Key result
PROMs for aortic dissection show significant heterogeneity with none fully evaluated under COSMIN psychometric standards.
Why the study?
To systematically identify all patient reported outcome measures used in aortic dissection and explore how well they evaluate quality of life according to COSMIN methodology.
What patient-reported outcome measures are used to assess quality of life in aortic dissection, and how well do they evaluate QOL according to COSMIN methodology?
Systematic Review (n=5,874)
What patient-reported outcome measures are used to assess quality of life in aortic dissection, and how well do they evaluate QOL according to COSMIN methodology?
There is significant heterogeneity in the PROMs used for patients with aortic dissection, and a lack of comprehensive psychometric evaluation highlights the need for a dissection-specific PROM.
Heterogeneity in PROMs with incomplete COSMIN validation limits reliable QOL assessment in aortic dissection; supports development of a dedicated, fully validated instrument.
OBJECTIVE: To systematically identify all patient reported outcome measures (PROMs) (quality of life [QOL] instruments or other instrument/methodology) that have been used to date in aortic dissection (AD) and to explore how well these instruments evaluate QOL according to the Consensus based Standards for the selection of health Measurement Instruments (COSMIN) methodology or guideline. DATA SOURCES: Embase, MEDLINE, PsycINFO, CINAHL, and Cochrane Library were search on 1st July 2022. REVIEW METHODS: This scoping review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) and the COSMIN guidelines for performing systematic reviews of validated PROMs. Studies that reported on any aspect or domain of QOL using a PROM or other instrument or methodology on AD were included. Data synthesis, including psychometric property analysis and risk of bias assessment were performed according to COSMIN guidelines. RESULTS: Forty-five studies, published between 1994 and 2021 reporting on 5 874 patients (mean age 63 years, 70.6% male), were included. A total of 39 PROMs were used, and three studies used semi-structured interviews. The majority (69%) of studies were in patients with type A aortic dissection (TAAD). The most common PROM used was the SF-36 (51%). Six studies evaluated one or more psychometric properties of a PROM. Only one of these studies was specifically designed as a validation study. No study reported on content validity. Internal consistency was the most evaluated psychometric property. No study evaluated all the psychometric properties according to COSMIN methodology. The methodological quality used to assess these PROMs was judged to be adequate or very good. CONCLUSION: This review highlights the heterogeneity of PROMs or methods used to determine QOL in AD patients. The lack of research regarding a comprehensive evaluation of the psychometric properties of a PROM used in AD highlights the need for the development and validation of a dissection specific PROM. [PROSPERO registration no. CRD42022310477].
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Hanna et al. (2023) conducted a systematic review in Aortic dissection (n=5,874). Patient reported outcome measures (PROMs) was evaluated on Psychometric properties of PROMs evaluated according to COSMIN methodology. A systematic review of 45 studies found significant heterogeneity in PROMs used for aortic dissection, with no study evaluating all psychometric properties according to COSMIN methodology.
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