Systematic review of eyecare Patient-Reported Experience Measures (PREMs) following COSMIN guidelines.

Abstract

Patient-Reported Experience Measures (PREMs) are essential for assessing healthcare quality from the patient's perspective. However, their use in eyecare is limited. This systematic review aimed to assess the existing evidence on the measurement properties of PREMs used to capture patient experiences of eyecare services. A comprehensive literature search was conducted across Web of Science Core Collection, Embase, PubMed, and Scopus to identify studies reporting the development and/or psychometric evaluation of PREMs in eyecare. The extracted measurement properties encompassed information on item development, content validity (the extent to which items are relevant, comprehensive, and understandable), structural validity (whether the items form the right scales), internal consistency (how well items measure underlying eyecare experience domains), cross-cultural validity, reliability, hypothesis testing, and responsiveness. Quality assessment, evaluation of measurement properties, evidence synthesis, and grading followed COSMIN methodology for systematic reviews. Thirteen studies were included, three of which evaluated 10 distinct PREMs, across settings, including low vision and primary/secondary eyecare. All ten PREMs met criteria for COSMIN Category B (potentially recommended, further validation needed). However, most lacked sufficient evidence for content validity and lacked supporting evidence for structural validity. None demonstrated adequate reliability, and none reported using Item Response Theory or Rasch Measurement Theory. Consequently, there was insufficient evidence to classify any of the identified PREMs into COSMIN recommendation Category A (recommended for use). Future studies on PREMs in eyecare should aim to strengthen the evidence for content and structural validity and provide robust proof of their reliability.