Patient-reported outcomes: Which ones are most relevant?

The use of patient-reported outcome measures (PROs) in research and clinical use in orthopedic trauma surgery has increased dramatically over the past decades, and this trend will continue in the future. This review aimed to provide insight into the way PROs can best be identified, reviewed, selected, and used in orthopedic trauma studies and patient care. Selection of instruments for a specific (research) question starts with a systematic literature review for identifying the mostly used instruments. From this list, the instruments that are most suitable for the intended use are selected. Readability, usability, and costs should be considered at this stage. For the selected instruments, the next step is to search the literature systematically in order to determine if the measurement properties of these instruments meet the quality standard as outlined by the COSMIN group. Instruments need to be valid for the targeted condition, intervention as well as population. If not available in the primary language of the targeted population, the instrument requires translation according to a state of the art procedure and validation in the new language. Reporting guidelines like the SPIRIT-PRO and CONSORT-PRO are available in order to guide the reporting of PROs in study protocol and outcome reports, respectively. Using Core Outcome Sets improves the validity of results of clinical research and increases the feasibility of conducting meta-analyses. If the standards and procedures as outlined above are used, the use of PROs will contribute to improved patient care and clinical research.