Influence of administration method on oral health-related quality of life assessment using the Oral Health Impact Profile

The impact of osteogenesis imperfecta severity on oral health-related quality of life in Spain: a cross-sectional study

BACKGROUND

Osteogenesis imperfecta (OI) affects dental and craniofacial development; therefore, it can influence oral health-related quality of life (OHRQoL). The objective of this study was to explore the influence of the severity of OI on OHRQoL in adults older than eighteen years residing in Spain.

METHOD

Adults with OI were recruited from the Spanish Association of Crystal Bone (AHUCE) foundation. OHRQoL was evaluated using the Spanish version of the Oral Health Impact Profile questionnaire (OHIP-14sp), oral hygiene habits, and a dental care survey. Clinical and radiological dental examinations were performed to evaluate the patients' oral conditions.

RESULTS

A total of 65 adults (n = 46 females) aged between nineteen and sixty-two years who were diagnosed with OI and classified as type I, III, and IV (n = 20, 14, and 31, respectively) participated in this research. The total OHIP-14sp scores were significantly greater (worse) for type III (23 [SD = 10]) and type IV (21.4 [SD = 12]) than for type I (13.8 [SD = 6]) (P < 0.05). The negative impact of OHRQoL was due to the association of type III OI with all domains except for the handicap domain, while type IV OI was associated with the physical disability, social disability, and handicap domains (P < 0.05 for all).

CONCLUSION

The severity of OI negatively impacted OHRQoL in adults. This association was statistically significant.

Assessment of Children and "Young" Adult Patients' Quality of Life after Prosthetic Treatment of Disorders of the Craniofacial Region-A Retrospective Study

BACKGROUND

Prosthetic rehabilitation for children and juvenile patients with congenital or acquired craniofacial disorders is the area of activity of many clinicians and is a major diagnostic and therapeutic challenge for dentists.

METHODS

Studies were carried out on a group of 30 patients (10 female and 20 male) aged 2.5 to 30 years who were treated prosthetically due to congenital and acquired craniofacial disorders. The aim of this study was to assess the quality of life using the CPQ 11-14 (Child Perception Questionnaire 11-14), OQLQ (Orthognathic Quality of Life Questionnaire), and PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire).

RESULTS

Before the prosthetic treatments, the mean values in the individual questionnaires were, respectively, CPQ 11-14-54 points; OQLQ-44.4 points; and PIDAQ-47.6 points. The following values were obtained after the treatments: CPQ 11-14-12.43 points; OQLQ-22.27 points; and PIDAQ-34.03 points. All obtained differences were statistically significant.

CONCLUSIONS

The total numerical results obtained in all questionnaires decreased, which means that prosthetic rehabilitation had a positive impact on the assessment of the quality of life based on individual categories.

Advancing Universal Oral Health Coverage via Person-Centred Outcomes

The World Health Organization member states proposed a comprehensive "Global Strategy on Oral Health," which includes achieving universal oral health coverage by 2030. Challenges and barriers, including persistent inequalities, will hamper the achievement of universal oral health coverage. In low- and middle-income countries, the oral health of a large proportion of the population has been neglected, increasing oral health inequalities. In high-income countries, some receive excessive dental treatment, whilst particularly those with higher needs receive too little dental care. Therefore, an analysis of individual countries' needs, encompassing the training of oral health professionals in a new philosophy of care and attention and the optimisation of the existing resources, is necessary. Distancing from a person-centred focus has prompted individual and societal issues, including under-/overdiagnosis and under-/overtreatment. The person-centred approach considers the perceptions, needs, preferences, and circumstances of individuals and populations. Patient-reported outcome measures, such as self-rated and -reported health, reflect an individual's overall perception of health and are designed to mediate human biology (ie, the disease) and psychology. The usage of patient-reported outcome measures in dentistry to place the individual at the centre of treatment is delayed compared to other areas. This paper discusses some challenges and potential solutions of patient-reported outcome measures in dentistry for achieving universal oral health coverage.

