Patient-reported outcome measures in cerebrovascular neurosurgery

Rithvik Ramesh Department of Neurological Surgery, University of California, San Francisco, California

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Alexander F. Haddad Department of Neurological Surgery, University of California, San Francisco, California

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Vijay Letchuman Department of Neurological Surgery, University of California, San Francisco, California

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Young M. Lee Department of Neurological Surgery, University of California, San Francisco, California

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Lorenzo Rinaldo Department of Neurological Surgery, University of California, San Francisco, California

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Adib A. Abla Department of Neurological Surgery, University of California, San Francisco, California

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Luis E. Savastano Department of Neurological Surgery, University of California, San Francisco, California

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Daniel M. S. Raper Department of Neurological Surgery, University of California, San Francisco, California

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OBJECTIVE

The object of this study was to describe the use of patient-reported outcome measures (PROMs) in cerebrovascular neurosurgery and to outline a framework for incorporating them into future cerebrovascular research.

METHODS

Following the standardized PRISMA guidelines, the authors performed a search of the PubMed and Embase databases in February 2023 using filters to investigate six specific cerebrovascular pathologies/procedures: subarachnoid hemorrhage (SAH), intracranial hemorrhage, ischemic stroke, arteriovenous malformation, chronic subdural hematoma, and carotid artery stenosis. PROMs in the identified articles were distinguished and classified as generic, symptom specific, or disease specific.

RESULTS

A total of 259 studies including 51 PROMs were eligible for inclusion in the review. Most of the PROMs were generic or symptom specific. Only 5 PROMs were disease specific, and all of these pertained to stroke or SAH.

CONCLUSIONS

There are only a limited number of disease-specific PROMs available for cerebrovascular pathologies and outcomes. Further validation of existing measures in independent cohorts, expanded incorporation of disease-specific PROMs in prospective trials, and the development of new PROMs specific to cerebrovascular conditions are critical to a better understanding of the impact of cerebrovascular diseases and novel therapies on patient lives.

ABBREVIATIONS

aSAH = aneurysmal SAH; AVM = arteriovenous malformation; CAS = carotid artery stenosis; CROM = clinician-reported outcome metric; cSDH = chronic subdural hematoma; FSS = Fatigue Severity Scale; GOS = Glasgow Outcome Scale; HADS = Hospital Anxiety and Depression Scale; ICH = intracranial hemorrhage; IS = ischemic stroke; mRS = modified Rankin Scale; MFS = Mental Fatigue Scale; PROM = patient-reported outcome measure; QOL = quality of life; SAH = subarachnoid hemorrhage; SAHOT = subarachnoid haemorrhage outcome tool; SIS = Stroke Impact Scale; SOS-SAH = Questionnaire for the Screening of Symptoms in aneurysmal Subarachnoid Hemorrhage; SS-QOL = stroke-specific QOL.

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