Patient-related experience measurement scales for endoscopy procedures - A systematic review, COSMIN and conceptual model evaluation.

BACKGROUND

Patient experience is a quality indicator in gastrointestinal endoscopy, as recognized by the European Society of Gastrointestinal Endoscopy (ESGE). Despite this, no standardized tools or metrics have been formally endorsed for routine use.

OBJECTIVE

To identify and evaluate patient-reported experience measures (PREM) used in endoscopic procedures, assessing their psychometric properties and conceptual completeness, and to explore gaps for future development.

METHODS

A systematic literature review was conducted up to March 2023, including studies involving adults (>18 years) who underwent endoscopic procedures and completed PREM. Instruments were assessed using the COSMIN risk of bias tool and a patient experience conceptual model.

RESULTS

Of 1.911 articles screened, 10 studies met the inclusion criteria. The Colonoscopy Experience Score Tool (CEST) proved the strongest psychometric performance, while the Endoscopic Patient-Reported Experience Measure (ENDOPREM) showed superior conceptual coverage. However, no single instrument met both psychometric and conceptual standards. A critical gap identified across all tools was the absence of items related to patient health motivation.

CONCLUSION

CEST is psychometrically superior and ENDOPREM is conceptually robust. Future PREM should adopt a hybrid approach-combining the psychometric strengths of CEST with the conceptual complexity of ENDOPREM-while also incorporating domains such as patient motivation to improve relevance and impact.

IMPLICATIONS

Measuring patient experience requires tools that are currently both scientifically rigorous and patient-centered. Developing a Hybrid PREM is an essential next step to support quality improvement in endoscopic care.