The CARe Burn Scales were created and tested following the recommended protocol of Cano et al (2004). This is a three-stage development and validation process based on the guidelines and criteria outlined by the Scientific Advisory Committee of the Medical Outcomes Trust for the development and review of health outcome measures. This involves a step-by-step process for item generation, item reduction, and psychometric evaluation.
In line with this process, we started the development of the CARe Burn Scales by conducting two systematic reviews of PROMs previously used in burns research with adults ( Download ) and children/young people ( Download ). These reviews concluded there was a need for burns-specific PROMs and provided a diverse range of domains for us to consider including in our PROMs. A series of qualitative studies, interviewing adults, young people, parents of children with burn injuries and health professionals working in burn care identified the key issues that needed to be included in a PROM that would assess the impact of the burn on their health. Feedback on draft versions of the PROMs was gathered from people with burn injuries, their families and members of the British Burn Association Psychosocial Special Interest Group.
A large scale, multi-centre study involving over 750 people whose lives are affected by burns then collected data on each scale, which was then subjected to rasch statistical analysis to reduce the number of items in each scale. Evidence of the reliability and validity of the final PROMs is being ascertained in a series of psychometric validation studies.