Health-Related Quality of Life in Women with Uterine Fibroids Recruited from Clinical and Online Settings: A Cross-Sectional Comparative Study.

Background: Uterine fibroids are the most common benign tumors of the female reproductive system and frequently affect women's health-related quality of life (HRQoL). The increasing use of online surveys in clinical research raises concerns regarding the comparability and reliability of data collected through different recruitment methods. This study aimed to compare the clinical and methodological comparability of data obtained from an online survey and a clinic-based survey assessing symptom severity and HRQoL among women diagnosed with uterine fibroids. Methods: A cross-sectional observational study was conducted among 167 women with confirmed uterine fibroids. The clinic-based cohort included 82 patients recruited in a gynecological outpatient clinic, while the online cohort consisted of 85 women participating through an internet-based survey. Both cohorts were assessed using identical inclusion and exclusion criteria, the same questionnaire structure, and the validated Uterine Fibroid Symptom and Health-Related Quality of Life (UFS-QoL) instrument. Symptom severity scores and HRQoL outcomes were compared descriptively and methodologically. Results: The two independently recruited cohorts showed broadly similar distributions of several demographic characteristics and patient-reported outcomes, although important differences between the source populations should be considered when interpreting these findings. Mean symptom severity scores were 48.55 ± 21.61 in the clinic-based cohort and 46.33 ± 21.40 in the online cohort, while mean HRQoL scores were 57.23 ± 22.81 and 62.50 ± 19.32, respectively. Formal comparisons revealed no significant differences in symptom severity (p = 0.506) or overall HRQoL (p = 0.110). Among the six UFS-QoL domains, only the Concern domain differed significantly between cohorts (p = 0.005), whereas all other domains showed broadly similar distributions. Separate multivariable regression models were fitted for each cohort. Although direct comparison of the models was limited by differences in variable coding, both models identified symptom severity as the strongest independent predictor of HRQoL (β = -0.715 and β = -0.752) and showed similar overall model performance (R2 = 0.595 and 0.578). Regression diagnostics confirmed normality of residuals, homoscedasticity, absence of influential outliers, and low variance inflation factors in both datasets. Conclusions: Despite differences in recruitment setting and source population, similar patterns of patient-reported HRQoL and symptom severity were observed across the two independently recruited cohorts. Similarities were observed across overall HRQoL scores, symptom severity measures, and multivariable regression models, suggesting that the relationships between symptom burden and quality of life remained consistent across recruitment methods. Although differences were identified in disease-related concerns and reproductive history, these findings did not substantially alter the overall pattern of results. Taken together, the findings demonstrate that similar patterns of patient-reported HRQoL and symptom severity were observed across two independently recruited cohorts of women with uterine fibroids. These findings support the feasibility of collecting disease-specific patient-reported outcomes within uterine fibroid-specific online communities but should not be interpreted as evidence that online and clinic-based recruitment methods generate equivalent study populations.