Measurement properties of patient-reported outcome measures (PROMs) in adults with obstructive sleep apnea (OSA): A systematic review

Abstract

This systematic review summarizes the evidence regarding the quality of patient-reported outcome measures (PROMs) validated in patients with obstructive sleep apnea (OSA). We performed a systematic literature search of all PROMs validated in patients with OSA, and found 22 measures meeting our inclusion criteria. The quality of the studies was assessed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. The results showed that most of the measurement properties of the PROMs were not, or not adequately, assessed. For many identified PROMs there was no involvement of patients with OSA during their development or before the PROM was tested in patients with OSA. Positive exceptions and the best current candidates for assessing health status in patients with OSA are the sleep apnea quality of life index (SAQLI), Maugeri obstructive sleep apnea syndrome (MOSAS) questionnaire, Quebec sleep questionnaire (QSQ) and the obstructive sleep apnea patient-oriented severity index (OSAPOSI). Even though there is not enough evidence to fully judge the quality of these PROMs as outcome measure, when interpreted with caution, they have the potential to add value to clinical research and clinical practice in evaluating aspects of health status that are important to patients.

Patient‐reported outcome measure for obstructive sleep apnea: Symptoms, Tiredness, Alertness, Mood and Psychosocial questionnaire: Preliminary results

“…There are currently four OSA‐related quality of life PROMs that have had thorough patient involvement in their development: the Obstructive Sleep Apnea Patient‐Oriented Severity Index (OSAPOSI), Maugeri Obstructive Sleep Apnea Syndrome (MOSAS) questionnaire, Quebec Sleep Questionnaire (QSQ) and Sleep Apnea Quality of Life Index (SAQLI) (Abma et al, ).…”

“…The article on the development of the OSAPOSI ( n = 32) reveals that this PROM contains some topics that were not covered in other PROMs (e.g., occupational impact, such as loss of a job), but the OSAPOSI is not publicly available or retrievable via the developer (Piccirillo, Gates, White, & Schectman, ). Regardless, psychometric properties of all the above instruments are poor to fair at best, other than content validity, which is good for all four (Abma et al, ).…”

“…The significant consequences of OSA across biological, psychological and social spheres make the focus on HRQoL during the care Quality of Life Index (SAQLI) (Abma et al, 2016).…”

“…Patient‐reported outcome measures (PROMs) that quantify OSA with relevance to HRQoL should allow for the best characterization of disease severity. A recent systematic review demonstrated that current PROMs were not suitable for use in clinical practice as they have not undergone the appropriate level of psychometric testing (Abma, van der Wees, Veer, Westert, & Rovers, ).…”

Development of a Barthel index based on dyspnea for patients with respiratory diseases

“…1 Relief from dyspnea during activities of daily living (ADLs) represents the major goal of respiratory rehabilitation 2 and its quantification through specific instruments (scales) is essential to define disability level and postrehabilitation improvement. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Approximately 40% of patients with chronic obstructive pulmonary disease (COPD) report a degree of disability and 68% lose at least one relevant function in daily life. 18 In routine clinical practice, various scales measuring ADLs are used to evaluate patients' motor and functional autonomy/disability, the most widely used being the Barthel Index (BI).…”