Oral Health Impact Profile (OHIP)-14 telephone interview reliability to assess oral health-related quality of life (OHRQoL) in orthosurgical patients

BACKGROUND

The influence of the Oral Health Impact Profile (OHIP)-14 administration method through telephone or face-to-face interviews in orthosurgical patients is unknown. The study aims to assess the reliability of the OHIP-14 questionnaire through its stability and internal consistency when applied through a telephone interview compared with a face-to-face interview.

METHODS

A total of 21 orthosurgical patients were selected to compare the scores obtained in OHIP-14. The interview was carried out by telephone, and 2 weeks later, the patient was invited to attend a face-to-face interview. Stability was verified by Cohen's kappa coefficient with quadratic weighting for individual items and intraclass correlation coefficient for the total OHIP-14 score. Internal consistency was assessed by Cronbach's alpha coefficient for the total scale and its seven subscales.

RESULTS

Items 5 and 6 showed reasonable agreement in the two modes of administration; 4 and 14 moderate; 1, 3, 7, 9, 11, and 13 substantial; and items 2, 8, 10, and 12 showed almost perfect agreement, according to the Cohen's kappa coefficient test. The instrument's internal consistency was better in the face-to-face interview (0.89) than it was in the telephone interview (0.85). For the evaluation of the seven OHIP-14 subscales, differences were found in functional limitations, psychological discomfort, and social disadvantage subscales.

CONCLUSIONS

Although there were some differences in OHIP-14 subscales between the interview methods, the total score of the questionnaire showed good stability and internal consistency. The telephone method can be a reliable alternative for the application of the OHIP-14 questionnaire in orthosurgical patients.

The Potential Role of Dental Patient-Reported Outcomes (dPROs) in Evidence-Based Prosthodontics and Clinical Care: A Narrative Review

Oral health problems are associated with poor quality of life, with the potential to cause functional, aesthetic, nutritional, and psychological difficulties, in addition to pain and suffering. Traditionally, dental treatment outcomes are measured using purely clinical parameters; however, this may be ineffective as these parameters cannot adequately capture the full impact of poor oral health on the patient, or their respective coping strategies. From this perspective, there are significant benefits when the patient's perception of their care is considered, and included in treatment planning and delivery. The impacts perceived by the patient on their treatment outcomes can be measured using patient-reported outcomes (PROS), or more specifically with dPROS, focused on dental patient-reported outcomes. Although there are some instruments available for measuring these outcomes in clinical trials, very little information is available for explaining the context in which these outcomes are considered, and also how to capture this information using appropriate instruments, specially in evidence-based dental practice. This article aims to review the literature, seeking to describe what has been considered about assessing patient's outcomes, as well as how to measure them, and explore the potential benefits of using dPROS in evidence-based prosthodontics and clinical care of partially and fully edentulous patients.

Is assessment of oral health-related quality of life burdensome? An item nonresponse analysis of the oral health impact profile

AIM

This study aimed to investigate if in the 49-item Oral Health Impact Profile (OHIP): (i) more missing data occurred when participants answered more questions, (ii) more missing data occurred in a particular item or set of related items, and (iii) item missingness was associated with the demographic characteristics and oral health-related quality of life (OHRQoL) impairment level.

METHODS

We used OHIP data from the Dimensions of OHRQoL (DOQ) project, which consolidated data from 35 individual studies. Among these studies, we analyzed OHIP data from 19 studies (4,847 surveyed individuals, of which 3,481 were completed under supervision and 1,366 were completed unsupervised) that contained some missing information. We computed descriptive statistics to investigate the OHIP missingness. We also used logistic regression analyses, with missing information as the dependent variable, and number of questions filled in (OHIP item rank) as the independent variable for samples with and without supervision. To investigate whether missing data occurs more in a particular item or set of related items we fitted regression models with individual OHIP items and the OHRQoL dimensions as indicator variables. We also investigated age, gender, and OHRQoL level as predictor variables for missing OHIP items.

RESULTS

We found very low levels of missingness across individual OHIP items and set of related items, and there was no particular item or set of related items that was associated with more missing data. Also, more missing data did not depend on whether the participants answered more questions. In studies without supervision, older persons and females were 5.47 and 2.66 times more likely to have missing items than younger persons and females. However, in studies with supervision, older persons, and participants with more OHRQoL impairment were 1.70 and 2.65 times more likely to have missing items.

