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 measures (PROMs) used to assess satisfaction in patients with musculoskeletal complaints who are treated in primary care. DESIGN: Systematic review of clinimetric 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 that 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 the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance, which includes an evaluation of PROM development, content validity studies, PROM content, and quality of evidence using the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Seven PROMs were identified. Their quality of development was inadequate. No studies evaluating the content validity of the satisfaction PROMs were retrieved. The content validity of the patient satisfaction PROMs was insufficient and supported by very low-quality evidence. CONCLUSION: In measuring satisfaction among patients with musculoskeletal complaints treated in primary care, none of the identified PROMs had adequate content validity. Future studies should address the relevance, comprehensiveness, and comprehensibility of PROMs used to measure patient satisfaction and emphasize patient involvement during the development of new instruments.