Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review
Abstract Objectives The aim of this literature review was to synthesise and report current practice in evaluation and reporting of scar outcomes in hand and wrist clinical research. Methods A systematic search from inception to 2022 was conducted using three electronic databases. English language ra...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06296-y |
| _version_ | 1797854045233217536 |
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| author | Donna L. Kennedy Tracy Chism-Balangue Dominic Furniss |
| author_facet | Donna L. Kennedy Tracy Chism-Balangue Dominic Furniss |
| author_sort | Donna L. Kennedy |
| collection | DOAJ |
| description | Abstract Objectives The aim of this literature review was to synthesise and report current practice in evaluation and reporting of scar outcomes in hand and wrist clinical research. Methods A systematic search from inception to 2022 was conducted using three electronic databases. English language randomized controlled trials and observational cohort studies reporting standardised scar outcome measures and/or scar symptoms, appearance, impairment, function, or mental health outcomes in patients with hand and wrist scars were included. Two independent reviewers determined study eligibility and performed data extraction of a priori identified scar outcome domains. Data analysis included descriptive statistics and identification of discordance in taxonomy. Results Fifty-nine studies were included. Elective surgery cohorts were the most frequently included clinical population (n = 28; 47%) followed by burns (n = 16; 27%). Six different standardised scar outcome measures were reported by 25% of studies however only 7% of studies utilised a patient-reported measure. Scar symptoms were the most frequently reported outcome domain (81%); but taxonomy was incongruous, constructs lacked working definitions required for generalisability and outcome measurement was variable and unreported. Nineteen different measures of scar appearance and structure were reported by 30 (51%) of studies however only nine (23%) were patient-reported. Seven different hand function PROMs were reported by 25 (43%) studies. Person-centred domains including scar acceptability (12%), mental health impact (5%), and social participation (4%) were rarely reported. Conclusions This review highlights that evaluation and reporting of hand and wrist scar outcomes is not standardised, assessment methods and measures are under-reported and there is discordance in taxonomy. Evaluation is not person-centred, rather it is dependent on clinician assessment. Domains including scar acceptability, mental health, and social participation are rarely addressed. A stakeholder consensus derived hand and wrist scar core outcome measurement set will promote standardisation and underpin improvements in clinical research quality, transparency, and rigour. |
| first_indexed | 2024-04-09T20:00:44Z |
| format | Article |
| id | doaj.art-4888f2e0e6c9412dab673114427762e1 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-09T20:00:44Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4888f2e0e6c9412dab673114427762e12023-04-03T05:13:29ZengBMCBMC Musculoskeletal Disorders1471-24742023-03-0124111110.1186/s12891-023-06296-yReporting of scar outcomes in the hand and wrist; a state-of-the-art literature reviewDonna L. Kennedy0Tracy Chism-Balangue1Dominic Furniss2Therapy Department, Charing Cross HospitalOccupational Therapy, West Coast UniversityNuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Botnar Research CentreAbstract Objectives The aim of this literature review was to synthesise and report current practice in evaluation and reporting of scar outcomes in hand and wrist clinical research. Methods A systematic search from inception to 2022 was conducted using three electronic databases. English language randomized controlled trials and observational cohort studies reporting standardised scar outcome measures and/or scar symptoms, appearance, impairment, function, or mental health outcomes in patients with hand and wrist scars were included. Two independent reviewers determined study eligibility and performed data extraction of a priori identified scar outcome domains. Data analysis included descriptive statistics and identification of discordance in taxonomy. Results Fifty-nine studies were included. Elective surgery cohorts were the most frequently included clinical population (n = 28; 47%) followed by burns (n = 16; 27%). Six different standardised scar outcome measures were reported by 25% of studies however only 7% of studies utilised a patient-reported measure. Scar symptoms were the most frequently reported outcome domain (81%); but taxonomy was incongruous, constructs lacked working definitions required for generalisability and outcome measurement was variable and unreported. Nineteen different measures of scar appearance and structure were reported by 30 (51%) of studies however only nine (23%) were patient-reported. Seven different hand function PROMs were reported by 25 (43%) studies. Person-centred domains including scar acceptability (12%), mental health impact (5%), and social participation (4%) were rarely reported. Conclusions This review highlights that evaluation and reporting of hand and wrist scar outcomes is not standardised, assessment methods and measures are under-reported and there is discordance in taxonomy. Evaluation is not person-centred, rather it is dependent on clinician assessment. Domains including scar acceptability, mental health, and social participation are rarely addressed. A stakeholder consensus derived hand and wrist scar core outcome measurement set will promote standardisation and underpin improvements in clinical research quality, transparency, and rigour.https://doi.org/10.1186/s12891-023-06296-yScarOutcome measurePainHypersensitivityAppearancePsychological |
| spellingShingle | Donna L. Kennedy Tracy Chism-Balangue Dominic Furniss Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review BMC Musculoskeletal Disorders Scar Outcome measure Pain Hypersensitivity Appearance Psychological |
| title | Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review |
| title_full | Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review |
| title_fullStr | Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review |
| title_full_unstemmed | Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review |
| title_short | Reporting of scar outcomes in the hand and wrist; a state-of-the-art literature review |
| title_sort | reporting of scar outcomes in the hand and wrist a state of the art literature review |
| topic | Scar Outcome measure Pain Hypersensitivity Appearance Psychological |
| url | https://doi.org/10.1186/s12891-023-06296-y |
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