In whom are distal radius fracture patient reported outcome measures developed? A systematic review of development studies.

Abstract

Patient-reported outcome measures (PROMs) are tools utilized to understand the patient perspective, guide shared decision-making, and evaluate outcomes for patients with distal radius fractures (DRFs). While widely utilized during the treatment of DRFs, the populations in whom these tools were developed may not represent the diverse patients in whom they are applied. This study evaluates the demographics of patients in the development of commonly used PROMs for DRFs. A systematic review was conducted to identify the development studies of DRF PROMs via PubMed, EMBASE, and Web of Science databases. PROMs were selected based on the Distal Radius Outcomes Consortium. Extracted demographic data (e.g., age, sex, language) from each study were included. Data were analyzed, reported descriptively, and findings were compared to the United States (U.S.) 2020 Census using a test of proportions. A total of 9323 studies were identified; 12 studies met inclusion criteria. The percentage of studies reporting each variable included age 83 %, sex 75 %, education 67 %, race/ethnicity 34 %, language spoken 25 %. Compared to the U.S. 2020 Census, participants were disproportionately white (81 % vs 62 %, p < 0.001), female (54 % vs 51 %, p < 0.001), and had education beyond high school (74 % vs 61 %, p < 0.001). Participants were less likely to be English-speaking (83 % vs. 84 %, p = 0.006). Overall, demographic reporting in DRF PROM development studies is inconsistent, with age and sex commonly reported, while education, race, and language are often omitted. This inconsistency and limited diversity may bias samples and reduce PROM generalizability and applicability across broader, diverse populations. IV.