A systematic review of patient-reported outcome measures (PROMs) in cystic fibrosis

Abstract

BackgroundTo determine patient-reported outcome measures (PROMs) which may be suitable for incorporation into the Australian Cystic Fibrosis Data Registry (ACFDR) by identifying PROMs administered in adult and paediatric cystic fibrosis (CF) populations in the last decade.MethodsWe searched MEDLINE, EMBASE, Scopus, CINAHL, PsycINFO and Cochrane Library databases for studies published between January 2009 and February 2019 describing the use of PROMs to measure health-related quality of life (HRQoL) in adult and paediatric patients with CF. Validation studies, observational studies and qualitative studies were included. The search was conducted on 13 February 2019. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias Checklist was used to assess the methodological quality of included studies.ResultsTwenty-seven different PROMs were identified. The most commonly used PROMs were designed specifically for CF. Equal numbers of studies were conducted on adult (32%, n=31), paediatric (35%, n=34) and both (27%, n=26) populations. No PROMs were used within a clinical registry setting previously. The two most widely used PROMs, the Cystic Fibrosis Questionnaire—Revised (CFQ-R) and the Cystic Fibrosis Quality of Life Questionnaire (CFQoL), demonstrated good psychometric properties and acceptability in English-speaking populations.DiscussionWe found that although PROMs are widely used in CF, there is a lack of reporting on the efficacy of methods and timepoints of administration. We identified the CFQ-R and CFQoL as the most suitable for incorporation in the ACFDR as they captured significant effects of CF on HRQoL and were reliable and valid in CF populations. These PROMs will be used in a further qualitative study assessing patients’ with CF and clinicians’ perspectives toward the acceptability and feasibility of incorporating a PROM in the ACFDR.PROSPERO registration numberCRD42019126931.

The measurement properties of tests and tools used in cystic fibrosis studies: a systematic review

“…While the measurement properties of PROMs evaluating HRQoL in CF studies have been previously evaluated [135], this is the first effort to systematically review evidence of the measurement properties of all tests and tools used in CF studies. A diverse range of tests and tools were identified which vary with respect to their reliability, responsiveness and validity.…”

Acceptability of patient reported outcome measures (PROMs) in a cystic fibrosis data registry

“…The results are detailed elsewhere. 15 We found the CFQ-R and Cystic Fibrosis Quality of Life Questionnaire (CFQoL) provided comprehensive assessment of defined domains of HRQOL and evidence of robust psychometric properties in English-speaking populations. 15 The CFQ-R is a validated CF-specific PROM with adult, adolescent and child versions.…”

“…15 We found the CFQ-R and Cystic Fibrosis Quality of Life Questionnaire (CFQoL) provided comprehensive assessment of defined domains of HRQOL and evidence of robust psychometric properties in English-speaking populations. 15 The CFQ-R is a validated CF-specific PROM with adult, adolescent and child versions. The adult version includes 48 questions around 11 domains: physical functioning, vitality, emotion, social, role/school, body image, treatment burden, health perceptions, weight, respiratory and digestion.…”

“…We conducted a systematic review of CF PROMs evaluating HRQOL to assess suitability for the ACFDR. 15 A search of six databases for studies published between February 2009 and February 2019 describing PROMs used for CF adults and children yielded 27 PROMs. The results are detailed elsewhere.…”

“… 15 We found the CFQ-R and Cystic Fibrosis Quality of Life Questionnaire (CFQoL) provided comprehensive assessment of defined domains of HRQOL and evidence of robust psychometric properties in English-speaking populations. 15 …”