Assessing the level of agreement between the self- and interview-administered Child-OIDP

The correlation of region-specific lifestyle and subjective perception of oral health with oral health-related quality of life among Tibetan early adolescents in Ganzi: a cross-sectional study

Background

The oral health-related quality of life (OHRQoL) of Tibetan adolescents has been largely overlooked.

Aim

This cross-sectional study examined the association of region-specific lifestyle, subjective perception, and clinician conditions of oral health with Tibetan adolescents' OHRQoL in Ganzi, Sichuan.

Methods

The OHRQoL was measured using standardized Child Oral Impacts on Daily Performances (sC-OIDP) scores. Binary logistic regression was used to explore the association between region-specific lifestyle, subjective perception of oral health, clinician oral health conditions (gingival bleeding on probing (BOP), dental calculus (DC), and decayed, missing, and filled teeth (DMFT)), and OHRQoL.

Results

In total, 485 Tibetan adolescents were included. In relation to region-specific lifestyle, the factors associated with poorer OHRQoL were residence altitude of 3,300 m (compared to 1,400 m), buttered tea consumption by adolescents or mother, and being a boarding student. Regarding the subjective perception of oral health, adolescents that rated bad or very bad oral health or self-reported dental pain had poorer OHRQoL. Interestingly, clinician oral health conditions were not related to OHRQoL.

Conclusions

This study underscores the relationship between region-specific lifestyle, subjective oral health perceptions, and OHRQoL among Tibetan adolescents. Addressing these factors through tailored health initiatives can play a pivotal role in improving oral health outcomes and overall quality of life in remote regions like Ganzi. Future research should focus on longitudinal studies to better understand the causality and long-term impact of targeted interventions.

Thai version of shortened Oral Impact on Daily Performances index for evaluating oral lichen planus patients

BACKGROUND

Patients' perceptions and Oral Health-related Quality of life (OHRQoL) are important parts of dental treatment in all fields, including oral lichen planus (OLP) patients. A shortened version of the Oral Impact on Daily Performances (OIDP) might be more practical and feasible in clinical setting due to the busy nature of oral medicine clinics and staff availability to conduct the interview for data collection. The aim of the study was to develop a Thai version of shortened OIDP for assessing the OHRQoL in OLP patients.

METHODS

Two types of shortened OIDP versions were tested in 69 OLP patients, one comprising the most commonly interfered with daily performances (OIDP-3 and OIDP-2) and another comprising either the highest frequency (OIDP frequency) or severity score (OIDP severity). The Numeric Rating Scale (NRS) and Thongprasom sign score were used to assess oral pain and clinical severity. Spearman rank-order correlation coefficients (r_s) were used to demonstrate the associations between the shortened and original OIDP, pain, and clinical severity.

RESULTS

OIDP-3 (Eating, Cleaning, and Emotional stability) and OIDP-2 (Eating and Emotional stability) were developed. The associations of the original OIDP with OIDP-3 and OIDP-2 (r_s = 0.965 and 0.911) were significantly higher than those of the original OIDP with OIDP frequency and OIDP severity (r_s = 0.768 and 0.880). The original OIDP, OIDP-3, and OIDP-2 were more significantly associated with pain compared with OIDP frequency and OIDP severity. The association between the clinical severity and oral impacts assessed by the original OIDP, OIDP-3, and OIDP-2 were similar and had higher correlation coefficients compared with those of OIDP frequency and OIDP severity.

CONCLUSION

OIDP-3 and OIDP-2 performed more similarly to the original OIDP than OIDP frequency and OIDP severity in assessing the OHRQoL of OLP patients.

TRIAL REGISTRATION

The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR 20190828002).

Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index and Oral Health Status in Spanish Adolescents

BACKGROUND

Our aim was to analyze the relationship between OHRQoL (Oral-Health-Related Quality of Life) assessed by the C-OIDP (Child-Oral Impacts on Daily Performances) indexand oral health status in 13-15 years old Spanish population.

METHODS

A cross-sectional study was designed in a random sample of 337 adolescents. The C-OIDP and an oral health perception questionnaire were applied. ICDAS II (International Caries Detection and Assessment System) classification was used for assessing caries status, CPI (Community Periodontal Index) for periodontal status and discrepancy in the three planes for occlusal evaluation. Statistical analysis included Mann-Whitney, Kruskal-Wallis and Spearman correlation tests.

