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A systematic review of Patient-Reported Outcome Measures used to evaluate pelvic organ prolapse severity

  • Author / Creator
    Conrad, Sarah J.

  • Introduction and Hypothesis: In measuring intervention impact, patient-reported outcome measures (PROMs) are recommended as they aim to capture what is most meaningful to patients. To accurately reflect the impact of pelvic organ prolapse (POP) from the patient's perspective, PROMs must have strong measurement properties such as validity, reliability, and responsiveness. The aim was to conduct a systematic review of studies reporting on the measurement properties of PROMs used in both surgical and conservative management settings for evaluating POP.

    Methods: Medline, EMBASE, CINAHL, Scopus, and Cochrane databases were searched from inception to May 2022 for studies that evaluated female adults with a diagnosis of or seeking treatment for POP. Studies were eligible if they involved 1) at least one group of female adults diagnosed with or presenting with symptoms of POP; 2) a self-reported outcome measure (PROMs, questionnaires) to evaluate POP-related domains; and 3) at least one measurement property including PROM development, content validity, internal consistency, reliability, measurement error, concurrent validity, discriminative validity, and/or responsiveness. Methodological quality was assessed using the COSMIN risk of bias (ROB) checklist, and measurement quality was determined using the COSMIN criteria for good measurement properties.

    Results: 2,495 abstracts were screened, and 68 full-text articles were reviewed, from which 12 studies met the selection criteria and were included in this review. The most frequently evaluated measurement properties were internal consistency (6 PROMs, five studies) and responsiveness (11 PROMs, ten studies). Most PROMs received a sufficient rating for the measurement quality of responsiveness in a surgical setting. Only five studies evaluated PROM responsiveness in the conservative management setting, and while most showed sufficient evidence of responsiveness, due to a small number of studies and small sample sizes, confidence in the reported quality of this measurement property is low for conservative settings.

    Conclusion: This original work identified a gap in evidence regarding the measurement qualities of identified PROMs used in the POP population. Few PROMs have empirical evidence supporting their content validity and responsiveness for evaluating the effectiveness of conservative interventions. Further research is needed to assess the full spectrum of measurement properties identified by COSMIN when considering existing PROMs used for those with POP.

  • Subjects / Keywords
  • Graduation date
    Fall 2023
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/r3-n1m1-hf29
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.