Evaluation of measurement properties of health-related quality of life instruments for burns: A systematic review

Abstract

BACKGROUND: Health-related quality of life (HRQL) is a key outcome in the evaluation of burn treatment. Health-related quality of life instruments with robust measurement properties are required to provide high-quality evidence to improve patient care. The aim of this review was to critically appraise the measurement properties of HRQL instruments used in burns. METHODS: A systematic search was conducted in Embase, MEDLINE, CINAHL, Cochrane, Web of Science, and Google scholar to reveal articles on the development and/or validation of HRQL instruments in burns. Measurement properties were assessed using the Consensus-based Standards for the selection of health Measurement Instruments methodology. A modified Grading of Recommendations, Assessment, Development, and Evaluation analysis was used to assess risk of bias (prospero ID, CRD42016048065). RESULTS: Forty-three articles covering 15 HRQL instruments (12 disease-specific and 3 generic instruments) were included. Methodological quality and evidence on measurement properties varied widely. None of the instruments provided enough evidence on their measurement properties to be highly recommended for routine use; however, two instruments had somewhat more favorable measurement properties. The Burn-Specific Health Scale-Brief (BSHS-B) is easy to use, widely accessible, and demonstrated sufficient evidence for most measurement properties. The Brisbane Burn Scar Impact Profiles were the only instruments with high-quality evidence for content validity. CONCLUSION: The Burn Specific Health Scale-Brief (burn-specific HRQL) and the Brisbane Burn Scar Impact Profile (burn scar HRQL) instruments have the best measurement properties. There is only weak evidence on the measurement properties of generic HRQL instruments in burn patients. Results of this study form important input to reach consensus on a universally used instrument to assess HRQL in burn patients.

Measurement instruments for the core outcome set of congenital melanocytic naevi and an assessment of the measurement properties according to COSMIN: a systematic review

“…In this process, the feasibility of instruments should also be considered as well; instruments should be easy and quick to use and should be low-cost or free of charges. Similar systematic reviews investigating the measurement properties according to the COSMIN checklist are available for diseases similar to CMN such as vitiligo, vascular malformations, capillary malformation and burn scars 17 , 23 , 24 , 25 . Although these studies also revealed a low quality of measurement instruments validated for their particular patient population, some of their recommendations may inform which instruments should be validated for CMN.…”

“…Disease-specific instruments measure the impact of a specific condition on the different aspects of ‘quality of life’, while generic instruments measure the overall ‘quality of life’ of a subject, allowing comparisons between a group of patients with a certain disease and their peers of the general populations. The systematic review evaluating ‘quality of life’ instruments for burn scars showed that burn scar specific instruments have the best measurement properties 24 .…”

Assessing Health-Related Quality of Life of Adult Patients with Intermediate Burns: The Added Value of an Itching and Cognition Item for the EQ-5D: A Retrospective Observational Study

“…Important advantages of the EQ-5D are its short form, so it can be applied worldwide as shown by a recent burn study in Tanzania [8], its availability in many languages, and the ability to assess the burden of disease by calculating DALYs [9] and cost-effectiveness of burn care by calculating QALYs [10]. However, because it does not include burn-specific problems, such as itching, disfigurement, fatigue, or cognition, a (potential) limitation of the EQ-5D is its seemingly limited sensitivity for burn-specific problems [11,12].…”

“…Within burns, the EQ-5D is sometimes applied with an extra cognition item as it is assumed to increase the sensitivity and comprehensiveness of the EQ-5D for burns [7,20,21]. However, this has not yet been formally studied [11]. Previous studies showed that cognition problems are negatively associated with burn severity [20,22].…”