RESULTS

The prevalence of impact was 48.1%. The most frequently affected dimension was eating (21.4%). The overall mean C-OIDP index was 3.28. Higher DMFT (Decayed Missed Filled Tooth) was significantly associated with C-OIDP index (p = 0.03). Participants with CPI > 0 showed an impact index almost twice as high as those with CPI = 0 (p > 0.05). Significant association was found between quality of life and CPI for women (p < 0.01). Only the molar Angle's class was associated with the impact index (p = 0.04).

CONCLUSIONS

The OHRQoL in Spanish adolescents is good. The DMFT index had an impact on adolescents' quality of life, showing a greater impact in men than in women. Periodontal status had a greater impact in women. No association between the extent of the caries lesion and the impact index was found.

Surgical Outcomes of Contrast Sensitivity and Visual Acuity in Uveitis-Associated Cataract

Purpose

To evaluate the pre- and post-operative outcomes of phacoemulsification in patients with uveitis-associated cataract in remission, such as conventional visual acuity (VA), photopic and mesopic contrast visual acuity (CVA), and flares in the anterior chamber objectively assessed as intraocular inflammation.

Patients and Methods

This prospective study included 26 eyes of 19 patients with uveitis and 45 eyes of 26 controls who underwent cataract surgery at the Kyushu University Hospital and Kyushu Medical Center in Fukuoka, Japan, from October 2016 to December 2018. Conventional VA and flare values in the anterior chamber were evaluated preoperatively and 1 and 3 months postoperatively. Photopic and mesopic CVAs were assessed preoperatively and 3 months postoperatively.

Results

The best-corrected VA (BCVA) was improved significantly from baseline to 1 and 3 months postoperatively in both groups (P < 0.01 in both groups). The mean preoperative 100% and 10% CVAs under the photopic condition were significantly lower in the uveitis group than in the control group (P < 0.05 for both CVA), whereas the mean preoperative 100% CVA under the mesopic condition was comparable between the two groups. Although the mean preoperative 100% and 10% CVAs improved significantly from baseline under both photopic and mesopic conditions in both groups (P < 0.01 in both groups), the postoperative contrast sensitivities under both photopic and mesopic conditions remained lower in the uveitis group than in the control group (P < 0.01 for both conditions). The postoperative complications included recurrence of active inflammation in five eyes and cystoid macular edema in one eye and were managed by topical steroid therapy alone.

Conclusion

Cataract surgery for uveitis-associated cataracts during remission is well tolerated. However, the present results suggest that amelioration of hemeralopia and/or nyctalopia is not as good as expected after cataract surgery in patients with uveitis.

A reliability generalization meta-analysis of Child Oral Impacts on Daily Performances (C - OIDP) questionnaire

AIM

To evaluate the cumulative estimates of reliability and conduct reliability generalization meta-analysis of Cronbach's alpha for the Child Oral Impacts on Daily Performances (C-OIDP) questionnaire.

METHODOLOGY

Systematic search of four databases from inception to November 30th, 2019 was performed. Studies that reported Cronbach alpha for the C-OIDP were included. Cronbach's alpha for each publication was used for the meta-analysis. I² and Q statistics were calculated to assess heterogeneity. Meta-analysis was performed using a random-effects model to derive a pooled estimate of Cronbach's alpha.

RESULTS

Out of 944 publications, data extraction was done from 33 publications after exclusion. The age range among the included publication was from 6 to 19 years. Cronbach's alpha ranged from 0.53 to 0.9. Majority of the publications (n = 21) reported alpha above the benchmark (0.7 and above). Only two publications used condition-specific C-OIDP questionnaires. Twelve publications used self-administered child-OIDP questionnaires. Most of the studies were at a low risk of bias (n = 29). The cumulative alpha was higher in publications with a low ROB (α = 0.74) than a moderate ROB (α = 0.65) The cumulative alpha was 0.73 (SE = 0.02) with a high heterogeneity among the included publications (I² = 99.28% and Q = 2048.68; P < 0.001).

CONCLUSION

Overall, the RG estimate of Cronbach's alpha for C-OIDP was above the widely accepted benchmark.

Psychometric evaluation of the child oral impacts on daily performances (C-OIDP) for use in Turkish primary school children: a cross sectional validation study

BACKGROUND

As patient-reported outcome, the Child Oral Impacts on Daily Performances (C-OIDP) has been commonly used for assessing children's oral health needs in order to facilitate oral health service planning. It was translated and cross-culturally adapted into Turkish in 2008. Since then, there is no study to assess its psychometric properties in Turkish child population. This cross-sectional study aimed to investigate the psychometric properties and factor structure of the Turkish version of the C-OIDP for use in Turkish primary school children.

