Patient-Reported Outcome Measures assessing genital self-image: a systematic review of measurement properties

This systematic review synthesizes and critically appraises the measurement properties of genital self-image measures. Nine measures that met the definition of body image assessment (i.e., subjective perceptions related to the genitals) were included. These measures were the Female Genital Self-Image Scale (FGSIS), Genital Self-Image Scale, Genital Appearance Satisfaction, Male Genital Self-Image Scale, FGSIS Spanish version, Index of Male Genital Image, and Korean Genital Image Scale. Articles evaluating the measurement properties of these scales (N = 22) were assessed for methodological quality using the COSMIN Risk of Bias Checklist. The COSMIN criteria were used to summarize and classify the measurement properties of each PROM. The Grading of Recommendations Assessment, Development, and Evaluation graded the evidence. None of the PROMs had all of the measurement properties graded, and there was insufficient evidence to support the recommendations. Only the FGSIS 7-item version was able to assess the quality of evidence for content validity, and its use was potentially recommended. The included studies had insufficient measurement properties. Future studies should collect additional data to assess the measurement properties of the FGSIS 7-item version using a robust methodology based on guidelines for conducting studies on measurement properties of PROMs. The measurement properties of each PROM are discussed in detail, including aspects of interpretability and feasibility.