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Measuring Quality of Life in Cranial Reconstruction: A Systematic Review of Patient-Reported Outcomes Measures

Taborah Zaramo,BS Ian Zelko,BS Deshaun Ragland, BS Daniel Naughton, BS Achombom Tunyi,BS Kerry-Ann S. Mitchell, MD-PhD
The Ohio State University-Wexner Medical Center
2022-01-15

Presenter: Taborah Zaramo

Affidavit:
Gregory Pearson, MD

Director Name: Gregory Pearson, MD

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

PURPOSE:
Cranioplasty is a procedure used to restore form and function after surgical removal of a portion of the skull. While traditional surgical outcomes centered on morbidity remain important, patient-reported outcome measures (PROMs) are increasingly critical for clinical research endeavors. Given this, reliable and valid patient questionnaires are essential for reconstructive surgeons.
Thus, the aim of this systematic review was to critically appraise the contents of PROMs in adult cranioplasty studies. The secondary aim was to perform a quality assessment of cranioplasty-specific PROM-validation studies.

METHODS:
Systematic literature searches were performed in the PubMed and EMBASE databases to identify PROMs validated for use in patients undergoing cranioplasty. The methodological quality of included papers was appraised using the Consensus-Based Standards for the selection of Health Measurement Instruments checklist, and evaluation of measurement properties (reliability, responsiveness, construct validity) was done in accordance with published quality criteria. Item content was appraised by linking health concepts to the International Classification of Functioning Disability and Health framework.

RESULTS:
Abstract screening of 1834 publications resulted in 80 publications that included health outcomes questionnaires used in cranial reconstruction. Of those, 29 articles which contained 16 validated questionnaires were selected. None of these questionnaires were validated nor were specifically developed for cranial reconstruction in adults.

CONCLUSIONS:
Valid and reliable tools to measure patient reported outcomes in cranioplasty are lacking. To evaluate the benefits of cranioplasty and evaluate the impact of different cranial implant materials on quality of life, future studies to develop and validate new cranioplasty-specific instruments are needed.

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