COSMIN guideline for systematic reviews of patient-reported outcome measures
Open accessAbstract
PURPOSE: Systematic reviews of patient-reported outcome measures (PROMs) differ from reviews of interventions and diagnostic test accuracy studies and are complex. In fact, conducting a review of one or more PROMs comprises of multiple reviews (i.e., one review for each measurement property of each PROM). In the absence of guidance specifically designed for reviews on measurement properties, our aim was to develop a guideline for conducting systematic reviews of PROMs. METHODS: Based on literature reviews and expert opinions, and in concordance with existing guidelines, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) steering committee developed a guideline for systematic reviews of PROMs. RESULTS: A consecutive ten-step procedure for conducting a systematic review of PROMs is proposed. Steps 1-4 concern preparing and performing the literature search, and selecting relevant studies. Steps 5-8 concern the evaluation of the quality of the eligible studies, the measurement properties, and the interpretability and feasibility aspects. Steps 9 and 10 concern formulating recommendations and reporting the systematic review. CONCLUSIONS: The COSMIN guideline for systematic reviews of PROMs includes methodology to combine the methodological quality of studies on measurement properties with the quality of the PROM itself (i.e., its measurement properties). This enables reviewers to draw transparent conclusions and making evidence-based recommendations on the quality of PROMs, and supports the evidence-based selection of PROMs for use in research and in clinical practice.
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The COSMIN guidelines emphasize the value of modern psychometric methods, such as Rasch analysis and IRT, in assessing measurement properties like structural validity and reliability at the item level.
“The COSMIN guidelines (Prinsen et al., 2018) emphasize the value of modern psychometric methods, such as Rasch analysis and IRT, in assessing measurement properties like structural validity and reliability at the item level.”
From Measuring mindfulness: A systematic review and evaluation of self-report mindfulness scales (2026) · cites this paper as Prinsen et al., 2018
In Results, Part B, step 6.1, the guideline says structural validity is usually assessed by factor analysis or IRT/Rasch analysis. But step 7 places reliability among properties evaluated for the scale or subscale as a whole, rather than at the item level. The cited paper therefore supports the structural-validity part, not item-level reliability; page numbers are not provided in our copy. (LLM, conf=0.89)
Experimental — accuracy not yet measuredBecause no studies assessed the unidimensionality of SF-36 subscales, internal consistency results cannot provide evidence in support of this measurement property.
“According to recent COSMIN guidance [24], because no studies assessed the unidimensionality of the SF-36 subscales, these results cannot provide evidence in support of this measurement property.”
From Evidence on the measurement properties of health-related quality of life instruments is largely missing in patients with low back pain: A systematic review (2018) · cites this paper as [24]
This SF-12 internal consistency study does not represent evidence on this measurement property because the unidimensionality of these scores was not assessed in any study.
“This study does not represent evidence on this measurement property because the unidimensionality of these scores was not assessed in any study [24].”
From Evidence on the measurement properties of health-related quality of life instruments is largely missing in patients with low back pain: A systematic review (2018) · cites this paper as [24]
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- Authors
- Prinsen, C. A. C., Mokkink, L. B., Bouter, L. M., Alonso, J., Patrick, D. L., de Vet, H. C. W., & Terwee, C. B.
- Affiliations
- Amsterdam Public Health (NL)
- Municipal Institute for Medical Research (ES)
- University of Washington (US)
- Corresponding author
- Prinsen, C. A. C.
- ORCID
- Venue
- Quality of Life Research
- Published
- 2018-02-12
- Volume
- 27
- Issue
- 5
- Pages
- 1147-1157
- ISSN
- 0962-9343 (ISSN-L)
- 1573-2649
- PMC
- PMC5891568
- OpenAlex
- W2793320726
- Cited by
- 3,345
- References
- 37
- Citations by year
- 2026: 467 · 2025: 473 · 2024: 634 · 2023: 455 · 2022: 457 · 2021: 436 · 2020: 266 · 2019: 125 · 2018: 29 · 2017: 1
- FWCI
- 42.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Quality of Life Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- European Commission (2007–2013, FP7 2007-2013, FP7/2007, 305081)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Keywords
- patient-reported outcome measures, systematic review methodology, measurement properties, COSMIN, health measurement instruments, methodological quality assessment, reporting guidelines
- MeSH terms
- Patient Reported Outcome Measures, Humans, Quality of Life, Surveys and Questionnaires, Guidelines as Topic
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