Content validity of patient-reported outcome measures of satisfaction with primary care for musculoskeletal complaints: A systematic review

OBJECTIVE: To evaluate the content validity of patient-reported outcome measurement (PROM) instruments used with patients with musculoskeletal complaints treated in primary care to assess satisfaction.

DESIGN: Systematic review of clinimetrical measurement.

LITERATURE SEARCH: A literature search in MEDLINE, EMBASE and CINAHL was undertaken (up to January 2020) to identify studies of the development or evaluation of content validity of a PROM aimed to assess patient satisfaction.

STUDY SELECTION CRITERIA: A PROM was considered eligible if it aimed to measure satisfaction with care in patients with musculoskeletal complaints. Two independent reviewers performed study selection, quality assessment, and data extraction.

DATA SYNTHESIS: Evaluation of content validity of the included PROMs was performed according to COSMIN guidance, which includes the evaluation of the quality of a PROM development, the quality of content validity studies, the content of the PROMs, and rating the quality of evidence with a modified GRADE approach.

RESULTS: Seven PROMs were identified. Their quality of development was inadequate. No studies evaluating content validity of the satisfaction PROMs were retrieved. The content validity of the satisfaction PROMs was insufficient, and supported by very low quality evidence.

CONCLUSION: In measuring patient satisfaction among patients with musculoskeletal complaints treated in primary care, none of the identified PROMs had adequate content validity. Future studies should address relevance, comprehensiveness, and comprehensibility of PROMs used to measure satisfaction, and emphasise patient involvement during the development of new instruments. J Orthop Sports Phys Ther, Epub 12 Nov 2020. doi:10.2519/jospt.2021.9788.