J Neurogastroenterol Motil  https://doi.org/10.5056/jnm22004
A Systematic Review of the Development and Psychometric Properties of Constipation-Related Patient-Reported Outcome Measures: Opportunities for Digital Health
V Vien Lee,1* Ni Yin Lau,1 David J Y Xi,1 Anh T L Truong,1,2 Agata Blasiak,1,2,3* Kewin T H Siah,4,5* and Dean Ho1,2,3*
1The N.1 Institute for Health, National University of Singapore, Singapore; 2Department of Biomedical Engineering, National University of Singapore, Singapore; 3The Institute for Digital Medicine (WisDM); Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 4Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; and 5Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Correspondence to: V Vien Lee, PhD
The N.1 Institute for Health (N.1), National University of Singapore, Center for Life Sciences, 28 Medical Drive, #05-COR, Singapore 117456
Tel: +65-6516-6666, E-mail: vvien.lee@nus.edu.sg

Agata Blasiak, PhD
The N.1 Institute for Health (N.1), National University of Singapore, Center for Life Sciences, 28 Medical Drive, #05-COR, Singapore 117456
Tel: +65-6516-6666, E-mail: agata.blasiak@nus.edu.sg

Kewin T H Siah, MBBS (London), MRCP
Division of Gastroenterology and Hepatology, National University Health System, 1E Kent Ridge Road, Level 10, Singapore 119228
Tel: +65-6779-5555, E-mail: kewin_siah@nuhs.edu.sg

Dean Ho, PhD
The N.1 Institute for Health (N.1), National University of Singapore, Center for Life Sciences, 28 Medical Drive, #05-COR, Singapore 117456
Tel: +65-6601-7515, E-mail: biedh@nus.edu.sg
Received: January 5, 2022; Revised: February 25, 2022; Accepted: May 24, 2022; Published online: June 20, 2022
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

Abstract
Background/Aims
Constipation can be a chronic condition that impacts daily functioning and quality of life (QoL). To aid healthcare providers in accurately assessing patient symptoms and treatment outcomes, patient-related outcome measures (PROMs) have been increasingly adopted in clinical settings. This review aims to (1) evaluate the methodological quality and measurement properties of constipation-related PROMs, using the COnsensus-based Standards for the selection of health Measurement INtruments (COSMIN) criteria; and (2) assess the modes of digital dissemination of constipation-related PROMs.
Methods
PubMed, Embase, and PsycINFO databases were searched and 11 011 records ranging from 1989 to 2020 were screened by 2 independent reviewers. A total of 26 studies (23 PROMs; 18 measuring symptom-related items and 5 measuring constipation-related QoL items) were identified for the review and assessed.
Results
There were multiple variations between PROMs, including subtypes of constipation, methods of administration, length of PROM and recall period. While no PROM met all the COSMIN quality standards for development and measurement properties, 5 constipation-related PROMs received at least 4 (out of 7) sufficient ratings. Only 2 PROMs were developed in Asia. Five PROMs were administered through digital methods during the validation process but methods of adapting the PROMs into digital formats were not reported.
Conclusions
The constipation-related PROMs identified in this review present varying quality of development and validation, with an overall need for improvement. Further considerations should be given towards more consistent methodology and reporting of PROM development, increase in culturally-specific PROMs, and better reporting of protocol for the digitisation of PROMs.
Keywords: Constipation; Digital health; Patient-reported outcome measures; Quality of life


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