Doran Christopher M, Bryant Jamie, Langham Erika, Bainbridge Roxanne, Shakeshaft Anthony, Hobden Breanne, Farnbach Sara, Freund Megan
Cluster for Resilience and Wellbeing, Manna and Appleton Institutes, Central Queensland University, Level 4, 160 Ann Street, Brisbane, QLD, 4000, Australia.
Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
Qual Life Res. 2025 Mar 28. doi: 10.1007/s11136-025-03956-5.
To critically appraise the psychometric properties and cultural appropriateness of self-reported generic patient-reported outcome measures (PROMs) applicable for use in the primary healthcare setting using the Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.
PROMs were identified via a published systematic review and searches of relevant websites. PROMs were included if they were generic (i.e., outcome measures that assessed general aspects of health); had a maximum of 30 items; were applicable for use by all adult primary care patients; and were validated in English. Data was extracted regarding the characteristics of each PROM and the characteristics of included validation studies. The COSMIN risk of bias checklist was used to assess methodological quality and the revised COSMIN criteria was used to assess measurement properties. An evidence synthesis was conducted across studies using the guidelines from the modified Grading of Recommendations Assessment, Development and Evaluation approach for systematic reviews of clinical trials.
399 PROMs were identified and 19 met inclusion criteria. The included PROMs measured general health related quality of life (n = 8), outcomes or impact of care (n = 3), patient enablement, activation, and empowerment (n = 3), quality of care (n = 3), health and disability (n = 1), and functional status (n = 1). Six PROMs met the recommended COSMIN threshold for implementation.
Although six PROMs can be recommended for use in primary care, further psychometric testing is still required to strengthen evidence related to internal consistency, responsiveness and cross-cultural validity/measurement invariance. Selection of a PROM for routine clinical use in primary care also needs to be guided by the patient population.
使用基于共识的健康测量工具选择标准（COSMIN）指南，严格评估适用于初级卫生保健环境的自我报告通用患者报告结局测量工具（PROMs）的心理测量特性和文化适宜性。
通过已发表的系统评价和相关网站搜索来识别PROMs。如果PROMs是通用的（即评估健康一般方面的结局测量工具）；最多有30个条目；适用于所有成年初级保健患者；并且已用英语验证，则将其纳入。提取了有关每个PROM的特征以及纳入的验证研究的特征的数据。使用COSMIN偏倚风险清单评估方法学质量，并使用修订后的COSMIN标准评估测量特性。根据改良的推荐分级评估、制定和评价方法（用于临床试验系统评价）的指南，对各项研究进行证据综合分析。
共识别出399个PROMs，其中19个符合纳入标准。纳入的PROMs测量了一般健康相关生活质量（n = 8）、护理结局或影响（n = 3）、患者赋能、激活和赋权（n = 3）、护理质量（n = 3）、健康和残疾（n = 1）以及功能状态（n = 1）。六个PROMs达到了推荐的COSMIN实施阈值。
尽管可以推荐六个PROMs用于初级保健，但仍需要进一步的心理测量测试，以加强与内部一致性、反应性和跨文化有效性/测量不变性相关的证据。在初级保健中选择用于常规临床使用的PROMs还需要以患者群体为指导。
