Advancing the evidence-based use of patient-reported outcome measures (PROMs) in mental health

Background

Patient-reported outcome measures (PROMs) are widely used in mental health research and support clinical and policy decision-making. International initiatives (e.g., CMMHS) recommend PHQ-9, GAD-7, WHODAS 2.0, and RCADS-25 for assessing depression, anxiety, and disability. However, evidence on their measurement properties is fragmented and heterogeneous, with complex appraisal and synthesis, limiting access, and context-sensitive use. We aim to systematically appraise and synthesise their measurement properties using a living approach and to develop an open-access, regularly updated platform to facilitate their access and use.

Methods

We follow established guidelines to conduct living systematic reviews of the measurement properties of four PROMs. Protocols were registered for each PROM in PROSPERO. A peer-reviewed search strategy was applied to MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science. A two-phase approach on Epistemonikos SK Platform was defined: Phase A, mapping eligible studies, and Phase B for targeted synthesis of more homogeneous groups, with expected dissemination via an open-access evidence platform.

Results

The initial searches retrieved 29,936 records across four PROMs, with evidence highly uneven and PHQ-9 studies predominating. A pilot screening of 4.8% of records suggests up to 900 PHQ-9 studies may be eligible for full synthesis. Pilot mapping showed substantial heterogeneity in study populations, contexts, and measurement properties. Further mapping results will be presented, refining identified knowledge gaps.

Conclusions

Preliminary findings indicate that evidence on PROM measurement properties in mental health is heterogeneous and structurally complex, supporting staged synthesis. Living systematic reviews offer a methodological approach to continuously update and synthesise this growing literature to ultimately improve access, use according to context, and evidence-informed decision-making via the planned platform.

Key messages

• Evidence on PROM measurement properties in mental health is large, unevenly distributed and highly heterogeneous, limiting straightforward synthesis and context-sensitive use.

• A living, staged synthesis approach enables continuously updated and structured evidence to support interpretation according to context, and informed decision-making of PROMs in mental health.