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Assessing the content based on ICF and quality based on COSMIN criteria of patient-reported outcome measures of functioning in breast cancer survivors: a systematic review

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Abstract

Purpose

To identify currently used patient-reported outcome measures (PROMs) to evaluate disability in breast cancer survivors (BC) and critically evaluate their content and measurement properties.

Methods

Four electronic databases (PubMed, EMBASE, CINAHL, Scopus and Google Scholar) were searched from 2001 to February 2021. PRISMA guidelines were followed. The content of the included PROM was evaluated by linking the items of the questionnaires to the International Classification of Functioning, Disability and Health (ICF) Core Set for BC using standard linking rules. Methodological quality and measurement properties were assessed using the COSMIN checklist. Qualitative synthesis was used to summarize the evidence on content validity and measurement properties. The overall quality of evidence on each measurement property was provided using GRADE principles.

Results

Ten eligible studies reported measurement properties of seven PROMs. The content of included PROMs mostly focused on disability (70% of items), and less on body function and structure (23%) or environmental factors (6%). There was high linkage to The Comprehensive Core Set for BC, Q-DASH (100%), UEFI (95%) and DASH (92%). The Core Set Unique Disability Representation for DASH, and WHODAS2 was 39% and BCSQ-BC, Lymph-ICF was 34%. BCSQ-BC, and Lymph-ICF represented 32, and 20% of the content of the Core Set for BC, respectively, however, the other questionnaires covered less than 20% of the content of the Core Set. High quality of evidence supports sufficient results for internal consistency, testretest, and measurement error for BCSQ-BC, Lymph-ICF, DASH and WHODAS2.

Conclusions

Despite a lack of evidence on all-important clinical measurement, two generic (DASH and WHODAS2) and two disease-specific (BCSQ-BC, Lymph-ICF) PROM demonstrated emerging evidence of adequate measurement properties. The stronger alignment of the BCSQ-BC to the breast cancer ICF core set makes it preferable is a disease-specific measure. The Lymph-ICF is recommended where lymphedema is a specific focus. The DASH and WHODAS2 might be most useful where patients with a variety of upper extremity conditions, including breast cancer survivors, are being evaluated in the clinic or research study.

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Acknowledgements

Joy MacDermid was supported by a Canada Research Chair and the Dr James Roth Chair (both in Musculoskeletal Measurement and Knowledge Translation).

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Author information

Authors and Affiliations

  1. Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Farkhondeh Jamshidi

  2. School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario. Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, ON, Canada

    Maryam Farzad

  3. Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, London, ON, Canada

    Maryam Farzad

  4. Physical Therapy and Surgery, Western University, London, ON, Canada

    Joy C. MacDermid

  5. Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, ON, Canada

    Joy C. MacDermid

  6. Rehabilitation Science McMaster University, Hamilton, ON, Canada

    Joy C. MacDermid

  7. Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Canada

    Azar Varahra

  8. Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Seyed Ali Hosseini

  9. Health Promotion Research Center, Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran

    Mojtaba Habibi Asgarabad

  10. Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway

    Mojtaba Habibi Asgarabad

Authors
  1. Farkhondeh Jamshidi
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  2. Maryam Farzad
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  3. Joy C. MacDermid
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  4. Azar Varahra
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  5. Seyed Ali Hosseini
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Contributions

All of the research team contributed to the study conception and study design. FJ and MF: contributed to the literature search, data extraction, quality assessment, and linkage between the content of the outcome measurements and the ICF framework. MF and FJ: mutually performed the analyses. AV: prepared the first draft of the manuscript, and MF: commented on each subsequent versions of the manuscript and did the final revisions. JCM: guided methods and revised the manuscript for important intellectual content. All authors read and approved the final manuscript to be published.

Corresponding author

Correspondence to Maryam Farzad.

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Jamshidi, F., Farzad, M., MacDermid, J.C. et al. Assessing the content based on ICF and quality based on COSMIN criteria of patient-reported outcome measures of functioning in breast cancer survivors: a systematic review. Breast Cancer 29, 377–393 (2022). https://doi.org/10.1007/s12282-022-01340-6

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