METHODS

The Turkish translated version was tested on a convenience sample of primary school children aged 11 to 12 years attending two public schools in Istanbul. Data were collected by clinical examinations, face-to-face interviews and self-completed questionnaires. The internal consistency, test-retest reliability, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), criterion related validity (concurrent and discriminant) were evaluated.

RESULTS

A total of 208 children were subjected to the tested the C-OIDP. Overall, 93.7% of them reported at least one oral impact in the last 3 months. The most frequently affected performances were "eating" (72.1%) and "cleaning mouth", while the performance with the lowest impact was "studying" (13%). The internal consistency and reproducibility of the C-OIDP were acceptable, with a Cronbach's alpha of 0.73 and an intra-class correlation coefficient of 0.83. The EFA yielded a two-factor model termed "functional limitation" and "psychosocial limitation". CFA identified the two- factor model which fit the data better than the previously proposed three-factor model, namely physical, psychological and social health. Having malocclusion, the presence of gum disease, reported history of oral problems in the mouth, dissatisfaction with oral health, bad self-rated oral health and having a problem-oriented pattern of dental attendance were found to be the most important factors related to worse oral health- related quality of life, supporting its criterion-related validity.

CONCLUSION

This study provided preliminary evidence the psychometric properties of the C-OIDP index among Turkish school children aged 11-12 years. It may be applied to evaluate the oral health impact on quality of life in this population.

Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain

BACKGROUND

There is a lack of large epidemiological studies researching the major factors of the oral well-being in schoolchildren.

AIMS

To quantify the impact of the different clinical conditions related to caries and periodontal and dento-facial anomalies on the quality of life captured by the Child-OIDP.

DESIGN

A standardized epidemiological study was conducted on 2041 Spanish schoolchildren, aged 6-12 years, to assess caries and periodontal and dento-facial disease. Data on oral health-related quality of life were collected using the Child-OIDP. Bivariate and multivariate analyses were performed to evaluate the modulating factors in the perceived oral well-being.

RESULTS

The prevalence of impact in this sample was 45.7%, mostly for eating (24.3%) but also for smiling (16.2%); however, 72.5% of the subjects had at least one type of normative needs, mainly for periodontal treatment (52.3%), followed by caries (32.3%) and orthodontic treatments (20.6%). The main predictors of the impact on quality of life were perceived dental treatment needs, caries, and periodontal diseases. Also, some demographic (age and gender) and behavioural factors (consumption of sweets) modulated the impact on several domains. Moreover, subjects who rated their general health as good or very good reported a significantly better oral well-being than their counterparts.

CONCLUSIONS

Pain and aesthetic-related domains (i.e., problems when eating or smiling) are the major components of the oral health-related quality of life perceived by Spanish schoolchildren. Perceived treatment needs as well as dental and periodontal status were the strongest predictors of oral well-being.

Change in Oral Impacts on Daily Performances (OIDP) with increasing age: testing the evaluative properties of the OIDP frequency inventory using prospective data from Norway and Sweden

BACKGROUND

Oral health-related quality of life, OHRQoL, among elderly is an important concern for the health and welfare policy in Norway and Sweden. The aim of the study was to assess reproducibility, longitudinal validity and responsiveness of the OIDP frequency score. Whether the temporal relationship between tooth loss and OIDP varied by country of residence was also investigated.

METHODS

In 2007 and 2012, all inhabitants born in 1942 in three and two counties of Norway and Sweden were invited to participate in a self-administered questionnaire survey. In Norway the response rates were 58.0% (4211/7248) and 54.5% (3733/6841) in 2007 and 2012. Corresponding figures in Sweden were 73.1% (6078/8313) and 72.2% (5697/7889), respectively.

RESULTS

Reproducibility of the OIDP in terms of intra-class correlation coefficient (ICC) was 0.73 in Norway and 0.77 in Sweden. The mean change scores for OIDP were predominantly negative among those who worsened, zero in those who did not change and positive in participants who improved change scores of the reference variables; self-reported oral health and tooth loss. General Linear Models (GLM) repeated measures revealed significant interactions between OIDP and change scores of the reference variables (p < 0.05). Stratified analysis revealed that the mean OIDP frequency score worsened in participants who became dissatisfied- and improved in participants who became satisfied with oral health. Compared to participants who maintained all teeth, those who lost teeth were more likely to experience improvement and worsening of OIDP across both countries. The two-way interaction between country and tooth loss was not statistically significant.

