Measurement Properties of Patient Reported Outcome Scales: A Systematic Review

Abstract

CONTEXT Recently a standard set for overall pediatric health outcomes in routine care was developed, which includes patient (or proxy) reported outcome measures (PROMs) for global health, cognitive functioning, and self-efficacy. OBJECTIVES To determine whether the following PROMs have sufficient measurement properties to be used in pediatric routine care: PROMIS Pediatric and Parent Proxy Scale - Global Health 7+2, PROMIS Parent Proxy Short Form - Cognitive Function 7a, and NIH Toolbox Self-Efficacy CAT Ages 13 to 17. DATA SOURCES Embase, Psych INFO, and Web of Science were searched from year of inception of each PROM to May 25, 2020; Medline to October 24, 2022. STUDY SELECTION English, full-text peer-reviewed articles that evaluated measurement properties of included PROMs were eligible. DATA EXTRACTION The COSMIN guideline for systematic reviews was used to appraise eligible studies and synthesize the overall evidence. RESULTS Screening >4000 titles yielded 4 to 6 eligible empirical studies for each PROM. The PROMIS instruments had sufficient content validity with low-quality evidence and at least low-quality evidence for sufficient structural validity and internal consistency. The NIH Toolbox lacked essential evidence for content validity. LIMITATIONS Assessments of measurement properties were based on information reported in the included studies; underreporting might have led to less favorable ratings. CONCLUSIONS The PROMIS instruments assessed in this review measure their intended construct for their targeted age group; clinicians can use these PROMs in pediatric routine care. Additional studies evaluating measurement properties, including content validity, are needed for the NIH Toolbox before it should be recommended for use in clinical practice.