title: Patient-reported outcome measures in reconstructive breast surgery: is there a role for generic measures?
abstract: BACKGROUND
  Patient-reported outcomes provide an invaluable tool in the assessment of outcomes in plastic surgery. Traditionally, patient-reported outcomes have consisted of either generic or ad hoc measures; however, more recently, there has been interest in formally constructed and validated questionnaires that are specifically designed for a particular patient population. The purpose of this systematic review was to determine whether generic measures still have a role in the evaluation of breast reconstruction outcomes, given the recent popularity and push for use of specific measures.
  
  
  METHODS
  A systematic review was performed to identify all articles using patient-reported outcomes in the assessment of postmastectomy breast reconstruction. Frequency of use was tabulated and the most frequently used tools were assessed for success of use, using criteria described previously by the Medical Outcomes Trust.
  
  
  RESULTS
  To date, the most frequently used measures are still generic measures. The 36-Item Short-Form Health Survey was the most frequently used and most successfully applied showing evidence of responsiveness in multiple settings. Other measures such as the Hospital Anxiety and Depression Scale, the Hopwood Body Image Scale, and the Rosenberg Self-Esteem Scale were able to show responsiveness in certain settings but lacked evidence as universal tools for the assessment of outcomes in reconstructive breast surgery.
  
  
  CONCLUSIONS
  Despite the recent advent of measures designed specifically to assess patient-reported outcomes in the breast reconstruction population, there still appears to be a role for the use of generic instruments. Many of these tools would benefit from undergoing formal validation in the breast reconstruction population.
authors.affiliation: Edmonton, Alberta, and Toronto, Ontario, Canada; and Baltimore, Md. From the Division of Plastic Surgery, Department of Surgery, University of Alberta; the Division of Plastic Surgery, Department of Surgery, University of Toronto; and the Center for Health Services and Outcomes Research, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Korus
authors.forename: Tatiana
authors.initials: T
authors.lastname: Cypel
authors.forename: Toni
authors.initials: T
authors.lastname: Zhong
authors.forename: Albert W
authors.initials: AW
authors.lastname: Wu
mesh_terms: D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires