Quality and acceptability of patient-reported outcome measures used in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review

To review the quality and acceptability of condition-specific, domain-specific and generic multi-item patient-reported outcome
measures (PROMs) used in the assessment of adults with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).

Systematic literature searches were made to identify PROMs. Quality and acceptability was assessed against an appraisal framework,
which captured evidence of both the thoroughness and results of evaluations: evidence of measurement (reliability, validity,
responsiveness, interpretability, data quality/precision) and practical properties (feasibility, patient acceptability), and
the extent of active patient involvement was sought.

A total of 11 CFS/ME-specific, 55 domain-specific and 11 generic measures were reviewed. With the exception of the generic
SF-36, all measures had mostly limited evidence of measurement and/or practical properties. Patient involvement was poorly
reported and often cursory.

The quality and acceptability of reviewed PROMs is limited, and recommendations for patient-reported assessment are difficult.
Significant methodological and quality issues in PROM development/evaluation were identified by the appraisal framework, which
must be addressed in future research. Clear discrepancies exist between what is measured in research and how patients define
their experience of CFS/ME. Future PROM development/evaluation must seek to involve patients more collaboratively to measure
outcomes of importance using relevant and credible methods of assessment.