Psychometric properties of health-related quality of life patient reported outcome measures for common cardiovascular conditions: a scoping review and COSMIN analysis

Abstract

Aims Health-related quality of life (HRQoL) is an important measure of disease status and represents a holistic approach to delivering patient-centered care. We conducted a scoping review of HRQoL patient reported outcome measures (PROMs) for cardiovascular diseases (CVDs) and evaluated their psychometric properties.Methods and results Randomized trials and observational studies that developed and validated HRQoL PROMs for adults with ischaemic heart disease (IHD), aortic stenosis (AS), atrial fibrillation (AF), heart failure (HF), or generic CVD were included, published from inception of databases to 8 February 2025 using PubMed, Web of Science, and Embase. Independent reviewers selected and extracted the psychometric properties of each PROM in accordance with the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist: content validity, reliability, internal consistency, structural validity, criterion/convergent, cross-cultural validity, measurement error, hypothesis testing, and responsiveness. Each PROM was graded using the Grading of Recommendations Assessment, Development, and Evaluation approach. Of 9430 articles, 220 studies for 38 different PROMs were included (HF n = 17, 45%; AF n = 11, 29%; IHD n = 7, 18%; generic n = 2, 5%; AS n = 1, 3%). Eleven PROMs (29%) satisfied all nine COSMIN criteria; the majority (n = 19, 50%) required further validation and eight were deemed inadequate for clinical use (21%).Conclusion This scoping review of HRQoL PROMs in individuals with common CVDs found evidence that many PROMs do not fulfill all nine COSMIN criteria for methodological quality, and for some CVDs there is a limited choice of suitable PROMs for HRQoL measurement. There is an opportunity to improve HRQoL evaluation for use within routine care and research.