CONCLUSION

The study participants from general and dental patient populations did not find OHIP-49 burdensome. OHIP item missingness did not depend on a particular OHIP item or set of related items, or if the study participants responded to a greater number of OHIP items. We did not find a consistent pattern of the influence of sociodemographic and OHRQoL magnitude information on OHIP missingness. The amount of missing OHIP information was low making any potential influence likely small in magnitude.

Effect of method of administration on the oral health-related quality of life assessment using the Early Childhood Oral Health Impact Scale (ECOHIS-G)

Objectives

The influence of the administration method used to collect oral health–related quality of life (OHRQoL) in children remains largely unknown. The aim of this study was to determine whether the OHRQoL information obtained using the Early Childhood Oral Health Impact Scale (ECOHIS) differed with different methods of data collection (face-to-face interview, telephone, or self-administered questionnaire).

Materials and methods

The OHRQoL of 38 preschool children, aged 1 to 5 years, was measured using the German version of the ECOHIS. The instrument was administered to the caregivers of these children using three different methods, with an interval of 1 week between each administration. Test-retest reliability for the repeated ECOHIS-G assessments across the three methods of administration, agreement, and convergent validity was determined.

Results

Kappa coefficients for agreement between two different methods of administration, respectively, ranged from moderate to substantial (0.47 to 0.65). Test-retest reliability was moderate (ICC 0.65–0.79).

Conclusion

In conclusion, the three methods of administration (face-to-face interview, telephone interview, or self-administered questionnaire) of the ECOHIS-G were comparable in 1- to 5-year-old preschool children.

Clinical relevance

All three methods of administration can be used to obtain valid and reliable OHRQoL information in German speaking countries.

Methodological considerations when measuring oral health-related quality of life

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.

<p>Measurement Equivalence of “Touch-Screen” versus “Paper-Based” Assessments of OHRQoL: A Randomized Crossover Trial</p>

Purpose

To determine the measurement equivalence of computer touch screen assessment (CTSA) and paper based assessment (PBA) of the oral health impact profile (OHIP-14).

Patients and Methods

A randomized crossover trial was conducted. Sixty participants were randomized to either i) Arm A: completed CTSA then PBA of OHIP-14, or ii) Arm B: PBA and then CTSA of OHIP-14 within the same day. User preference and time taken to complete the assessments were recorded. Agreement between CTSA and PBA was determined using directional difference (DD), absolute difference (AD), and intraclass correlation coefficient (ICC).

Results

There was no significant difference in CTSA and PBA OHIP-14 scores (P>0.05). The magnitude of the DD in scores between assessment methods was small for overall scores and all domains (<0.3). The AD in OHIP-14 scores was small (~6% for overall score, between 8–16% for domains). Agreement between CTSA and PBA was high (ICC=0.9; 95% CI=0.8–0.9) for overall OHIP-14 scores, but ICC values varied across domains. Most (78%) preferred CTSA. There was no significant difference in time taken to complete assessments (P=0.09). Regression analyses did not identify any significant socio-demographic factor associated with absolute difference between CTSA and PBA scores.

Conclusion

There is equivalence of measurements in OHRQoL assessments from CTSA and PBA, and the time taken to complete assessment by either means is similar. There is a greater preference for CTSA. This has implications to support the use of CTSA in OHRQoL assessments.

The Spanish Language 5-Item Oral Health Impact Profile

OBJECTIVE

To test validity and reliability of the Spanish version of the 5-item Oral Health Impact Profile (OHIP-Sp5).

METHODS

Spanish-speaking dental patients (n = 331, response rate = 61%, age: 42.9 + 12.3 years, 59% female) with a scheduled appointment at HealthPartners dental clinics in Minnesota, USA, were investigated. To assess score reliability, we computed Cronbach's alpha, expecting 'good' reliability (alpha > 0.70). To assess score validity, we correlated the OHIP-Sp5 summary score with five OHRQoL measures [49- and 14-item OHIP-Sp, the Spanish version of the General Oral Health Assessment Index (GOHAI-Sp), the Spanish version of the Oral Impacts on Daily Performances (OIDP-Sp) and a Global Oral Health Assessment]. We expected a pattern of 'very large' (r > 0.70) correlation coefficients for OHIP-Sp5 relationships with the two longer OHIP-Sp versions and 'large' (r > 0.50) correlation coefficients for the other three measures.

RESULTS

Patients had a mean OHIP-Sp5 score of 3.7 (SD = 4.0). The Instrument's reliability was, as expected, 'good', according to the Cronbach's alpha statistic of 0.83. The Instrument's validity was supported by the expected pattern of validity coefficients. OHIP-Sp5 summary scores correlated with OHIP-Sp14 as well as with OHIP-Sp49 (both r = 0.95: 'very large' effect) and with GOHAI-Sp, OIDP and the Global Oral Health Assessment with r = -0.80, 0.73, and -0.56 (absolute effect magnitude all 'very large' or 'large'), respectively.

CONCLUSIONS

The Spanish version of OHIP-5 is a brief and psychometrically sound instrument to measure oral health-related quality of life (OHRQoL) in Spanish-speaking populations. It can effectively replace longer OHIP instruments and would be applicable across all settings of clinical practice and research.

Dental Patient-Reported Outcome Measures Are Essential for Evidence-Based Prosthetic Dentistry

For evidence-based dental treatment decision-making in prosthetic dentistry, evidence from scientific studies performed in the appropriate population with state-of-the-art interventions, reasonable controls, and relevant outcomes is required. This article will briefly review patient populations involved and interventions applied in prosthetic dentistry and more extensively review outcomes used for evidence-based dental treatment decision-making in prosthetic dentistry. Dental patient populations in prosthetic dentistry usually suffer from extensive loss of tooth substance and/or tooth loss. Typical interventions in prosthetic dentistry are replacement of a substantial amount of tooth structure and lost teeth with conventional or implant-supported fixed or removable dental protheses. Sufficient controls or comparisons should also involve no treatment for tooth loss as a legitimate option. For many years, prosthodontic treatment almost solely focused on disease-oriented outcomes such as numerical replacement of missing teeth to restore current oral health and prevent further deterioration, and now, dental patient-reported outcomes (dPROs), the outcomes that are directly reported by the patient, are gaining increasing attention. dPROs are what matters most for the patient, and dPRO measures have several advantages when applied in clinical practice and research settings compared with traditional disease-oriented measures such as ease of applicability and less burdensome for the clinicians. In evidence-based prosthetic dentistry, there should be a shift to fewer applied dPRO measures, with only one instrument becoming standard. Furthermore, dPROs will probably also become tools to assess patients' oral health status in clinical practice in a standardized manner. Finally, information on dPROs will become an integral part of evidence-based treatment decision-making in prosthetic dentistry.

Influence of a face-bow on oral health-related quality of life after changing the vertical dimension in the articulator: a randomized controlled trial. Part II

OBJECTIVES

In a double-blind randomized controlled clinical trial, the impact of face-bow registration for remounting complete dentures (CDs) on oral health-related quality of life (OHRQoL) was evaluated.

MATERIALS AND METHODS

New CDs of 32 subjects were clinically remounted using intraoral pin registration. CDs were transferred into a semi-adjustable articulator corresponding to group #1: mean settings with Bonwill triangle and Balkwill angle, and group #2: arbitrary hinge axis with a face-bow registration. After occlusal adjustment, subjects were followed up after 3 (T1) and 84 (T2) days. The primary outcome was the change of OHRQoL by OHIP-G49, while as secondary outcome, mucosal alterations were evaluated over time. Mean values of OHIP-G49 total sum scores and OHIP-dimensions were calculated for baseline (T0) and days 3 (T1) and 84 (T2) after intervention. Based on bootstrapping methods (changes of total OHIP sum score) and the Wilcoxon test (changes of sum scores of OHIP dimensions), analyses of between-group differences were performed.

RESULTS

Mean values (MV) of OHIP-G49 sum scores decreased in both groups from T0 (#1 48.56; #2 45.46) to T1 (#1 31.43 (p = 0.012); #2 43.20) and to T2 (#1 29.06; #2 29.40), which represents an improvement in OHRQoL. MV of OHIP-dimension sum scores decreased from T0 to T1 in both groups (#1 seven dimensions; #2 four dimensions); the decrease of sum scores was tested as not statistically significant (p > 0.05).

CONCLUSIONS

From the patient's perspective, mean-value-based remounting methods are of value. The use of a face-bow was not perceived as superior.

CLINICAL RELEVANCE

From the patient's perspective, remounting of CDs will be positively perceived, irrespective of the use of a face-bow.

Comparison of Face-To-Face Interview and Telephone Methods of Administration on the Ecohis Scores

The aim of this study was to compare the administration of the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire, applied by face-to-face and telephone format. A randomized sample of 76 parents/guardians of children up to 6 years old was selected in a Pediatric Dentistry Clinic of the Federal University of Santa Maria, Brazil. Patients were randomly selected for 2 different groups, according to administration sequence: F-T (Face-to-face-Telephone) and T-F (Telephone-Face-to-face). Two interviewers administered the ECOHIS questionnaire with 2 week interval between the methods. The reliability between sections of the different methods of administration was assessed by Cronbach's alpha and Intraclass Correlation Coefficient (ICC). There were differences in means of the ECOHIS between face-to-face and telephone methods. However, the value Cronbach's alpha were between 0.94-0.96, and value ICC ranged from 0.91-0.93, proving to be acceptable values. The Bland-Altman plots confirmed the results of reliability tests, supporting the accuracy of the methods. Although there is a slight difference in the scores, the use of both mode of administration of the ECOHIS yields reliable data when single method is used from the beginning to the end of the study. The results provided evidence to use either Face-to-face or Telephone method of administration of the ECOHIS.

Awareness assessment in Turkish subpopulation with chronic oral mucosal diseases

Objectives:

The aim of this study was to evaluate the awareness of group Turkish patients with chronic oral mucosal diseases by chronic oral mucosal diseases questionnaires (COMDQ).

Materials and Methods:

Eighty patients with chronic oral mucosal diseases were participated in the study. A detailed medical history of each patient was taken, and all the COMDQ questions, which were translated from English version, were filled out. The data were analyzed with the IBM Statistical Package for Social Sciences Statistics 22.0.

Results:

The mean ages of patients were 48.91 ± 13.36 years. Of the total 80 cases of chronic oral mucosal diseases identified 52 (65%) were female and 28 (35%) male. The standardized mean scores for COMDQ were 1.72 ± 1.11 for “pain and functional limitation,” 1.09 ± 0.94 for “medication and treatment,” 2.31 ± 1.06 for “social and emotional,” and 2.27 ± 0.83 for “patient support,” respectively.

Conclusions:

The results of this study indicate that the Turkish version of the COMDQ has the profitable psychometric peculiarity and comfortable to patients with chronic oral mucosal diseases in Turkey.

Validation of a Dutch version of the Geriatric Oral Health Assessment Index (GOHAI-NL) in care-dependent and care-independent older people

BACKGROUND

The GOHAI is a frequently used instrument to measure oral health-related quality of life (OHRQoL) of adults, in particular older people. The aim of this study was to translate the original English version of the GOHAI into a Dutch version (GOHAI-NL), and to test the validity and reliability of the GOHAI-NL in care-independent and care-dependent older people.

METHODS

The GOHAI questionnaire was translated into Dutch, discussed by an expert panel, back-translated to the original, pilot-tested and assessed for cognitive and conceptual equivalence. The resulting GOHAI-NL was tested in a groups of care-independent (Group A, n = 109, mean age 73.1 ± 5.4 years) and care-dependent (Group B, n = 118, mean age 85.6 ± 7.0. years) cognitively alert people of 65 years and over. Psychometric properties including reliability (internal consistency, item-total, item-dimension, dimension-total, inter-item correlation, and test-retest stability), and validity (convergent, discriminant, known-group), and floor and ceiling effects were assessed.

