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Patient-reported outcome measures in scar treatment: a systematic review

dermatology
evidence-based-medicine
public-health
science-and-medical-education
healthcare-services

Abstract

Background: Scar formation is a common result of tissue injury, and effective scar management is crucial for improving patients' quality of life. Patient-reported outcome measures (PROMs) are used to assess the effectiveness of scar treatments by capturing patient perceptions. However, a comprehensive overview of the effectiveness of scar treatments in relation to PROMs, along with the quality of studies and PROMs, is lacking.

Objective: This systematic review aims to provide a comprehensive evaluation of PROMs used in scar treatment, including the methodological quality of studies, the effectiveness of scar treatments in relation to PROMs, and the quality of the PROMs employed.

Methods: A literature search was conducted on November 12, 2024, across PubMed, Web of Science, and Embase, covering studies from database inception to the search date. Eligible studies were original clinical research involving scar-related PROMs in scar treatment. Exclusions included non-English studies, case series (≤10 cases), case reports, conference abstracts, animal studies, protocols, reviews, and commentaries. Two independent reviewers evaluated studies based on inclusion/exclusion criteria. The modified Downs and Black checklist assessed study quality, while the ISOQOL checklist evaluated the quality of PROMs.

Results: A total of 24 studies were included: 14 randomized controlled trials, 7 cohort studies, 2 case-control studies, and 1 case series. Based on the modified Downs and Black checklist, 3 studies were of good quality, 15 were fair, and 6 were poor. Eight different PROMs were identified, with the “Patient” component of the Patient and Observer Scar Assessment Scale (POSAS-P) being the most commonly used in 17 studies. The POSAS-P demonstrated the best quality in the ISOQOL assessment.

Conclusions: This review highlights improvements in PROMs following scar treatments but reveals variability in study quality, treatment approaches, and PROM tools. The findings emphasize the need for rigorous, long-term studies using standardized and validated PROMs to enhance the evidence base.

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