Patient-Reported Outcome Measures in High-Risk Medical Device Registries: A Scoping Review

Abstract

Little is known about the methods and outcomes of Patient Reported Outcome Measures (PROMs) use among high-risk medical device registries. The objective of this scoping review was to assess the utility and predictive ability of PROMs in high-risk medical device registries. We searched Ovid MEDLINE, Embase, APA PsychINFO, Cochrane Library and Scopus databases for published literature. After searching, 4323 titles and abstracts were screened and 262 full text were assessed for their eligibility. Seventy-six papers from across orthopaedic (n = 64), cardiac (n = 10), penile (n = 1) and hernia mesh (n = 1) device registries were identified. Studies predominantly used PROMs as an outcome measure when comparing cohorts or surgical approaches (n = 45), or to compare timepoints (n = 13) including pre and post-intervention. Fifteen papers considered the predictive ability of PROMs. Of these, 8 treated PROMs as an outcome, 5 treated PROMs as a risk factor through regression analysis, and 2 papers treated PROMs as both a risk factor and as an outcome. One paper described PROMs to study implant survival. To advance methods of PROM integration into clinical decision-making for medical devices, an understanding of their use in high-risk device registries is needed. This scoping review found there is a paucity of studies using PROMs to predict long-term patient and clinical outcomes in high-risk medical device registries. Determination as to why PROMs are rarely used for predictive purposes in long-term data collection is needed if PROMs data are to be considered suitable as real-world evidence for high-risk device regulatory purposes, as well as to support clinical decision-making.