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Generic instruments still have a role for patient evaluation after reconstructive breast surgery

In a recently published study, researchers attested to the role that generic survey and testing instruments, like the 36-Item Short-From Health Survey, can play in the assessment of patient-reported outcomes in breast reconstruction patients.

The researchers systematically reviewed a total of 1,254 records through a database search to identify all literature in which patient-reported outcomes were used to assess postmastectomy breast reconstruction. Of these, 493 articles were confirmed and included in the final study.

Formalized patient-reported outcomes were used in 110 records, and the researchers identified 73 different patient-reported outcome measures.

The researchers found the most commonly used measures not specific to breast cancer or reconstruction were the 36-Item Short-Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale, the Rosenberg Self-Esteem Scale and the Hopwood Body Image Scale.

The SF-36 quantifies general health status through limitations in physical, social and usual role activities; bodily pain; general mental health; vitality and general health perceptions, and it has been observed to offer adequate internal consistency and reproducibility, according to the researchers. This measure was also found to be the most frequently and successfully used for demonstrating evidence of responsiveness.

The Hospital Anxiety and Depression Scale has strengths in assessing anxiety and depression in those with postoperative complications, and the Rosenberg Self-Esteem Scale surveys patient self-worth, self-criticism and self-acceptance, according to the researchers. However, although these tools demonstrated responsiveness in certain settings, they were found to lack evidence as universal tools for assessing breast reconstruction surgery outcomes.

The BREAST-Q measures quality of life and satisfaction before and after breast reconstruction or augmentation.

According to the researchers, within the general population and in those with chronic diseases, most of the instruments provided evidence of acceptable reliability. However, the researchers also stated that many of the tools would likely benefit from being formally validated within the breast reconstruction population. – by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.