RESULTS

Internal consistency was confirmed by Cronbach's alphas of 0.86 (group A) and 0.80 (group B). Item-total score correlations were between 0.4 and 0.7 except for item 3 in group A (0.34) and B (0.08) and for item 12 in group A (0.20). Item-dimension and dimension-total correlations were between 0.30 and 0.78 and around 0.7 respectively for the dimensions 'physical functioning' and 'psychosocial functioning', but lower for the dimension 'pain and discomfort' with item-dimension correlations between 0.13 and 0.44. Average inter-item correlations were 0.34 ± 0.11 (group A) and 0.33 ± 0.08 (group B). Test-retest correlation of the total score (GOHAI-ADD) was 0.88 in group A (ICCs: 0.62 - 0.88) and 0.93 in group B (ICCs: 0.64 - 0.91). Significant correlations in the expected direction were found between GOHAI and most oral health-related variables except for presence of caries in group A, and perceived general health, prosthodontic status and number of natural teeth in group B. No floor or ceiling effects were detected at GOHAI-ADD level; however ceiling effects did occur at dimension level.

CONCLUSION

The GOHAI-NL has satisfactory reliability and validity and can be used to measure OHRQoL in Dutch care-dependent and care-independent older people.

Mode of administration does not cause bias in patient-reported outcome results: a meta-analysis

PURPOSE

Technological advances in recent decades have led to the availability of new modes to administer patient-reported outcomes (PROs). To aid selecting optimal modes of administration (MOA), we undertook a systematic review to determine whether differences in bias (both size and direction) exist among modes.

METHODS

We searched five electronic databases from 2004 (date of last comprehensive review on this topic) to April 2014, cross-referenced and searched reference lists. Studies that compared two or more MOA for a health-related PRO measure in adult samples were included. Two reviewers independently applied inclusion and quality criteria and extracted findings. Meta-analyses and meta-regressions were conducted using random-effects models.

RESULTS

Of 5100 papers screened, 222 were considered potentially relevant and 56 met eligibility criteria. No evidence of bias was found for: (1) paper versus electronic self-complete; and (2) self-complete versus assisted MOA. Heterogeneity for paper versus electronic comparison was explained by type of construct (i.e. physical vs. psychological). Heterogeneity for self-completion versus assisted modes was in part explained by setting (clinic vs. home); the largest bias was introduced when assisted completion occurred in the clinic and follow-up was by self-completion (either electronic or paper) in the home.

CONCLUSIONS

Self-complete paper and electronic MOA can be used interchangeably for research in clinic and home settings. Self-completion and assisted completion produce equivalent scores overall, although heterogeneity may be induced by setting. These results support the use of mixed MOAs within a research study, which may be a useful strategy for reducing missing PRO data.

Effects of method of administration on oral health-related quality of life assessment using the Child Perceptions Questionnaire (CPQ-G11-14)

OBJECTIVES

Questionnaires that measure oral health-related quality of life (OHRQoL) in children and adolescents have emerged in recent years as an important source of patient-reported outcomes. The aim of this study was to investigate potential effects of the method of administration (face-to-face interview, telephone interview, or self-administered questionnaire) in 11- to 14-year-old children and adolescents on OHRQoL information obtained using the Child Perceptions Questionnaire (CPQ).

MATERIALS AND METHODS

OHRQoL was measured using the German version of the CPQ (CPQ-G11-14). The instrument was administered to 42 children and adolescents aged 11 to 14 years using the three different methods in a randomized order with an interval of 1 week between each administration. Test-retest reliability for the repeated CPQ-G11-14 assessments across the three methods of administration, internal consistency, and convergent validity were determined.

RESULTS

The CPQ-G11-14 mean summary scores did not vary statistically significantly across the three administration methods (P = 0.274). Test-retest reliability was moderate to good (ICC 0.69-0.82), internal consistency was satisfactory (Cronbach's alpha 0.85-0.88), and CPQ-G11-14 mean summary scores were correlated in the expected direction with a global measure of self-reported oral health for all the three administration methods.

CONCLUSION

In conclusion, the method of administration (face-to-face interview, telephone interview, or self-administered questionnaire) did not influence CPQ-G11-14 scores in 11- to 14-year-old children and adolescents to a significant extent.

