Remote usage of digital patient-reported outcome measures for shoulder and elbow pathologies: a systematic review

Patient-reported outcome measures (PROMs) report patient-centered outcomes. Digital PROMs enable remote monitoring of larger cohorts and support clinical decision-making without in-person visits. This review evaluates their use in shoulder and elbow pathologies, highlighting key benefits and challenges.

A systematic PubMed Medical Subject Headings search (through March 2025) identified studies evaluating digital PROMs applicable outside clinical settings. Studies were screened and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

The search yielded 2,331 records; 474 remained after filtering. After screening, 62 full texts were reviewed, and 11 met all inclusion criteria. Six studies focused on shoulder conditions, two on elbow pathology, and three on broader upper-extremity disorders. Study designs included six prospective cohorts, two randomized trials, two retrospective analyses, and 1 implementation study. Digital PROM tools fell into five categories and PROMs into five outcome domains. Response rates were reported in only four studies and varied substantially from 43% to 91.6%, limiting the consistency and interpretability of adherence-related findings. Baseline PROMs were collected in 8 of 11 studies. Digital tools demonstrated feasibility and patient acceptance, with comparable performance to paper-based or conventional methods only when directly assessed in individual studies.

Electronic PROMs appear to be a feasible and acceptable option for remote follow-up in shoulder and elbow pathologies. In studies with direct comparison, their performance was generally comparable to paper-based or conventional collection methods. However, the current evidence is heterogeneous, response rates were inconsistently reported, and important barriers remain for older adults and patients with limited digital access or literacy.