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Evaluating quality of patient-reported outcome measures in keratitis: A systematic review
Haile W Alemu1,2, Sheela E Kumaran1, Nicole Carnt1
1School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Purpose:
To evaluate the quality of existing patient-reported outcome measures (PROMs) used to assess the impact of keratitis on the quality of life (QoL).
Methods:
A literature search was conducted using Embase, PubMed, Scopus, Web of Science, CINAHL, and PsycINFO. The review included PROMs used to assess the impact of keratitis on QoL. Data on the content development and psychometric properties were extracted. Quality assessment was performed using the established criteria for ophthalmic PROMs.
Results:
A total of seven articles met our inclusion criteria. The study populations in the reviewed articles consist of individuals diagnosed with different types of microbial keratitis. Ten unique PROMs were reviewed. Nine were ophthalmic and one was generic. Only the impact of vision impairment PROM has undergone psychometric validation in keratitis. Although the validation indicated acceptable unidimensionality (grade B), both the eigenvalue and item-person targeting demonstrated misfit to the Rasch model. Psychometric appraisal showed that keratitis patients were not involved in PROM content development, leading to misalignment and inconsistencies between the constructs outlined by the instruments and evaluation findings. Limited available literature constrains the depth of this review.
Conclusions:
Initiating psychometric validation of the PROM in keratitis conditions is a good starting point. All evaluated PROMs lack psychometric validation and are not specific to keratitis. The findings of this review underscore the need to create a psychometrically robust, keratitis-specific PROM. The systematic review registration number is CRD42023449213.
