Presently PROMs are not tailored for athletes and high-performance sports practitioners: a systematic review

Abstract

Importance The concept of patient-reported outcome measures (PROMs) has come to the forefront in the evaluation of the results of treatment for musculoskeletal ailments, reflecting the concerns of improving patient-centred care. However, athletes and physically active individuals have physical and psychological expectations and goals that differ from those of the general population. Objective This systematic review aimed to investigate, with no restriction to the type of musculoskeletal sports injury, whether there is a standardisation of how to perform PROMs for athletes and physically active individuals. Evidence review A systematic review of the literature was performed searching the following electronic databases—The Cumulative Index to Nursing and Allied Health Literature; Cochrane Library; Embase; Medline-Ovid; Portal Regional da BVS/BIREME; ProQuest Health and Medical Collection; PubMed; SPORTDiscus, Web of Science with no limitations for year of publication up to December 2018. The search terms used were: patient outcomes measures, patient outcomes assessment, sports medicine. The articles were considered eligible according to the following criteria: studies related to populations of regular professional or recreational sports practitioners of any age, surgically managed sports injury, articles reporting PROMS evaluation in at least 50 athletes, postoperative evaluation and articles published in English, French, Portuguese, Spanish and Italian. We excluded systematic reviews, meta-analyses, editorials, articles reporting the results of non-surgical treatment, articles where no PROMS evaluation was performed, abstracts and case reports. Findings PROMs in athletes and high-performance sports practitioners were not uniform even when the same surgical procedure, such as anterior cruciate ligament reconstruction, was performed. Moreover, this study found 24 different PROMs reported in the 16 selected articles, confirming that, in Sports Medicine, there is a void in PROMs tailored to evaluate the postoperative outcomes regarding the physical and psychological demands of athletes and sports practitioners. Conclusion and relevance This systematic review evidences that the 16 selected articles did not present a standardisation in how to evaluate the postoperative outcomes in athletes and high-performance sports practitioners. Moreover, the preinjury status of physical demand reported should be of prime importance in developing PROMs tailored to this group athletes and regular sports practitioner. PROSPERO registration number CRD42019120701. Level of evidence Level IV, systematic review of levels I–IV studies.