Needed: guidance for reporting knowledge synthesis studies on measurement properties of outcome measurement instruments in health research

Nancy J. Butcher, Meta-researcher, Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute

Other Contributors:

Andrea Monsour
Lidwine B. Mokkink
Caroline B. Terwee
Andrea C. Tricco
Joel Gagnier
Martin Offringa
September 22, 2020

To the editor:

Lorente et al. identified significant heterogeneity in the tools, procedures, and definitions used by systematic reviewers to evaluate instrument measurement properties and highlighted key omissions in the reported methodological information in nearly 250 published systematic reviews on quality of life instruments.1 As we encounter with other health outcome measurement instruments used in child health and mental health research, poor compliance with methodological or reporting guidance in published reports impedes appraisal of the quality of the instruments’ measurement properties.2-6 This impairs knowledge users’ (such as policy-makers, other researchers, patients, healthcare providers) comprehensive appraisal of the sufficiency of the instruments that are used in studies or that are recommended to be used, as related to their key measurement properties and to issues of feasibility, burden, and fairness.

The authors raised important points concerning the current shortcomings of systematic reviews conducted to assess measurement properties of instruments. Lorente et al. concluded that improved adherence to methodological and reporting guidelines for the conduct and dissemination of systematic reviews on measurement properties of instruments is urgently needed. They recommended the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) checklist as the optimal framework to be used to conduct high-quality systematic reviews on measurement properties of health instruments for an evaluative purpose. Indeed, COSMIN hosts on online database of such systematic reviews ( Yet, empirical analysis of studies in the COSMIN database shows that there still are important gaps in the quality of the reporting of these reviews.5 6

We propose that guidance for reporting knowledge synthesis studies on measurement properties of outcome measurement instruments in health research be developed and implemented. To this aim, expansion of the widely used and recently updated reporting checklist, PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses7 8; cited >36 000 times9) checklist with the key methodological details relevant to reviews of measurement instruments, e.g., as specified by COSMIN methodology,10 could facilitate ease of use and uptake. If developed using modern scientific methods11 and subsequently implemented in ways that make the task of reporting studies of outcome measurement instruments easier, not more cumbersome, by providing a checklist of reporting items with a clear “user manual,” this new reporting guideline would have the potential to reduce a vast ongoing source of research waste in health measurement.

1. Lorente S, Viladrich C, Vives J, et al. Tools to assess the measurement properties of quality of life instruments: a meta-review. BMJ Open 2020;10:e036038.

2. Monsour A, Mew EJ, Patel S, et al. Primary outcome reporting in adolescent depression clinical trials needs standardization. BMC Med Res Methodol 2020;20:129.

3. Ding S, Mew EJ, Chee ATA, et al. Neurodevelopmental outcome descriptions in cohorts of extremely preterm children. Arch Dis Child Fetal Neonatal Ed 2020;0:F1-F10.

4. Stallwood E, Monsour A, Rodrigues C, et al. Systematic review: The measurement properties of the Children’s Depression Rating Scale-Revised (CDRS-R) for adolescents with major depressive disorder. J Am Acad Child Adolesc Psychiatry 2020, in-principle acceptance.

5. Terwee CB, Prinsen CA, Ricci Garotti MG, et al. The quality of systematic reviews of health-related outcome measurement instruments. Qual Life Res 2016;25:767-79.

6. Mokkink LB, Terwee CB, Stratford PW, et al. Evaluation of the methodological quality of systematic reviews of health status measurement instruments. Qual Life Res 2009;18:313-33.

7. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.

8. Page M, McKenzie J, Bossuyt P, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. 2020. doi:10.31222/

9. Caulley L, Cheng W, Catalá-López F, et al. Citation impact was highly variable for reporting guidelines of health research: a citation analysis. J Clin Epidemiol 2020;127:96-104.

10. Prinsen CA, Mokkink LB, Bouter LM, et al. COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res 2018;27:1147-57.

11. Moher D, Schulz KF, Simera I, et al. Guidance for developers of health research reporting guidelines. PLoS Med 2010;7:e1000217.

Conflict of Interest

None declared