A systematic review finds limited data on measurement properties of instruments measuring outcomes in adult intensive care unit survivors

J Clin Epidemiol. 2017 Feb:82:37-46. doi: 10.1016/j.jclinepi.2016.08.014. Epub 2016 Nov 16.


Background and objective: There is a growing number of studies evaluating the physical, cognitive, mental health, and health-related quality of life (HRQOL) outcomes of adults surviving critical illness. However, there is little consensus on the most appropriate instruments to measure these outcomes. To inform the development of such consensus, we conducted a systematic review of the performance characteristics of instruments measuring physical, cognitive, mental health, and HRQOL outcomes in adult intensive care unit (ICU) survivors.

Methods: We searched PubMed, Embase, PsycInfo, Cumulative Index of Nursing and Allied Health Literature, and The Cochrane Library in March 2015. We also conducted manual searches of reference lists of eligible studies and relevant review articles. Two people independently selected studies, completed data abstraction, and assessed the quality of eligible studies using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) initiative checklist.

Results: We identified 20 studies which explicitly evaluated measurement properties for 21 different instruments assessing outcomes in ICU survivors. Eleven of the instruments assessed quality of life, with few instruments assessing other domains. Of the nine measurement properties evaluated on the COSMIN checklist, six were assessed in <10% of the evaluations. Overall quality of eligible studies was generally poor to fair based on the COSMIN checklist.

Conclusions: Although an increasing number of studies measure physical, cognitive, mental health, and HRQOL outcomes in adult ICU survivors, data on the measurement properties of such instruments are sparse and generally of poor to fair quality. Empirical analyses evaluating the performance of instruments in adult ICU survivors are needed to advance research in this field.

Keywords: Critical care survivors; Outcome measures; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Checklist / methods*
  • Checklist / statistics & numerical data*
  • Critical Illness
  • Health Status*
  • Humans
  • Intensive Care Units*
  • Outcome Assessment, Health Care / methods*
  • Quality of Life*
  • Survivors / statistics & numerical data