life experience, healthcare professionals, research clinicians, and patient to compare, combine, and contrast trial results [17]. Our study will develop a COS for PIU clinical trials.
Primary outcome
To develop a core outcome set in PIU.