Scoping review of single‐item global rating scales utilized in epilepsy research: Patterns of use, challenges, and recommendations

SIGRs (single-item global ratings) are gaining popularity among clinicians and health researchers as efficient tools to assess patient-reported outcomes. There has been no systematic assessment of domains explored, methodological aspects, and validation efforts of SIGRs in epilepsy. We aimed to critically appraise and provide recommendations on the use and reporting of SIGRs in epilepsy research. We performed a systematic scoping review using the Joanna Briggs Institute's recommendations. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) method was used to search five electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane Register of Controlled Trials) from 1980 to present day. We included English-language studies utilizing SIGRs that assessed health aspects (concept) in people with epilepsy of all ages (participants), in all settings (context), containing ≥30 patients, and using SIGRs with continuous or categorical responses in any study design. Abstract and full-text review was conducted independently by two reviewers; disagreements were resolved through consensus. Standardized data abstraction was used. Of 16 417 citations, we included 289 studies, involving 114 584 patients who underwent 747 unique measurements using SIGRs. Use increased over time; 30% were published in the last 4 years, and 51% used 1 SIGR (range 1-23 SIGRs). Commonly assessed domains were overall health (24.2%) and seizure-related aspects (23.5%), whereas 37% measured perceived change. Most studies used SIGRs descriptively (80.1%). Numerous SIGR formats were used (most commonly Likert-like, 73.3%). Ad hoc SIGRs without validation occurred frequently (45.6%). Stem questions were absent in 9.5% of measures, and only 6.5% reported SIGR measurement properties. SIGRs are widely used and increasingly prevalent in epilepsy research to assess diverse domains across various formats. However, many SIGRs suffer from poor reporting and methodological limitations. We provide a comprehensive catalog of SIGRs and offer recommendations to improve their use in research and clinical practice.