Methodological considerations when measuring oral health–related quality of life

Abstract

Background Dental patient‐reported outcomes (dPROs) and their measures, dPROMs, are fundamental for evidence‐based dentistry. However when selecting, applying and evaluating an instrument with a focus on OHRQoL assessment for adults, several methodological considerations are essential to derive valid and meaningful results. Methods In this review article, criteria for selecting the appropriate OHRQoL instrument, aspects of administering the instrument and how to evaluate resulting scores of single and multiple assessments are presented and critically assessed. Results Oral disease–generic and dimension–generic instruments capturing the entire construct OHRQoL allow for best comparability of findings across different diseases, settings and populations, with the Oral Health Impact Profile (OHIP) being the most often used and methodologically best investigated one. It is available in several versions with the 5‐item version being the one with the lowest burden for the patient. Responses are given on a 5‐point ordinal rating scale, the recommended response scale for dPROMs. A 7‐day recall period allows for assessment of short‐term effects. Clinically relevant effects of item or instrument order or administration method on OHIP scores do not seem to be likely. OHIP summary and dimension scores can be compared to norms from general population or different patient populations. Change scores should be set into context with the minimal important difference of the instrument. Conclusion OHIP‐5 has greatest potential to be used across all settings for assessment and evaluation of OHRQoL in adults. It allows a comprehensive characterising of patients suffering from oral diseases and of this impact using OHRQoL dimensions.

Psychosocial oral health‐related quality of life impact: A systematic review

“…Therefore, these data were not suitable for synthesis with results from the articles included in the present study. For more detailed information regarding the measurement of OHRQoL and its related practical issues please see the chapter by Reissman 45 …”

Orofacial Esthetic Scale and Psychosocial Impact of Dental Aesthetics Questionnaire: development and psychometric properties of the Finnish version

“…tooth whitening, orthodontics and veneers) with an increasing demand for them [3]. Thus, it is important to assess the individual's perception of their orofacial appearance in both a clinical and a research context [4,5]. In the clinical context, this information will allow for the elaboration of a patient-centred treatment plan that can satisfy the individual's expectations [4][5][6].…”

“…Thus, it is important to assess the individual's perception of their orofacial appearance in both a clinical and a research context [4,5]. In the clinical context, this information will allow for the elaboration of a patient-centred treatment plan that can satisfy the individual's expectations [4][5][6]. At the same time, the clinician's role as expert has to be emphasized to bring evidence-based information to the patient-centred concept.…”

“…However, the perception of orofacial appearance cannot be directly measured. A standardized way of conducting this assessment is to use specific instruments known as dental patient-reported outcome measures (dPROMs) [4,6,7]. The Orofacial Esthetic Scale (OES) [8] and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) [9] are dPROMs that are intended to assess orofacial appearance.…”

Functional oral health‐related quality of life impact: A systematic review in populations with tooth loss

“…Like in this review, the considerable number of publications with non‐compatible scores limits data synthesis in systematic reviews and meta‐analyses. Recommendations on how to measure OHRQoL are available 81 …”