Coronary heart disease health behavior assessment tools based on COSMIN guidelines: a systematic review

To review existing health behavior assessment tools for coronary heart disease, evaluate their methodological quality and measurement properties, and identify appropriate instruments for health behavior assessment. A systematic search was conducted in PubMed, Embase, Web of Science, CNKI, Wanfang Data, and VIP Database from inception to August 1, 2026. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) risk of bias checklist was used to evaluate methodological quality. COSMIN criteria were applied to rate and summarize the psychometric properties of each PROM. The modified Grading of Recommendation Assessment, Development, and Evaluation approach was used to assess the certainty of evidence. The Coronary Heart Disease Active Health Behavior Assessment Scale, Health Behavior Motivation Scale, and Coronary Artery Disease Empowerment Scale were classified as Grade A based on the available evidence, whereas the remaining six scales received Grade B recommendations and require further validation of certain psychometric properties. The Coronary Heart Disease Active Health Behavior Assessment Scale, Health Behavior Motivation Scale, and Coronary Artery Disease Empowerment Scale can be considered for evaluating health behavior in patients with coronary heart disease. However, most existing tools have not undergone comprehensive evaluation of all PROM psychometric properties, and important dimensions related to barriers to healthy behaviors remain insufficiently represented in item content.