Patient-reported outcome measures in cardiac surgery: A systematic review

Objectives: Patient-reported outcome measures (PROM) are standardized questionnaires, often referred to as tools, allowing patients to self-report their health, quality of life, or functional status associated with the perioperative care they received. There has been recent increased emphasis on their standardized incorporation into clinical practice, quality improvement initiatives, and clinical trials. Methods: We performed a systematic review (registration ID: CRD42021262914, no funding source) on PROM use in the adult cardiac surgery literature to summarize study characteristics, questionnaire use, and formal methodologic quality assessment using the Newcastle-Ottawa and Joanna Briggs Institute tools. Results: We included 668 publications from MEDLINE, EMBASE, PsycINFO, and CINAHL (2000-2024), using 341 unique PROM tools, in 229,392 patients. We used descriptive statistics to summarize study and patient characteristics as well as PROM and traditional outcome use, methods, and reporting characteristics. There was heterogeneous use of PROM tools and a low rate of baseline assessments, inconsistent assessment time intervals, and infrequent reporting of questionnaire element raw values. The measured PROM results were seldom compared or associated with traditional outcomes such as mortality, length of stay, or complications. Conclusions: To achieve the maximum utility of PROMs for optimizing perioperative care and patient-centered recovery, they must be applied in a consistent and standardized fashion within clinical practice, quality improvement initiatives, and clinical trials.