Patient-Reported Outcome Measures for Quality of Life in Adolescent Idiopathic Scoliosis: Validity, Reliability, and Clinical Utility-A Narrative Review.

BACKGROUND

Patient-reported outcome measures are important for capturing health-related quality of life and treatment-specific concerns in adolescent idiopathic scoliosis (AIS).

OBJECTIVE

This narrative review aimed to summarize the validity, reliability, responsiveness, minimal clinically important difference, floor and ceiling effects, cross-cultural adaptation, and clinical utility of commonly used quality of life and treatment-specific patient-reported outcome measures in AIS.

METHODS

A narrative literature review was conducted focusing on frequently used AIS-related instruments, including the SRS-22/SRS-22r, SRS-7, QLPSD, ISYQOL, SJ-27, BSSQ-Brace/BSSQ-Deformity and BrQ. Evidence regarding psychometric properties and clinical applicability was synthesized narratively.

RESULTS

Most instruments demonstrated acceptable to high internal consistency and test-retest reliability. Reported Cronbach's alpha values generally ranged from 0.71 to 0.96 for SRS-22/SRS-22r, 0.87 to 0.94 for QLPSD, 0.75 to 0.88 for ISYQOL, 0.898 to 0.991 for SJ-27, 0.80 to 0.87 for BSSQ-Brace/BSSQ-Deformity, and 0.82 to 0.96 for BrQ. Treatment-specific tools such as BSSQ and BrQ provide additional information on brace-related quality of life, stress, and coping. However, evidence on responsiveness, minimal clinically important difference, and conservative treatment-specific interpretability remains limited for most instruments.

CONCLUSIONS

No single instrument appears sufficient to capture the multidimensional impact of AIS. General quality of life measures should be selected according to the clinical or research question, and treatment-specific tools should be added when brace-related burden or stress is relevant. Future studies should further define responsiveness, minimal clinically important change, and longitudinal utility in conservative AIS management.