Abstract
BackgroundSeveral measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures.MethodsA systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group.ResultsThe search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n = 117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis.ConclusionThe three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely tested and several versions are available. COHIP employed a rigorous development strategy but has been tested in fewer populations. C-OIDP is shorter and has been used successfully in epidemiological studies. Further testing using modern psychometric techniques such as item response theory is recommended. Future developments should also focus on the development of measures which can evaluate longitudinal change.
Highlights
Several measures of oral health-related quality of life have been developed for children
The majority used a version of the Child Perceptions Questionnaire (CPQ), most frequently the original version of CPQ11–14 (Figure 1)
Further testing using modern psychometric techniques, which have previously been applied to some translated versions, may allow them to be refined further
Summary
Several measures of oral health-related quality of life have been developed for children. The aim of this study was to assess the methodological quality of the development and testing of these three measures. The drive for the use of patient reported outcome measures (PROMs) has come from the shift from a biomedical perspective to a broader biopsychosocial model of health [2]. Patients themselves are in the best position to assess the improvement in their symptoms or quality of life. + a clear description is provided of the aim of the measure, the target population, concepts being measured and involvement of the target population and/or investigators or experts in item selection. ? A clear description of the above is lacking or only target population involved or doubtful design or method. The proposed benefits of such an approach to patient care are [3]: 1. patients themselves are in the best position to assess the improvement in their symptoms or quality of life
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