Patient-Reported Outcome Measures (PROMs) Relevant to Musculoskeletal Conditions Translated and Validated in the Greek Language: A COSMIN-Based Systematic Review of Measurement Properties

Abstract

Background: The use of patient-reported outcome measures (PROMs) constitutes a valuable tool in evaluating the quality of care offered in orthopaedic surgery. The aim of this review is to identify the PROMs that have been translated into and validated in the Greek language, summarise their measurement properties, and evaluate their methodological quality according to the COSMIN Risk of Bias Checklist. Methods: A structured literature search was conducted using the databases PubMED/MEDLINE, Embase, Scopus, and the Cochrane Library in order to identify PROMs relevant to musculoskeletal conditions translated and validated in the Greek language. The methodological quality of the studies was assessed according to the COSMIN Risk of Bias Checklist, and the quality of measurement properties according to the COMSIN criteria. Results: Literature search yielded 6743 articles. After removal of duplicates and screening of the articles, 32 studies including PROMs related to musculoskeletal conditions were identified. The studies included 31 PROMs and reported 171 measurement properties. Methodological quality was adequate for 81 of them (47.3%). The most commonly reported measurement properties were internal consistency, reliability, construct validity and responsiveness. Conclusion: The majority of PROMs translated into Greek involves the lower extremity and especially knee pathologies. The search revealed that there are areas of Musculoskeletal Medicine such as skeletal trauma, musculoskeletal oncology, and paediatric orthopaedics in which patient reported-outcome measures have not been translated into Greek. Translation and validation of new outcome measures is encouraged, using studies designed in compliance with the COSMIN guidelines, and further validation of the translated instruments.

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“…Structural validity refers to the degree to which the patient-reported outcome (PROM) scores are an adequate reflection of the dimensionality of the construct to be measured [ 40 ]. However, only one study performed the evaluation of structural validity [ 16 ], and the authors tested the property by means of standardized fit statistics with z scores and with the absence of other standard tests expected by the COSMIN, such as item response theory.…”

“…For COSMIN, the construct validity is assessed through the hypothesis test, where the consistency of the scores of a PROM are estimated from the comparison of instruments. Thus, the more specific the hypotheses and the more hypotheses tested, the more evidence is collected for this measurement property [ 40 ].…”