CONCLUSIONS

Changes in OIDP at the individual level were more pronounced than the percentage distribution of OIDP at each point in time would suggest. The OIDP frequency score showed promising evaluative properties in terms of acceptable longitudinal validity, responsiveness and reproducibility among older people in Norway and Sweden. This suggests that the OIDP instrument is able to detect change in the oral health status that occurred over the 5 year period investigated. Norwegian elderly were more likely to report worsening in OIDP than their Swedish counterparts. Disease prevention should be at focus when formulating the health policy for older people.

Assessment of the quality of measures of child oral health-related quality of life

Background

Several measures of oral health-related quality of life have been developed for children. The most frequently used are the Child Perceptions Questionnaire (CPQ), the Child Oral Impacts on Daily Performances (C-OIDP) and the Child Oral Health Impact Profile (COHIP). The aim of this study was to assess the methodological quality of the development and testing of these three measures.

Methods

A systematic search strategy was used to identify eligible studies published up to December 2012, using both MEDLINE and Web of Science. Titles and abstracts were read independently by two investigators and full papers retrieved where the inclusion criteria were met. Data were extracted by two teams of two investigators using a piloted protocol. The data were used to describe the development of the measures and their use against existing criteria. The methodological quality and measurement properties of the measures were assessed using standards proposed by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) group.

Results

The search strategy yielded 653 papers, of which 417 were duplicates. Following analysis of the abstracts, 119 papers met the inclusion criteria. The majority of papers reported cross-sectional studies (n = 117) with three of longitudinal design. Fifteen studies which had used the original version of the measures in their original language were included in the COSMIN analysis. The most frequently used measure was the CPQ. Reliability and construct validity appear to be adequate for all three measures. Children were not fully involved in item generation which may compromise their content validity. Internal consistency was measured using classic test theory with no evidence of modern psychometric techniques being used to test unidimensionality of the measures included in the COSMIN analysis.

Conclusion

The three measures evaluated appear to be able to discriminate between groups. CPQ has been most widely tested and several versions are available. COHIP employed a rigorous development strategy but has been tested in fewer populations. C-OIDP is shorter and has been used successfully in epidemiological studies. Further testing using modern psychometric techniques such as item response theory is recommended. Future developments should also focus on the development of measures which can evaluate longitudinal change.

Level of agreement between self-administered and interviewer-administered CPQ₈₋₁₀ and CPQ₁₋₁₄

OBJECTIVES

The aim of the present study was to assess the psychometric properties and level of agreement between the self-administered and interviewer-administered Child Perceptions Questionnaire (CPQ) for children between 8 and 10 years of age (CPQ(8-10) ) and between 11 and 14 (CPQ(11-14) ) years of age.

METHODS

A randomized cross-over study was carried out, involving 180 children (Group 1 - 90 children between 8 and 10; Group 2 - 90 children between 11 and 14 years of age) in the state of Minas Gerais, Brazil. All children completed both administration modes of the CPQ; half of each group received interviewer-administered mode first [Subgroup A (CPQ(8-10) n = 45) and Subgroup C (CPQ(11-14) n = 45)], and the other half performed the self-administered mode first [Subgroup B (CPQ(8-10) n = 45) and Subgroup D (CPQ(11-14) n = 45)]. Test-retest reliability of each mode of administration was tested on 60 children (30 for CPQ(8-10) ; 30 for CPQ(11-14) ), who were not included in the other analyses. The level of agreement between scores on the self-administered and interviewer-administered versions of the CPQ(8-10) and CPQ(11-14) was established using the intraclass correlation coefficient (ICC). The order of presentation of both instruments was tested considering the four subgroups (A, B, C and D). The calculation of effect size proposed by Cohen (1992) was used to test the clinical significance of the findings.

RESULTS

Both the self-administered and interviewer-administered versions of CPQ(8-10) and CPQ(11-14) demonstrated acceptable psychometric properties. Agreement between the administration modes for the CPQ(8-10) and CPQ(11-14) was 0.90 and 0.88 (ICC), respectively. With the exception of the functional limitation subscale, the scores of the subscales and overall score on the CPQ(8-10) were significantly higher in the group of children who responded to the interviewer-administered measure first. With the CPQ(11-14) , statistically significant differences were found only for the emotional well-being subscale.

