Evaluating the psychometric properties of patient-reported outcome measurements for urolithiasis: a COSMIN-based systematic review

Abstract

Objective: Urolithiasis has emerged as a substantial public health burden, characterized by recurrent pain and profound disruptions to health-related quality of life (HRQoL). While multiple patient-reported outcome measurements (PROMs) have been developed to assess HRQoL in this population, yet the methodological quality and psychometric properties of these condition-specific instruments remain unclear. This study aimed to systematically identify urolithiasis-specific PROMs for assessing HRQoL, evaluate and integrate the quality of the measurement properties.

Materials and methods: PubMed, Web of Science and relevant reference lists were systematically searched until January 2025. Studies developing or validating urolithiasis-specific HRQoL PROMs were included. The methodological qualities were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. The measurement properties were assessed against the criteria COSMIN recommended. The final overall rating was established through a synthesis based on modified GRADE approach.

Result: Thirty-three publications were deemed eligible. Six urolithiasis-specific PROMs for assessing HRQoL were identified, each of which has specific value in clinical practice and research. The most common finding was the limited evidence of comprehensiveness of content validity. Half of all measures lacked the necessary psychometric evidence on structural validity. The Urinary Stones and Intervention Quality of Life (USIQOL) received a Class A recommendation, the remaining five PROMs were assigned Class B recommendations.

Conclusion: This systematic review provides the basis for identifying urolithiasis-specific PROMs with potential utility. The USIQOL is currently the most rigorously validated PROM for comprehensive HRQoL assessment in urolithiasis. Other instruments are useful for targeted applications but require further validation. Further research is required to validate and complement the missing information on the psychometric properties of these instruments.

Keywords: Health outcome; Health-related quality of life; Instruments; Patient reported outcome measurement; Psychometric property; Systematic review; Urolithiasis.