Evaluation of measurement properties of health-related quality of life instruments for burns: a systematic review

BACKGROUND Health-related quality of life (HRQL) is a key outcome in the evaluation of burn treatment. Health-related quality of life 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 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 methodology. A modified Grading of Recommendations, Assessment, Development, and Evaluation 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 favorable 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 were the only instruments with high-quality evidence for content validity. CONCLUSION The Burn Specific Health Scale - Brief (burn-specific HRQL) and the Brisbane Burn Scar Impact Profile (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 Systematic review, level III