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Review
. 2025 Oct 2:38:14497.
doi: 10.3389/ti.2025.14497. eCollection 2025.

Quality of Measurement Properties in Patient Reported Outcomes Used in Adult Liver Transplant Candidates and Recipients: a Systematic Review

Samira E M van Knippenberg #  1 , Sarah F Powell-Brett #  2   3 , Kunal Joshi  2 , Víola B Weeda  4 , Hermien Hartog  3   5
Affiliations
Review

Quality of Measurement Properties in Patient Reported Outcomes Used in Adult Liver Transplant Candidates and Recipients: a Systematic Review

Samira E M van Knippenberg et al. Transpl Int. .

Abstract

Objective: Patient Reported Outcome Measures (PROMs) are increasingly recognized in liver transplant (LT)-patients, yet recent evaluations of their quality are lacking. This systematic review gives a comprehensive overview of available PROMs in adults awaiting or undergoing LT and their measurement properties.

Method: A systematic search in MEDLINE, EMBASE, PubMed, and COCHRANE (01/2010-08/2023) included studies involving adult LT-candidates and/or recipients utilizing PROMs with original evaluations of measurement properties. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was used to ascertain the quality of measurement properties.

Results: In total, 23 studies encompassing 35 PROMs were identified, including nine disease-specific and 26 generic PROMs. The (Short-form) Liver Disease Quality of Life ((SF-)LDQoL), Transplant Effects Questionnaire (TxEQ) and Post-Liver Transplant Quality of Life (pLTQ) were the most utilized disease-specific PROMs. Most studies demonstrated low-quality evidence for measurement properties. pLTQ demonstrated high-quality evidence for internal consistency, reliability, and responsiveness; the generic Hospital Anxiety and Depression Scale (HADS) showed strong evidence for internal consistency and construct validity.

Conclusion: Measurement properties in LT-patients remains of low-quality. pLTQ stands out for its superior methodological quality among disease-specific PROMs. For future studies, there is a strong recommendation to focus more on patients' subjective measures and their measurement properties.

Keywords: liver transplantation; measurement properties; patient reported outcome measures; quality of life; surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram.
See this image and copyright information in PMC

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