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Health Status and Quality of Life in Tuberculosis: Systematic Review of Study Design, Instruments, Measuring Properties and Outcomes

Sumeera Khan, Balamurugan Tangiisuran, Ayesha Imtiaz, Hadzliana Zainal

Background: Evaluation of patient reported outcome measures are important in improving the quality of life and effectiveness of care. Several measures have been developed to assess the health related quality of life of patients with tuberculosis.

Objective: To systematically identify health related quality of life outcome measures that could be used in tuberculosis care and examine their feasibility of use and psychometric properties. A systematic literature review and analysis of psychometric properties.

Method: Systematic literature research was done through PubMed, EMBASE and web search. Eligible studies assessed for unidimensional or multidimensional health related quality of life in patients with tuberculosis disease or infection using standardized instruments. Measuring psychometric properties such as internal consistency, reliability, validity and responsiveness were also examined. Results of included studies were summarized qualitatively.

Results: From 6020 articles, 99 articles were selected for full text assessment. A total of 30 studies meet or inclusion exclusion criteria and examined the psychometric properties of 6 health related quality of life measures. Evidence was limited as half of the information on psychometric properties per instrument was missing and measurement error was not analyzed in any of the included articles and responsiveness was only analyzed in one study.

Conclusion: A variety of instruments are used to assess the health related quality of life in tuberculosis patients. However, there has been only one disease specific instrument developed, making it difficult to understand the impact of illness. Most of the studies included does not required measuring properties or had problem with methodological quality. Further validation studies are required to support the use of health related quality of life measures in tuberculosis patients.