Patient-reported outcome measures in osteoarthritis: a systematic search and review of their use and psychometric properties

Abstract

IntroductionPatient-reported outcome measures (PROM) or self-completed questionnaires have been used to report outcomes in osteoarthritis (OA) for over 35 years. Choices will always need to be made about what should be measured and, if relevant, what would be the most appropriate PROM to use. The current study aims to describe the available PROMs used in OA and their performance quality, so that informed choices can be made about the most appropriate PROM for a particular task.MethodsThe study included a systematic search for PROMs that have been in use over 17 years (period 2000–2016), and to catalogue their psychometric properties, and to present the evidence in a user-friendly fashion.Results78 PROMs were identified with psychometric evidence available. The domains of pain, self-care, mobility and work dominated, whereas domains such as cleaning and laundry and leisure, together with psychological and contextual factors, were poorly served. The most frequently used PROMs included the Western Ontario McMaster Osteoarthritis Index, the Short Form 36 and the Knee Disability and Osteoarthritis Outcome Score which, between them, appeared in more than 4000 papers. Most domains had at least one PROM with the highest level of psychometric evidence.ConclusionA broad range of PROMs are available for measuring OA outcomes. Some have good psychometric evidence, others not so. Some important psychological areas such as self-efficacy were poorly served. The study provides a current baseline for what is available, and identifies the shortfall in key domains if the full biopsychosocial model is to be explored.

Blocking extracellular Galectin-3 in patients with osteoarthritis

“…These patient reported outcome tools reliably gauge physiological burden of disease in OA patients, and their results are used by clinicians when prescribing OA treatment. [13]. Despite improvement across all surveys in the 12-week study, MCP treatment outcomes did not significantly differ from placebo.…”

A systematic review on the high variability in study design and outcome reporting in randomized controlled trials examining intra-articular platelet-rich plasma injection for knee osteoarthritis

“…A recent systematic review of PROMs utilized across studies examining knee OA suggest strong validity and responsiveness across both KOOS and WOMAC instruments in the evaluation of knee osteoarthritis. 58 WOMAC Physical Function (PF) has demonstrated ideal instrument responsiveness, however, it may not most appropriately separate the cause of limitations between pain and function. 59,60 The administration of KOOS instruments has the added advantage of assessing additional domains including Sports and Recreational Activities and Quality of Life, both of which are important in younger patients with lower grades osteoarthritis (i.e.…”

Applications of Wearable Technology in a Real-Life Setting in People with Knee Osteoarthritis: A Systematic Scoping Review

“…Although the use of an accelerometer allows researchers and clinicians the ability to track a broad scope of outcomes, its current use in a real-world setting is limited to assessing physical activity metrics. Nevertheless, accelerometers provide greater objectivity in assessing physical activity than patient-reported outcomes which are subject to the ceiling effect and recall bias [ 89 ]. Moreover, accelerometers can measure the four dimensions of physical activity: frequency, intensity, time, and type, but an inability to measure all activities with equal accuracy has been suggested as their current limitation [ 15 ].…”