Reliability and validity of patient-reported outcome measures in assessing knee osteoarthritis in the Chinese population: A systematic review

Objective: Knee osteoarthritis (KOA) is a prevalent condition in China, necessitating effective assessment tools for treatment outcomes. This study systematically reviews and analyzes the reliability, validity, and selection of patient-reported outcome measures (PROMs) for evaluating KOA. Methods: Following PRISMA guidelines, a literature search was conducted across seven databases, including CNKI, PubMed, and Embase, covering publications from December 2012 to December 2022. The methodological quality of the studies was assessed using the COSMIN checklist. Results: Twenty-one studies met the inclusion criteria, involving eight types of KOA PROMs. The Oxford Knee Score (OKS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were the most frequently utilized, appearing in nine and four studies, respectively. OKS achieved a ''strong'' rating in internal consistency, test-retest reliability, content validity, responsiveness, and measurement error, while WOMAC received a ''strong'' rating in internal consistency, test-retest reliability, and content validity, with a ''moderate'' rating in structural validity. Conclusion: Both OKS and WOMAC are effective PROMs for evaluating KOA in China. However, the choice of a specific tool should be based on the study's objectives and the practical context, considering each tool's reliability, validity, and other measurement properties.