CONCLUSIONS

Both administration modes of the CPQ(8-10) and CPQ(11-14) demonstrated satisfactory psychometric properties and a high level of agreement. Although statistically significant differences were observed for oral symptoms, emotional well-being and social well-being, with the first administration of the interviewer-administered version, the effect of the order of administration had small to medium effects on the CPQ scores.

Social inequality in oral health-related quality-of-life, OHRQoL, at early older age: evidence from a prospective cohort study

OBJECTIVES

This study aimed to assess the long-term effect of socio-behavioral characteristics on oral impacts on daily performances (OIDP) at age 65 and the influence on OIDP at age 65 of changes in socio-behavioral characteristics between age 50 and 65.

METHODS

In 1992, all 50-year-olds in two counties of Sweden were invited to participate in a longitudinal survey. A total of 6346 responded and, of those, 4143 completed follow-ups at ages 55, 60 and 65 years.

RESULTS

At age 65, 26.9% had oral impacts. Subjects being immigrants, being unmarried, reporting economic barriers, bad general health, bad quality dental care, less than annual dental attendance, limited social network and smoking at age 50 experienced oral impacts at age 65 more frequently than their counterparts in the opposite groups. Compared to the stable advantaged groups, stable disadvantaged groups regarding marital status, health status, smoking and reported quality of care had increased ORs for oral impacts. Compared to the stable advantaged groups, those who experienced deterioration with respect to health status, dental attendance and quality of oral health care and those who quitted smoking had increased ORs for oral impacts.

CONCLUSIONS

Disadvantaged socio-behavioral condition at age 50 had a long lasting detrimental effect on OHRQoL at age 65. Deterioration in socio-behavioral circumstances was associated with increased oral impacts. Early protection against the effect of socio-behavioral adversity by imposing economic barriers, ensure provision of high quality care and by promotion of healthy lifestyles seems to have the potential to reduce oral impacts at older ages.

Discriminative ability of the generic and condition-specific Child-Oral Impacts on Daily Performances (Child-OIDP) by the Limpopo-Arusha School Health (LASH) project: a cross-sectional study

Background

Generic and condition-specific (CS) oral-health-related quality-of-life (OHRQoL) instruments assess the impacts of general oral conditions and specific oral diseases. Focusing schoolchildren from Arusha and Dar es Salaam, in Tanzania, this study compared the discriminative ability of the generic Child OIDP with respect to dental caries and periodontal problems across the study sites. Secondly, the discriminative ability of the generic-and the CS Child OIDP attributed to dental caries, periodontal problems and malocclusion was compared with respect to various oral conditions as part of a construct validation.

Methods

In Arusha, 1077 school children (mean age 14.9 years, range 12-17 years) and 1601 school children in Dar es Salaam (mean age 13.0 years, range 12-14 years) underwent oral clinical examinations and completed the Kiswahili version of the generic and CS Child-OIDP inventories. The discriminative ability was assessed as differences in overall mean and prevalence scores between groups, corresponding effect sizes and odd ratios, OR.

Results

The differences in the prevalence scores and the overall mean generic Child-OIDP scores were significant between the groups with (DMFT > 0) and without (DMFT = 0) caries experience and with (simplified oral hygiene index [OHI-S] > 1) and without periodontal problems (OHI-S ≤ 1) in Arusha and Dar es Salaam. In Dar es Salaam, differences in the generic and CS Child-OIDP scores were observed between the groups with and without dental caries, differences in the generic Child-OIDP scores were observed between the groups with and without periodontal problems, and differences in the CS Child-OIDP scores were observed between malocclusion groups. The adjusted OR for the association between dental caries and the CS Child-OIDP score attributed to dental caries was 5.4. The adjusted OR for the association between malocclusion and CS Child-OIDP attributed to malocclusion varied from 8.8 to 2.5.

Conclusion

The generic Child-OIDP discriminated equally well between children with and without dental caries and periodontal problems across socio-culturally different study sites. Compared with its generic form, the CS Child-OIDP discriminated most strongly between children with and without dental caries and malocclusion. The CS Child OIDP attributed to dental caries and malocclusion seems to be better suited to support clinical indicators when estimating oral health needs among school children in Tanzania.