A Quantitative Systematic Review of Clinical Outcome Measure Use in Peripheral Nerve Injury of the Upper Limb

BACKGROUND: Peripheral nerve injury (PNI) is common, leading to reduced function, pain, and psychological impact. Treatment has not progressed partly due to inability to compare outcomes between centres managing PNI. Numerous outcome measures exist but there is no consensus on which outcome measures to use nor when.
OBJECTIVE: To perform a systematic review in order to describe and classify outcome measures used in PNI.
METHODS: A search of Ovid Medline, Ovid Embase, Allied and Complementary Medicine Database (AMED) and CENTRAL (Cochrane Clinical Trials) was conducted. Randomised control trials, cohort studies, case-controlled and case series ( 5 participants) published from inception of the database until 2019 investigating adult patients with a traumatic upper limb peripheral nerve injury in which an outcome measurement was utilised were included.
RESULTS: Ninety-six studies were included (15 RCTs, 8 case-control studies, 18 cohort studies, 5 observational studies and the remainder were case-series or retrospective reviews). Fifty-six individual outcome measures were identified, utilised across 28 different countries and 7,097 patients. Ten core domains were defined: sensory subjective, sensory objective, motor subjective, motor objective, sensorimotor function, psychology and wellbeing, disability, quality of life, pain and discomfort, and neurotrophic measures.
CONCLUSION: Lack of consensus on outcome measure use hinders comparison of outcomes between nerve injury centres and the development of novel treatments. Development of a core outcome set will help standardise outcome reporting, improve translation of novel treatments from lab to clinical practice, and ensure future research in peripheral nerve injury is more amenable to systematic review and meta-analysis.