Abnormal uterine bleeding: a review of patient-based outcome measures

Objective: To summarize and evaluate the patient-based outcome measures (PBOMs) that have been used to study women with abnormal uterine bleeding (AUB). Design: Systematic review. Setting: Original articles that used at least one PBOM and were conducted within a population of women with AUB. Patient(s): Women with AUB. Intervention(s): The titles, abstracts, and studies were systematically reviewed for eligibility. The PBOMs used in eligible studies were summarized. Essential psychometric properties were identified, and a list of criteria for each property was generated. Main Outcome Measure(s): Quality of individual PBOMs as determined using the listed criteria for psychometric properties. Result(S): Nine hundred eighty-three studies referenced AUB and patient-reported outcomes. Of these, 80 studies met the eligibility criteria. Fifty different instruments were used to evaluate amount of bleeding, bleeding-related symptoms, or menstrual bleeding-specific quality of life. The quality of each of these instruments was evaluated on eight psychometric properties. The majority of instruments had no documentation of reliability, precision, or feasibility. There was no satisfactory evidence that any one instrument completely addressed all eight psychometric properties. Conclusion(s): Studies of women with AUB are increasingly using PBOMs. Many different PBOMs were used; however, no single instrument completely addressed eight important measurement properties. (Fertil Steril (R) 2009;92:205-16. (C) 2009 by American Society for Reproductive Medicine.)