Abstract
ObjectiveTo identify and assess the psychometric properties of patient-reported outcome measures (PROMs) of health-related quality of life (HRQoL) in people living with HIV (PLWH).MethodsNine databases were searched from January 1996 to October 2020. Methodological quality was assessed by using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties of each PROM. A modified Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the certainty of evidence.ResultsSixty-nine studies reported on the psychometric properties of 30 identified instruments. All studies were considered to have adequate methodological quality in terms of content validity, construct validity, and internal consistency. Limited information was retrieved on cross-cultural validity, criterion validity, reliability, hypothesis testing, and responsiveness. High-quality evidence on psychometric properties was provided for the Medical Outcomes Study HIV Health Survey (MOS-HIV), the brief version of the World Health Organization's Quality of Life Instrument in HIV Infection (WHOQoL-HIV-BREF), 36-Item Short Form Survey (SF-36), Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQoL-HIV), and WHOQoL-HIV.ConclusionsThe findings from the included studies highlighted that among HIV-specific and generic HRQoL PROMs, MOS-HIV, WHOQoL-HIV-BREF, SF-36, MQoL-HIV, and WHOQoL-HIV are strongly recommended to evaluate HRQoL in PLWH in research and clinics based on the specific aims of assessments and the response burden for participants.
Highlights
With the introduction of antiretroviral therapy (ART), the life expectancy of people living with HIV (PLWH) has been prolonged
The advantage of using generic health-related quality of life (HRQoL) Patient-reported outcome measure (PROM) is that researchers can directly compare the results with those of other groups based on the same problem without standardizing the data
For PLWH, generic PROMs may not be as sensitive as specific PROMs assessing HIV-specific dimensions of HRQoL regarding stigma, relationship issues, and comorbidities [29]
Summary
With the introduction of antiretroviral therapy (ART), the life expectancy of PLWH has been prolonged. In addition to MOS-HIV, other HIV-specific HRQoL PROMs are widely used, including the WHOQoL-HIV-BREF [9], Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQoL-HIV) [10], HIV Disease Quality of Life 31-Item Instrument (HIV-QL31) [11], and Patient-Reported Outcomes Quality of Life–HIV instrument (PROQoL-HIV) [12]. In addition to HIV-specific PROMs, some generic PROMs, including the Short Form Health Survey (SF-12, SF-36) [18, 19], EuroQol—5 Dimensions (EQ-5D) [20, 21], World Health Organization Quality of Life assessment (WHOQoL) [22], Medical Outcomes Study Health Survey (MOS) [23], Missoula-Vitas Quality-of-Life Index (MVQOLI) [24], Patient-Reported Outcomes Measurement Information System (PROMIS) [25], Health Assessment Questionnaire Disability Index (HAQ-DI) [26], Quality of Well-Being scale (QWB) [27], and Health Utility Index 3 (HUI3) [28], have been validated and used in the PLWH population globally. For PLWH, generic PROMs may not be as sensitive as specific PROMs assessing HIV-specific dimensions of HRQoL regarding stigma, relationship issues, and comorbidities [29]
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