Psychometric Characteristics of Health-Related Quality-of-Life Questionnaires in Oropharyngeal Dysphagia

Abstract

Dysphagia can have severe consequences for the patient's health, influencing health-related quality of life (HRQoL). Sound psychometric properties of HRQoL questionnaires are a precondition for assessing the impact of dysphagia, the focus of this study, resulting in recommendations for the appropriate use of these questionnaires in both clinical practice and research contexts. We performed a systematic review starting with a search for and retrieval of all full-text articles on the development of HRQoL questionnaires related to oropharyngeal dysphagia and/or their psychometric validation from the electronic databases PubMed and Embase published up to June 2011. Psychometric properties were judged according to quality criteria proposed for health status questionnaires. Eight questionnaires were included in this study. Four are aimed solely at HRQoL in oropharyngeal dysphagia: the deglutition handicap index (DHI), dysphagia handicap index (DHI'), M.D. Anderson Dysphagia Inventory (MDADI), and SWAL-QOL, while the EDGQ, EORTC QLQ-STO 22, EORTC QLQ-OG 25 and EORTC QLQ-H&N35 focus on other primary diseases resulting in dysphagia. The psychometric properties of the DHI, DHI', MDADI, and SWAL-QOL were evaluated. For appropriate applicability of HRQoL questionnaires, strong scores on the psychometric criteria face validity, criterion validity, and interpretability are prerequisites. The SWAL-QOL has the strongest ratings for these criteria, while the DHI' is the most easy to apply given its 25 items and the use of a uniform scoring format. For optimal use of HRQoL questionnaires in diverse settings, it is necessary to combine psychometric and utility approaches.

Effects of Capsaicin on Older Patients with Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled, Crossover Study

“…In older persons, in particular, OD may cause fatal complications, such as aspiration pneumonia and suffocation, or lead to undernutrition due to decreased oral intake or decreased mental activity [9,10]. Therefore, caution is required in the early phase of OD in older patients.…”

Psychometric Properties of Questionnaires on Functional Health Status in Oropharyngeal Dysphagia: A Systematic Literature Review

“…Systematic literature reviews have been published on the psychometric properties of oropharyngeal dysphagia screening [8, 9] and HR-QoL questionnaires [10] but not on FHS questionnaires.…”

Swallowing Quality of Life After Zona Incerta Deep Brain Stimulation

“…The effect of DBS on swallowing is a complicated but important matter to address, as DBS brings a clear-cut improvement in cardinal symptoms of PD, but does not seem to have the same pronounced effect on swallowing function 23 . Swallowing function can be assessed by using fiber endoscopy, video fluoroscopy, or patient selfreports 13,16,29 . Traditionally, little attention has been given to patients' subjective experience, even though it has been shown that the feelings and attitudes towards swallowing and eating of patients with PD affect both their eating habits and their mental well-being 13,16 .…”

“…Traditionally, little attention has been given to patients' subjective experience, even though it has been shown that the feelings and attitudes towards swallowing and eating of patients with PD affect both their eating habits and their mental well-being 13,16 . However, over the last few years, several self-report assessment scales have been suggested to supplement the clinical examination of swallowing function 29,30 . Such selfreport questionnaires encompass the patients' own perception of their condition, and hence could be argued to reduce possible observer bias.…”

“…Such selfreport questionnaires encompass the patients' own perception of their condition, and hence could be argued to reduce possible observer bias. Several of the self-report questionnaires focus on QOL 29 . This is favorable, as it is known that PD affects both overall health-related QOL 31,32 and swallowing specific QOL 18,33 , and that these two types of QOL measures are related 13,18 .…”