# Comparison of the Catquest-9SF and Cat-PROM5 Patient-Reported Outcome Measures: A Literature Review

## TL;DR

This paper compares two patient-reported outcome measures for cataract surgery, highlighting their strengths and weaknesses for assessing quality of life improvements.

## Contribution

A systematic review comparing the psychometric properties and practical advantages of Catquest-9SF and Cat-PROM5 for postoperative cataract patients.

## Key findings

- Both Catquest-9SF and Cat-PROM5 show excellent psychometric performance with high reliability and responsiveness.
- Cat-PROM5 is preferred by patients due to fewer questions and larger font size, while Catquest-9SF is more versatile for other ocular conditions.
- Catquest-9SF is validated in multiple languages and has more data, making it suitable for broader use.

## Abstract

Patient-reported outcome measures (PROMs) have become increasingly more popular in modern medicine. The use of validated, precise, and succinct PROMs is necessary to accurately assess for changes in patients’ quality of life (QoL) postoperatively and keep pace with high-volume surgery clinics. Cataract surgery is one of the most performed surgeries worldwide. The Catquest-9SF and Cat-PROM5 are PROM tools for assessing QoL improvement in postoperative cataract patients. The aim of this review is to present the advantages and disadvantages of the Catquest-9SF and the Cat-PROM5 and to discuss the clinical relevance of each. A PubMed search was performed without field restrictions for “Catquest-9SF” and “Cat-PROM5”, dated January 2009 to March 14, 2025. This identified 105 articles: 95 of those referenced the Catquest-9SF, 11 of those referenced the Cat-PROM5, and one of those referenced both. These were screened to include randomized control trials, meta-analyses, systematic reviews, clinical studies, comparative studies, reviews, observational studies, and validation studies. This provided a total of 52 studies, eight studies focused on Cat-PROM5, 45 focused on Catquest-9SF, and one study with both. A review of the Cochrane database was also performed that yielded no additional items. Based on data of psychometric properties from the direct comparison study, both PROM tools exhibited excellent performance with Person Reliability indices of 0.90 (Cat-PROM5) and 0.88 (Catquest-9SF) as well as 1.45 SD (Cat-PROM5) and 1.47 SD (Catquest-9SF) for responsiveness to surgery using Cohen’s standardized effect size with a correlation of R=0.85. Both the Catquest-9SF and the Cat-PROM5 perform similarly regarding psychometric properties. However, the Cat-PROM5 has a larger font and fewer questions (five items) that is preferred by patients. In contrast, the Catquest-9SF has more questions (nine items), has more data, is validated in multiple different languages, and is proven to be useful to assess other ocular conditions apart from cataracts. This would suggest that either tool could be used to great effect when assessing postoperative cataract patients, but the Catquest-9SF may be the tool of choice for other ocular conditions or procedures.