Minimally important difference of the Child Oral Health Impact Profile for children with orofacial anomalies

Abstract

BackgroundThe Child Oral Health Impact Profile (COHIP) is an instrument designed to measure the self-reported oral health-related quality of life of children between the ages of 8 and 15, including domains for oral health, functional well-being, social-emotional well-being, school environment and self-image. The purpose of this study was to estimate the minimally important difference (MID) of the COHIP for patients with cleft lip/palate.MethodsData from a 6-year, prospective, longitudinal cohort study of children with cleft lip/palate were analyzed to estimate the MID. Analysis was restricted to patients with data at baseline and first follow-up and not receiving a surgical intervention in the intervening years (N = 281). MIDs were estimated via the anchor-based method, using the Global Assessment of Change, and the effect size distribution method.ResultsBased on the distributional method, the minimally important differences were 0.16 (oral health), 0.12 (functional), 0.22 (social-emotional), 0.21 (school environment) and 0.19 (self-image). MID anchor estimates for COHIP domains ranged from −0.32 to 0.84. The anchor-based and effect size MID estimates for the overall COHIP score were 2.95 and 0.25, respectively.ConclusionThe minimally important difference of the Child Oral Health Impact Profile is recommended for interpreting clinically meaningful change in patients with cleft lip/palate.

Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings

“…In other research conducted with a subsample of the present participants, MID (minimally important difference) estimates using an anchor-based approach indicated that the minimally important difference for the overall COHIP was 2.95 [35]. Framing the present finding in this manner suggests that the surgical candidates initially rated their OHRQoL as lower than peers without a surgical recommendation and that the improvements over time were modest.…”

“…Furthermore, current analyses used tests of statistical significance, which may not capture the true effect of treatment on OHRQoL [51]. Additional reporting of the minimally important difference and clinically meaningful change will be undertaken but is beyond the scope of this paper [27, 35, 52]. Finally, since there was no control group in this study, incorporating population-based assessments like items from the National Survey on Children with Special Health and N-HANES queries as well as generic quality of life surveys would provide worthwhile comparisons [53–55] regarding employment, educational attainment, health care utilization, barriers to care and QoL that facilitate group comparisons and elucidate long-term treatment outcomes in this population.…”

Challenges in conducting multicentre, multidisciplinary, longitudinal studies in children with chronic conditions

“…During the course of the study, some participating children received secondary cleft‐related surgery, while others did not. Further details regarding the study protocol and procedures have been previously published …”

“…However, a higher number of previous surgical interventions was also associated with lower self‐ and caregiver‐rated OHRQoL scores . Additionally, minimally important differences (MID) for clinically meaningful change were calculated for the study sample using both the anchor‐based and distribution criteria method . These estimates can be used for surgeons and researchers to determine whether surgical intervention for CL/P has had a meaningful impact beyond statistical significance on patients.…”

“…Further details regarding the study protocol and procedures have been previously published. [2][3][4][5] Over the 6-year course of the study, a total of 787 surgeries (43% of the participants) were performed across six cleft treatment centres. Approximately 90% of participants completed baseline and one follow-up visit, 60% completed the study protocol (two followup visits postsurgery or baseline), 15% had pending surgical recommendations, and 25% were lost to follow-up.…”