A systematic review of Thyroid-specific Health-related Quality of Life Instruments

Abstract

Aim/Background: This review critically appraised the psychometric properties of standardized thyroid-specific health-related quality of life (HRQOL) instruments, and to provide recommendations on the choice of HRQOL instruments for thyroid disease patients. Methods: Systematic review of English-language literature published between 1993 and 2015 identified psychometric studies involving patients with thyroid disease through a search of Pubmed, Web of Science, Embase, and OVID Medline. Methodological quality of each eligible study and overall levels of evidence per psychometric property and per HRQOL instrument were graded by two independent reviewers using a Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Results: After a review of 743 original studies, 17 studies reporting 11 standardized HRQOL instruments targeted for hypothyroidism (n = 4), thyroid cancer (n = 2), other thyroid disease (n = 3) and non-thyroid tumor sites (n = 2) were identified. Among nine methodological qualities included in COSMIN checklist, hypothesis testing was evaluated most frequently. The 84-item thyroid-specific patient-reported outcome measure (ThyPRO) originally developed in Denmark was the most extensively evaluated instrument. The highest number of positive ratings in overall level of psychometric evidence was found in ThyPRO and 11-item Thyroid Treatment Satisfaction Questionnaire (ThyTSQ) instruments. No existing instruments that are specific to thyroid cancer had adequate level of psychometric evidence. Conclusions: The ThyPRO is recommended to assess HRQOL in patients with benign thyroid diseases whilst psychometric property of ThyTSQ is satisfactory in measuring HRQOL in patients with hypothyroidism. This review highlights the need for the evaluation of psychometric properties of HRQOL instrument for patients with thyroid cancer.