Albishi Waleed, Alsanawi Hisham, Alsharidah Muhannad, Alhuqbani Mohammed, Aldosari Zyad, Aldosari Omar, Elmaraghy Amr
Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Orthopedic Surgery, St Joseph's Health Centre, University of Toronto, Toronto, ON, Canada.
JSES Rev Rep Tech. 2025 May 6;5(3):523-532. doi: 10.1016/j.xrrt.2025.04.005. eCollection 2025 Aug.
Elbow-related issues are common among adults and can significantly impact their daily activities and quality of life. Patient-reported outcome measures (PROMs) are increasingly being used nowadays to assess the subjective experience of patients with elbow problems. Identifying reliable, valid, and responsive tools is deemed necessary to be embedded in the assessment and treatment planning. This study aimed to identify currently available PROMs designed for people with elbow pathology and appraise, compare, and synthesize psychometric data supporting these PROMs.
This review adhered to the methodology outlined by Cochrane and followed the principles set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Systematic searches were conducted in databases such as MEDLINE and Embase to identify studies related to PROMs for elbow diseases. The search was limited to papers published until July 2023. The inclusion criteria were specifically targeted toward adult populations, English-language publications, and research that provided information on the psychometric features of PROMs. The COSMIN Risk of Bias checklist was used to do data extraction and quality assessment.
Of the 6741 articles, 58 full-text articles were evaluated to determine their eligibility. Nineteen studies fulfilled the requirements for inclusion, providing information on 10 PROMs for elbow problems. PROMs such as the Disabilities of the Arm, Shoulder, and Hand, Quick Disabilities of Arm, Shoulder, and Hand, and Oxford Elbow Score have shown strong reliability and construct validity. Most PROMs did not have thorough qualitative evaluations and concept elicitation. The Patient-Rated Ulnar Nerve Evaluation and Patient-Rated Elbow Evaluation showed strong reliability and responsiveness, but the Elbow Self-Assessment Score and Kerlan-Jobe Orthopaedic Clinic score exhibited satisfactory reliability but lacked comprehensive qualitative assessment.
Ten elbow PROMs were reviewed, showing psychometric diversity. Some PROMs are reliable and valid; others require further development and validation. Future studies could enhance qualitative assessments and standardization of PROM evaluation guidelines. A core outcome set for elbow-related PROMs could improve consistency and comparability in clinical research.
肘部相关问题在成年人中很常见，会显著影响他们的日常活动和生活质量。如今，患者报告结局测量（PROMs）越来越多地用于评估肘部问题患者的主观体验。确定可靠、有效且具有反应性的工具被认为有必要纳入评估和治疗计划中。本研究旨在确定目前为肘部疾病患者设计的PROMs，并评估、比较和综合支持这些PROMs的心理测量数据。
本综述遵循Cochrane概述的方法，并遵循系统评价和Meta分析的首选报告项目所规定的原则。在MEDLINE和Embase等数据库中进行系统检索，以识别与肘部疾病PROMs相关的研究。检索限于截至2023年7月发表的论文。纳入标准专门针对成年人群、英文出版物以及提供PROMs心理测量特征信息的研究。使用COSMIN偏倚风险清单进行数据提取和质量评估。
在6741篇文章中，对58篇全文文章进行了评估以确定其是否符合纳入标准。19项研究符合纳入要求，提供了有关10种肘部问题PROMs的信息。手臂、肩部和手部功能障碍、手臂、肩部和手部快速功能障碍以及牛津肘部评分等PROMs显示出很强的可靠性和结构效度。大多数PROMs没有进行全面的定性评估和概念引出。患者评分尺神经评估和患者评分肘部评估显示出很强的可靠性和反应性，但肘部自我评估评分和Kerlan-Jobe骨科诊所评分表现出令人满意的可靠性，但缺乏全面的定性评估。
对10种肘部PROMs进行了综述，显示出心理测量的多样性。一些PROMs可靠且有效；其他的则需要进一步开发和验证。未来的研究可以加强定性评估和PROM评估指南的标准化。肘部相关PROMs的核心结局集可以提高临床研究的一致性和可比性。
