Patient-related experience measurement scales for endoscopy procedures – A systematic review, COSMIN and Conceptual Model evaluation

BACKGROUND: patient experience is a quality indicator in gastrointestinal endoscopy, as recognized by the European Society of Gastrointestinal Endoscopy (ESGE). Despite this, no standardized tools or metrics have been formally endorsed for routine use. OBJECTIVE: to identify and evaluate patient-reported experience measures (PREM) used in endoscopic procedures, assessing their psychometric properties and conceptual completeness, and to explore gaps for future development. METHODS: a systematic literature review was conducted up to March 2023, including studies involving adults (> 18 years) who underwent endoscopic procedures and completed PREM. Instruments were assessed using the COSMIN risk of bias tool and a patient experience conceptual model. RESULTS: of 1.911 articles screened, 10 studies met the inclusion criteria. The Colonoscopy Experience Score Tool (CEST) proved the strongest psychometric performance, while the Endoscopic Patient-Reported Experience Measure (ENDOPREM) showed superior conceptual coverage. However, no single instrument met both psychometric and conceptual standards. A critical gap identified across all tools was the absence of items related to patient health motivation. CONCLUSION: CEST is psychometrically superior and ENDOPREM is conceptually robust. Future PREM should adopt a hybrid approach-combining the psychometric strengths of CEST with the conceptual complexity of ENDOPREM-while also incorporating domains such as patient motivation to improve relevance and impact. IMPLICATIONS: measuring patient experience requires tools that are currently both scientifically rigorous and patient-centered. Developing a Hybrid PREM is an essential next step to support quality improvement in endoscopic care.

• ✓CONCLUSION: CEST is psychometrically superior and ENDOPREM is conceptually robust.
• ✓Future PREM should adopt a hybrid approach-combining the psychometric strengths of CEST with the conceptual complexity of ENDOPREM-while also incorporating domains such as patient motivation to improve relevance and impact.
• ✓IMPLICATIONS: measuring patient experience requires tools that are currently both scientifically rigorous and patient-centered.
• ✓Developing a Hybrid PREM is an essential next step to support quality improvement in endoscopic care.