Measurement properties of oral health related patient reported outcome measures in patients with oral cancer: A systematic review using COSMIN checklist.

Shailesh M Gondivkar,Monal Yuwanati,Rima S Gondivkar,Sachin C Sarode,Gargi S Sarode,Shankargouda Patil,Amol R Gadbail,Ali Montazeri

doi:10.1371/journal.pone.0218833

Abstract

BackgroundOral cancer (OC) is one of the common malignant neoplasm resulting in a range of debilitating symptoms. Patient reported outcome measures (PROMs) could provide a valuable insight into the impact of OC on patients’ quality of life (QoL). Selecting an adequate instrument among available PROMs for OC has been challenging for clinicians due to lack of information on their psychometric quality. This systematic review provides an extensive overview of methodological quality of all currently available PROMs for OC.MethodA systematic search was performed in PubMed, Scopus, Web of Science and CINAHL for relevant literature until 10th January 2019 and data was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COnsensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist.ResultsSeven studies were found evaluating 6 health-related QoL PROMs. Among six, there were 1 disease-specific and 5 generic PROMs. Information regarding important measurement properties was often incomplete. The evidence for the quality of measurement properties was found to be variable, none of the instruments performed sufficient on all measurement properties. Considering results of this review, QOL-OC appeared to have adequate COSMIN measurement properties.ConclusionQOL-OC can be implemented in future studies to better understand symptoms and expectations of OC patients and help inform clinicians to formulate treatment strategies as per patients’ needs.

Highlights

QOL-Oral cancer (OC) can be implemented in future studies to better understand symptoms and expectations of OC patients and help inform clinicians to formulate treatment strategies as per patients’ needs
[4] As unnoticeable initially, OC usually is diagnosed at later stages carrying 5-year survival rate of only 40–50%. [5,6] Along with manifestations including pain, burning sensation [7], toothache, tooth mobility [8], OC is strongly associated with social and psychological morbidity [9,10] leading to poor quality of life (QoL). [10,11,12,13] Despite of several advantages, the available treatment options induces functional impairments such as disabled mastication, deglutition, phonetics and facial disfigurement, again decreasing the post-treatment QoL of these patients
Numerous Patient reported outcome measures (PROMs) have been available in the literature for use in OC patients. [16,17,18,19,20] These include European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck-specific module (EORTC QLQ-H&N35), the University of Washington Quality of Life (UWQOL), Functional Assessment of Cancer Therapy- Head and Neck module FACT-head & neck (H&N) (v 4.0), Speech Handicap Index (SHI), Swallowing Quality of Life Questionnaire (SWAL-QOL), Cancer needs questionnaire, short form, head and neck cancer-specific (CNQ-SF-hn) and Oral Cancer Quality-of-life Questionnaire (QOL-OC)

Summary

Introduction

Lip, oral cavity, and pharyngeal cancers have been estimated to be responsible for 529,500 incident cases and 292,300 deaths in 2012, accounting for about 3.8% of all cancer cases and 3.6% of cancer deaths. [1] OC is highly prevalent in Indian subcontinent with tobacco chewing and smoking, betel quid chewing, alcohol consumption and human papilloma virus (HPV) are considered to be the most common risk factors. [2,3] In India, OC is the third most common cancers with (7.2) with high mortality and morbidity rate. [4] As unnoticeable initially, OC usually is diagnosed at later stages carrying 5-year survival rate of only 40–50%. [5,6] Along with manifestations including pain, burning sensation [7], toothache, tooth mobility [8], OC is strongly associated with social and psychological morbidity [9,10] leading to poor quality of life (QoL). [10,11,12,13] Despite of several advantages, the available treatment options induces functional impairments such as disabled mastication, deglutition, phonetics and facial disfigurement, again decreasing the post-treatment QoL of these patients.In recent decades, health-related QoL (HRQoL) has gained an increased importance in clinical practice and research. [16,17,18,19,20] These include European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck-specific module (EORTC QLQ-H&N35), the University of Washington Quality of Life (UWQOL), Functional Assessment of Cancer Therapy- Head and Neck module FACT-H&N (v 4.0), Speech Handicap Index (SHI), Swallowing Quality of Life Questionnaire (SWAL-QOL), Cancer needs questionnaire, short form, head and neck cancer-specific (CNQ-SF-hn) and Oral Cancer Quality-of-life Questionnaire (QOL-OC) As they vary significantly with respect to their development and validation, none has clearly been considered as gold standard.

Methods

Results

Conclusion