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

Background and Objective:  There is a growing number of studies evaluating the physical, cognitive, mental health and health-related quality of life (QOL) 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 QOL, with few instruments assessing other domains. Of the 9 measurement properties evaluated on the COSMIN checklist, 6 were assessed in <10% of the evaluations. Overall quality of eligible studies was poor to fair based on the COSMIN checklist.

Conclusions:  While 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.

This article was published online in the Journal of Clinical Epidemiology in late November 2016.  The full text of the article is available to subscribers to this journal via this link.  The Library and Knowledge Service can obtain the full text of the article for registered members by requesting one via the library

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