Patient-reported outcome measures of musculoskeletal symptoms and psychosocial factors in musicians: a systematic review of psychometric properties

Purpose: To systematically review patient-reported outcome measures (PROMs) of musicians' musculoskeletal symptoms (MSS) and psychosocial factors and their psychometric properties.

Methods: Six databases were searched. Studies evaluating at least one psychometric property of a PROM developed for or adapted to adult musicians and measuring MSS or occupational psychosocial factors were included. Study quality was evaluated using mainly the COSMIN checklist.

Results: Twenty-eight studies were included, yielding 27 PROMs. Most COSMIN scores are Doubtful or Inadequate. Validity and internal consistency are the most evaluated psychometric properties. Test-retest reliability was evaluated in five studies (all inadequate sample sizes), measurement error in one, and responsiveness in none. The English, German and Polish Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians (MPIIQM), the 40-item English and Peruvian Spanish Kenny Music Performance Anxiety Inventory (KMPAI) and the Psychosocial Risks Questionnaire for Musicians (PRQM, Polish) are the most robust scales for their constructs. Their internal consistency is sufficient (Cronbach's α ≥ 0.70). Test-retest reliability and construct validity are only sufficient for the German MPIIQM (intraclass correlation coefficients ≥ 0.70). However, results are based on one study per PROM; all require further validation before validity, reliability and responsiveness can be confirmed.

Conclusion: Due to generally poor methodological quality and one study per PROM on average, none can be confirmed valid, reliable and responsive. Yet, preliminary validation recommends prudent use of some PROMs pending further validation. Robust PROM studies are needed to fill the important literature gap regarding musician-specific, validated PROMs.