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Patient-related experience measurement scales for endoscopy procedures ‒ A systematic review, COSMIN and Conceptual
Maria José Dias1, Hugo Rodrigues2, Mário Dinis-Ribeiro3
1Nursing and Health Science, Universitat de Barcelona. Oncology Nursing Research Unit IPO Porto Research Center (CI-IPOP), Portugal.
Background:
patient experience is a quality indicator in gastrointestinal endoscopy, as recognized by the European Society of Gastrointestinal Endoscopy (ESGE). Despite this, no standardized tools or metrics have been formally endorsed for routine use.
Objective:
to identify and evaluate patient-reported experience measures (PREM) used in endoscopic procedures, assessing their psychometric properties and conceptual completeness, and to explore gaps for future development.
Methods:
a systematic literature review was conducted up to March 2023, including studies involving adults (> 18 years) who underwent endoscopic procedures and completed PREM. Instruments were assessed using the COSMIN risk of bias tool and a patient experience conceptual model.
Results:
of 1.911 articles screened, 10 studies met the inclusion criteria. The Colonoscopy Experience Score Tool (CEST) proved the strongest psychometric performance, while the Endoscopic Patient-Reported Experience Measure (ENDOPREM) showed superior conceptual coverage. However, no single instrument met both psychometric and conceptual standards. A critical gap identified across all tools was the absence of items related to patient health motivation.
Conclusion:
CEST is psychometrically superior and ENDOPREM is conceptually robust. Future PREM should adopt a hybrid approach-combining the psychometric strengths of CEST with the conceptual complexity of ENDOPREM-while also incorporating domains such as patient motivation to improve relevance and impact.
Implications:
measuring patient experience requires tools that are currently both scientifically rigorous and patient-centered. Developing a Hybrid PREM is an essential next step to support quality improvement in endoscopic care.
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