Patient-Reported Outcomes and Outcome Measures in Military Trauma: A Scoping Review

Patient-reported outcomes (PROs) are crucial for understanding recovery after traumatic injury and for supporting patient-centered care. However, previous research has highlighted limited assessment of these outcomes across trauma research and inconsistent use of patient-reported outcome measures (PROMs) to evaluate them. This scoping review identified the PROMs used and PROs assessed in military trauma research. It summarized which PROMs were used, which PROs were assessed, and the timing of their use postinjury, providing an overview of current practice and highlighting gaps for future research.

We conducted a systematic search of online databases for studies published between 2013 and 2024 that used PROMs to evaluate PROs in military personnel with traumatic injuries. Data were charted on injury type, mechanism of injury, time to follow-up, PROMs used, and PROs assessed. Findings were summarized through narrative synthesis and reported according to the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines.

A total of 481 studies met inclusion criteria, with the majority originating from the United States (95%) and focusing on traumatic brain injury (TBI). Across studies, a wide variety of PROs and PROMs were identified, with substantial heterogeneity in their selection, use, and timing. The 5 most frequently used PROMs were the post-traumatic stress disorder (PTSD) Checklist (PCL), Neurobehavioral Symptom Inventory (NSI), Patient Health Questionnaire (PHQ), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI), while the most commonly assessed PROs included post-traumatic stress, depression, TBI outcomes, pain, and sleep. Median follow-up was approximately 5 years postinjury, with notable variation across injury types, PROMs, and PROs.

We identified the most frequently used PROs and PROMs in military trauma research, as well as the timing of their use postinjury. These findings may help guide clinicians and researchers working with military trauma populations. Moving forward, we recommend the development of a core set of PROs and PROMs for use after military trauma. Implementation of this will enable comparability between studies, improve understanding of PROs following military trauma, and ultimately support the delivery of patient-centered care.