BACKGROUND: Health-related quality of life (HRQL) is a key outcome in the evaluation of burn treatment. HRQL instruments with robust measurement properties are required to provide high quality evidence to improve patient care. The aim of this review was to critically appraise the measurement properties of HRQL instruments used in burns.
METHODS: A systematic search was conducted in in EMBASE, MEDLINE, CINAHL, Cochrane, Web of Science and Google scholar to reveal articles on the development and/or validation of HRQL instruments in burns. Measurement properties were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. A modified GRADE analysis was used to assess risk of bias (Prospero ID: CRD42016048065).
RESULTS: Forty-three articles covering 15 HRQL instruments (12 disease-specific and 3 generic instruments) were included. Methodological quality and evidence on measurement properties varied widely. None of the instruments provided enough evidence on their measurement properties to be highly recommended for routine use, however two instruments had somewhat more favourable measurement properties. The Burn Specific Health Scale Brief (BSHS-B) is easy to use, widely accessible and demonstrated sufficient evidence for most measurement properties. The Brisbane Burn Scar Impact Profiles (BBSIPs) were the only instruments with high quality evidence for content validity.
CONCLUSION: The BSHS-B (burn specific HRQL) and the BBSIP (burn scar HRQL) instruments have the best measurement properties. There is only weak evidence on the measurement properties of generic HRQL instruments in burn patients. Results of this study form important input to reach consensus on a universally used instrument to assess HRQL in burn patients.
LEVEL OF EVIDENCE: III, Systematic review.