Patient reported outcome measures for facial skin cancer: A systematic review and evaluation of the quality of their measurement properties
Authors:
Dobbs, T. D., Samarendra, H., Hughes, S., Hutchings, H. A., and Whitaker, I.
Abstract:
INTRODUCTION: Skin cancer is the commonest malignancy worldwide, often occurring on the face. Both the condition and treatment can lead to scarring and facial disfigurement, affecting a patient's health-related quality of life (HRQoL), which can be measured using patient-reported outcome measures (PROMs). This systematic review identifies PROMs for facial skin cancer and appraises their methodological quality and psychometric properties using up-to-date methods.
METHODS: MEDLINE, EMBASE, PsychINFO, Cochrane and CINAHL were systematically searched in accordance with PRISMA guidelines, identifying all PROMs designed for or validated in facial skin cancer. Methodological quality and evidence of psychometric properties were assessed using the COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) checklist and criteria proposed by Terwee et al. A best evidence synthesis and assessment of instrument focus on post-resection reconstruction was also performed.
RESULTS: Twenty-four studies on 11 PROMs were included. Methodological quality and psychometric evidence was variable, with the Patient Outcome of Surgery - Head/Neck (POS-H/N), Skin Cancer Index (SCI), Skin Cancer Quality of Life Impact Tool (SCQLIT) and Essers et al demonstrating the greatest level of validation. None scored well in their relevance to post-skin cancer reconstruction of the face.
DISCUSSION: This systematic review critically appraises PROMs for facial skin cancer using internationally accepted criteria. The identified PROMs demonstrate a variation in the quality of validation performed, with a need to improve this across all PROMs in the field. Only through improving the quality of PROMs available and their focus on the post-treatment aesthetic and functional outcome will we be able to truly appreciate the concerns of our patients' and improve the management of facial skin cancer. This article is protected by copyright. All rights reserved.
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