Møller Anne, Bissenbakker Kristine Henderson, Arreskov Anne Beiter, Brodersen John
Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Patient Relat Outcome Meas. 2020 Jan 8;11:1-10. doi: 10.2147/PROM.S226576. eCollection 2020.
The aim of this study is to search systematically for Patient Reported Outcome Measures (PROMs) used among patients with multimorbidity. Furthermore, the aim is to evaluate the adequacy and validity of the PROMs identified.
This systematic review follows the PRISMA guidelines. To assess the adequacy and validity of the identified PROMs the COSMIN Risk of Bias Checklist is used, more specifically a validation of the development, content validity, structural validity, and internal consistency of the PROMs.
Four PROMs were identified in the primary search, and one was found from references. The sixth PROM was published after the primary search. None of the identified PROMs were aimed specifically at measuring the quality of life in patients with multimorbidity. According to the checklist, the development process and content validity were rated "adequate" in only one measure and "invalid"/"doubtful"/"inadequate" in the rest of the measures. The structural validity of the measures was rated "adequate" in four measures and "very good" in one. Regarding the internal consistency, two measures were rated doubtful and three "very good". None of the six PROMs reported analyses about invariant measurement. The COSMIN Risk of Bias Checklist proved easy to use; however, there are some concerns in the rating of bias, that are discussed further.
All six PROMs developed for patients with multimorbidity identified possessed inadequacy in their measurement properties. Therefore, the aim for the future is to develop a valid and adequate measure of the quality of life among patients with multimorbidity.
本研究旨在系统检索合并症患者使用的患者报告结局量表(PROMs)。此外,目的是评估所识别的PROMs的充分性和有效性。
本系统评价遵循PRISMA指南。为评估所识别的PROMs的充分性和有效性,使用了COSMIN偏倚风险检查表,更具体地说是对PROMs的开发、内容效度、结构效度和内部一致性进行验证。
在初步检索中识别出4个PROMs,从参考文献中找到1个。第六个PROM在初步检索后发表。所识别的PROMs均未专门针对测量合并症患者的生活质量。根据检查表,仅一项测量的开发过程和内容效度被评为“充分”,其余测量被评为“无效”/“可疑”/“不充分”。四项测量的结构效度被评为“充分”,一项被评为“非常好”。关于内部一致性,两项测量被评为可疑,三项被评为“非常好”。六个PROMs均未报告关于测量不变性的分析。COSMIN偏倚风险检查表证明易于使用;然而,在偏倚评级方面存在一些问题,将进一步讨论。
为合并症患者开发的所有六个PROMs在所测量的属性方面都存在不足。因此,未来的目标是开发一种有效且充分的合并症患者生活质量测量方法。