Systematic review reveals limited psychometric quality across diabetes self-management tools, suggesting current instruments warrant cautious clinical use.
Key Points
To systematically evaluate the methodological quality and psychometric measurement properties of behavior-related self-management assessment instruments for individuals with diabetes.
Conducted a systematic search across eight biomedical databases (CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Embase, and CINAHL) from inception to December 15, 2025.
Applied the COSMIN guideline by two independent reviewers to evaluate methodological quality, assess measurement properties, and determine recommendation grades for eligible instruments (PROSPERO CRD420251178394).
Included 14 studies evaluating 11 assessment instruments; zero instruments met the criteria for a Grade A recommendation, with 5 classified as Grade B and 6 as Grade C.
Identified frequent methodological reporting deficiencies leading to indeterminate content validity, alongside a pervasive lack of evidence for cross-cultural validity, measurement error, and responsiveness.
Observed relatively stronger evidence for the SDSCA in adults with type 2 diabetes and the C-SMOD-A-23 in adolescents with type 1 diabetes, though both remain Grade B recommendations requiring cautious use.