Choosing the most appropriate PROM for clinical studies in sports medicine

Abstract

This paper presents a series of practical steps for the sports medicine researcher who wishes to use a PROM for a specific research objective. It is not meant as an overarching review of all aspects of PROM generation, validation, and utility, as these aspects are covered in subsequent articles in this series, and comprehensive reviews of these aspects can be found elsewhere. [5][6][7][8] Moreover, an international multidisciplinary team of researchers has established the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) checklist (https://www.cosmin.nl/cosmi n-tools/), which is the most extensive resource for assessing which PROM can be applied for various purposes. 7 The COSMIN taxonomy is specifically addressed further on in this paper and in subsequent papers in this series. This paper does not attempt to compete with COSMIN, but simply offers a concrete approach to locating and choosing potentially relevant PROMs for studies of patients with sports-related pathologies.An important topic in patient-centered measurement is how to choose the most appropriate PROM for a study, and which course of action to take if a suitable PROM does not exist. In order to assess the effectiveness of interventions, particularly within the paradigm of evidence-based medicine, physicians should formulate clinical questions in terms of the problem/population, intervention, comparison, and outcome(s). 9 This is known as the PICO framework, which is used to separate the research question into its distinctive components. Thus, the choice of PROM depends on the patient groups being assessed (P), the interventions (I) being compared (C), and which outcomes (O) are used to measure possible changes or differences. In the process of choosing the most appropriate PROM, the focus is primarily on the P and the O, as which patients will be assessed with which measures must be firmly sorted out before any interventions or comparisons can be made.Choosing the optimal PROM depends on whatever topic is most relevant for the targeted patients involved in the planned

Persistent Deficits after an Achilles Tendon Rupture: A Narrative Review

“…Many outcome measures can be used to evaluate the effect of an intervention, but patient-reported outcome measures (PROMs) that emphasize how the patient experiences the impact of the disorder or injury have become the gold standard in clinical research [ 27 ]. When evaluating patients with a more specific diagnosis such as Achilles tendon rupture, a condition-specific PROM is most appropriate [ 28 ]. Several PROMs have been used for Achilles tendon ruptures, such as the VISA-A [ 29 ] and the foot and ankle outcome score (FAOS) [ 30 ], but the most widely used is the Achilles tendon total rupture score (ATRS), which has been validated as a condition-specific PROM [ 31 ].…”

Patient-reported outcome measures: it is time for authors, reviewers, journal editors and health care strategists to take sufficient responsibility

“…Clinicians and researchers may find it difficult to understand the theoretical background of PROMs, how to apply a PROM in the clinical setting, and difficult to evaluate whether articles that conclude that particular PROMs are valid and reliable are actually valid. Therefore, with the aim to make all relevant information about PROMs available and understandable for clinicians and researchers without any particular statistical education, we and a group of colleagues produced a 10‐article series, which was recently published in the Scandinavian Journal of Medicine and Science in Sports [2, 4–6, 12, 14, 17, 19–21]. This also included an analysis of the validity of 61 musculoskeletal PROMs [14].…”

Patient-reported outcome measures as an outcome variable in sports medicine research

“…Recent efforts to establish guidelines and checklists for including PROMs in research, particularly clinical trials, are helpful and should be used early in study development ( 22 – 25 ). For example, general guidelines to follow when selecting a PROM should: (1) identify relevant PROM domains of interest that align with research questions, (2) consider disease or condition-specific, population-specific, and region-specific PROMs that are likely to be influenced by the therapy or intervention being studied, (3) evaluate the psychometric properties (reliability, validity and responsiveness) of PROMs in the population being studied, and (4) consider practicalities of using the PROM in the study, such as respondent burden and mode of administration ( 17 , 21 , 24 , 26 , 27 ).…”