Quality of life measurement tools for heavy menstrual bleeding: A systematic review and critical appraisal

Accurate and reliable heavy menstrual bleeding (HMB) specific quality of life (QoL) tools can offer a holistic assessment of HMB impact and response to treatment. We systematically reviewed published disease-specific QoL assessment tools for HBM to assess their methodological quality.

We searched PubMed and EMBASE until March 2024 complemented by a search of PROQOLID database and reference lists for studies reporting on the development or validation of HMB specific QoL instruments for adult women. We assessed them against the COSMIN checklist. We scored tools for their methodological quality to make recommendations for use in practice.

We identified 2621 citations and included 17 studies reporting on the development and validation of 10 HMB specific QoL tools. All the studies were conducted in the USA and western Europe, and all were available in the English language except one. Three tools were in digital format, while seven were in paper format (7/10, 70 %). The median of QoL tool items was 21 (range 3-72) with a recall period of 1-3 months in 7/10 (70 %) tools. The overall quality was low to medium and none of the tools met all the COSMIN requirements to be recommended in clinical practice. The UFS-QOL and SAMANTA tools showed high quality for validity, responsiveness and interpretability but require further validation.

None of the available QoL tools for HMB are appropriate for use in practice. There is a need to invest in developing and validating reliable tools that offer high quality qualitative and quantitative assessment.