Evidence map›Paper›PMID 42775318›Full record

ReviewPatient related outcome measures2026

How is the "most bothersome symptom" construct measured across health conditions? A systematic review of patient-reported outcome measures.

Alice M Mitchell, Vincent Singh Paramanandam, Dongzhe Lei, Theresa Donhauser, Niamh Waters, Cathy Hayles, Bethany Gower, Danushi Rajapakse, Eleanor Dickens, Ariane Suhood and 8 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Patient related outcome measures, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Alice M MitchellSchool of Health Sciences, Western Sydney University, Penrith, Australia.ORCID https://orcid.org/0000-0001-7414-5542
Vincent Singh ParamanandamAustralian Lymphoedema Education, Research and Treatment (ALERT) Centre, Department of Health Sciences, Macquarie University, Sydney, Australia.ORCID https://orcid.org/0000-0002-9976-9172
Dongzhe LeiDepartment of Medical Education, Western Clinical School, University of Melbourne, Melbourne, Australia.ORCID https://orcid.org/0009-0005-6528-7131
Theresa DonhauserInstitute for Social Medicine and Health Systems Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.ORCID https://orcid.org/0000-0002-0640-1169
Niamh WatersCollege of Medicine and Public Health, Flinders University, Adelaide, Australia.ORCID https://orcid.org/0000-0003-0059-1915
Cathy HaylesMovement & Me Exercise Physiology, Leabrook, South Australia, Australia.ORCID https://orcid.org/0009-0003-3293-0157
Bethany GowerAlliance for Research in Exercise Nutrition and Activity (ARENA), Adelaide University, Adelaide, Australia.ORCID https://orcid.org/0000-0001-6969-6913
Danushi RajapakseMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.ORCID https://orcid.org/0009-0002-4096-822X
Eleanor DickensAllied Health and Human Performance, Adelaide University, Adelaide, Australia.ORCID https://orcid.org/0009-0004-0472-8653
Ariane SuhoodSchool of Health Sciences, Western Sydney University, Penrith, Australia.ORCID https://orcid.org/0000-0001-9652-1991
K Jane ChalmersIIMPACT in Health Research, Adelaide University, Adelaide, Australia.ORCID https://orcid.org/0000-0001-6991-559X
Steven J KamperSchool of Health Sciences, University of Sydney, Sydney, Australia.ORCID https://orcid.org/0000-0003-3012-5499
Claudia ChengDepartment of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Melbourne, Australia.ORCID https://orcid.org/0000-0002-6901-9135
Chen X ChenUniversity of Arizona College of Nursing, Tucson, Arizona, USA.ORCID https://orcid.org/0000-0002-6902-1227
Richard B LiptonDepartment of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.ORCID https://orcid.org/0000-0003-2652-2897
Martha HickeyDepartment of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Melbourne, Australia.ORCID https://orcid.org/0000-0002-3941-082X
Marian ShowellDepartment of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.ORCID https://orcid.org/0000-0002-1227-4303
Sarah LensenDepartment of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Melbourne, Australia.ORCID https://orcid.org/0000-0002-1694-1142

Funding

Vaginal Microbiome, Inflammatory Mediators, Metabolome, and Dysmenorrhea Symptom-based PhenotypesR01HD110994 · NICHD · UNIVERSITY OF ARIZONA · PI Chen X Chen · 2023 to 2026
$2.5M
NICHD NIH HHS R01 HD110994
6 · The paper itself

Abstract

Objective: Patient-reported outcome measures (PROMs) capture patients' experiences and perspectives of symptoms. One approach involves measuring the "most bothersome symptom," an outcome recommended in some regulatory guidance and core outcome sets. This systematic review aimed to identify and characterize PROMs to measure the "most bothersome symptom," describe available measurement properties, and examine terminology used to describe "bother." Methods: This review was registered in PROSPERO (CRD42022210384). A systematic search of EMBASE, MEDLINE, PsycINFO, and PROQOLID was conducted. Reviewers independently screened and extracted data on PROMs that directly measured the "most bothersome symptom" or indirectly assessed symptom bothersomeness. PROMs using related terminology (e.g. troublesome, distressing) were included. PROMs directly measuring the "most bothersome symptom" were evaluated using COSMIN and modified GRADE criteria. Results: In total, 270 articles describing 171 PROMs were included. Most PROMs (n = 135) indirectly captured bothersomeness through symptom scoring. Terminology inconsistencies were common; among 130 PROMs measuring "bother," authors also used "distress" (10%), "severity" (8%), and "burden" (6%). Fourteen PROMs directly measured the "most bothersome symptom," with only three demonstrating adequate content validity. Conclusions: Limited high-quality evidence supporting the measurement properties of PROMs designed to directly assess this construct, particularly content validity, restricts interpretability. More rigorous PROM development is required.

Indexed as

botherCOSMINmeasurement propertiespatient-reported outcomepsychometricssymptoms

Identifiers

PMID42775318
PMCPMC13596887

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.