Validity of Patient-Reported Swallowing and Speech Outcomes in Relation to Objectively Measured Oral Function Among Patients Treated for Oral or Oropharyngeal Cancer

Abstract

The objective of this study was to test the construct validity of the patient-reported outcomes Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI) in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer. The study sample consisted of patients treated for oral or oropharyngeal cancer. Outcome measures were the SWAL-QOL and the SHI, and the Functional Rehabilitation Outcomes Grade (FROG), a test to measure oral and shoulder function. Spearman's rank correlation coefficient was used to test associations between the SHI and SWAL-QOL scales, and the FROG scales. During a study period of 3 months, 38 patients (21 males, 17 females; mean age 54 years) were included who visited the outpatient clinic for follow-up care 6-155 months after surgical treatment (n = 14) or combined surgery and radiotherapy (n = 24) for oral (n = 21) or oropharyngeal cancer (n = 17). Most SWAL-QOL and SHI scales (except the SWAL-QOL Fatigue scale) correlated significantly with one or more FROG oral function scales. None of the SWAL-QOL and SHI scales correlated significantly with the FROG shoulder function scale. These results support the construct validity of the SWAL-QOL and SHI questionnaires for assessing speech and swallowing problems in daily life that are moderately but significantly related to oral function. A multidimensional assessment protocol is recommended for use in clinical practice and for research purposes for measuring oral function and swallowing- and speech-related problems in daily life among head and neck cancer patients.

Dysphagia‐related quality of life in oculopharyngeal muscular dystrophy: Psychometric properties of the SWAL‐QOL instrument

“…The questionable dysphagia specificity of the sleep, fatigue , and communication scales in OPMD is also supported by the finding of no correlation between dysphagia duration and the sleep and fatigue scales, and only a weak correlation between dysphagia duration and the communication scale (Table ). In line with our view, other researchers using the SWAL‐QOL have questioned the dysphagia‐specificity of the sleep, fatigue , and communication scales and have excluded these scales when calculating a total SWAL‐QOL score …”

“…Third, although registry participants resided in 25 states across the United States, it is not known to what extent our sample represents the worldwide OPMD population. Finally, although we used CFA to support our use of a derived Composite SWAL‐QOL score for group comparisons, in practice, various “total” scores for the SWAL‐QOL have been generated and used in prior studies . Because studies have used different methods for calculating a global score, we urge caution when comparing results across studies.…”

Feasibility and potential value of lipofilling in post‐treatment oropharyngeal dysfunction

“…After the lipofilling sessions she had one more episode of aspiration pneumonia treated conservatively, but this did not change her mind about her subjectively improved swallowing (as underlined in her SWAL-QOL results) and resuming her oral intake. This is in line with the literature that patient-reported outcome measures usually provide distinct but complementary information about swallowing, 24 and that patients' perceived swallowing function is important for quality of life.…”

Physical and Psychological Impairments Associated with Mucositis after Oral Cancer Treatment and Their Impact on Quality of Life

“…Severe impairment of the oral mucosa can be a consequence of irradiation [28]. The most common impairments associated with posttherapeutic oral mucositis in this study were similar to those described in previous studies [29-31]. Mucositis-associated disorders, especially pain and xerostomia, can negatively impact diet, ingestion, and speech [32-24].…”