CLINICAL RELEVANCE

Investigators in German-speaking countries can choose between all three methods of administration to obtain valid and reliable OHRQoL information.

Quality of life data in older adults: self-assessment vs interview

BACKGROUND AND PURPOSE

There are obstacles for older people when reporting quality of life (QoL) in a survey format. The aim of this study was to explore the quality of data obtained on self-assessed QoL among older people with respect to modes of administration.

METHOD AND RESULTS

Approximately half of the QoL items showed significantly higher mean values in the mail sample than in the interview sample. Data suggest that there may be more vulnerability towards offering socially desirable answers. Problems with reduced energy and loss of memory affect both modes of administration.

CONCLUSIONS

This study demonstrates that investigating the mode of questionnaire administration among older people can be a valuable means by which to detect possible threats to data quality when interpreting QoL scores.

The Canadian systemic sclerosis oral health study: orofacial manifestations and oral health-related quality of life in systemic sclerosis compared with the general population

OBJECTIVE

The aim of this study was to compare oral abnormalities and oral health-related quality of life (HRQoL) of patients with SSc with the general population.

METHODS

SSc patients and healthy controls were enrolled in a multisite cross-sectional study. A standardized oral examination was performed. Oral HRQoL was measured with the Oral Health Impact Profile (OHIP). Multivariate regression analyses were performed to identify associations between SSc, oral abnormalities and oral HRQoL.

RESULTS

We assessed 163 SSc patients and 231 controls. SSc patients had more decayed teeth (SSc 0.88, controls 0.59, P = 0.0465) and periodontal disease [number of teeth with pocket depth (PD) >3 mm or clinical attachment level (CAL) ≥5.5 mm; SSc 5.23, controls 2.94, P < 0.0001]. SSc patients produced less saliva (SSc 147.52 mg/min, controls 163.19 mg/min, P = 0.0259) and their interincisal distance was smaller (SSc 37.68 mm, controls 44.30 mm, P < 0.0001). SSc patients had significantly reduced oral HRQoL compared with controls (mean OHIP score: SSc 41.58, controls 26.67, P < 0.0001). Multivariate regression analyses confirmed that SSc was a significant independent predictor of missing teeth, periodontal disease, interincisal distance, saliva production and OHIP scores.

CONCLUSION

Subjects with SSc have impaired oral health and oral HRQoL compared with the general population. These data can be used to develop targeted interventions to improve oral health and HRQoL in SSc.

Factor analyses of the Oral Health Impact Profile - overview and studied population

PURPOSE

A desideratum of oral health-related quality of life (OHRQoL) instruments - such as the Oral Health Impact Profile (OHIP) - is that they accurately reflect the structure of the measured construct(s). With this goal in mind, the Dimensions of Oral Health-Related Quality of Life (DOQ) Project was proposed to investigate the number and nature of OHRQoL dimensions measured by OHIP. In this report, we describe our aggregate data set for the factor analyses in the project, which consists of responses to the 49-item OHIP from general population subjects and prosthodontics patients from 6 countries, including a large age range of adult subjects and both genders.

MATERIALS AND METHODS

The DOQ Project's aggregate data set combines data from 35 individual studies conducted in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden.

RESULTS

The combined data set includes 10778 OHIPs from 9348 individuals (N=6349 general population subjects, N=2999 prosthodontic patients). To elucidate the OHIP latent structure, the aggregated data were split into a Learning Sample (N=5173) for exploratory analyses and a Validation Sample (N=5022) for confirmatory analyses. Additional data (N=583) were assigned to a third data set.

CONCLUSION

The Dimensions of Oral Health-Related Quality of Life Project contains a large amount of international data and is representative of populations where OHIP is intended to be used. It is well-suited to assess the dimensionality of the questionnaire.

Does the mode of administration of the Oral Health Impact Profile-49 affect the outcome score?

OBJECTIVE

To determine if there are differences in outcome scores if the Oral Health Impact Profile-49 (OHIP-49) is delivered by two different modes of administration (manual-self complete versus telephone interview).

METHODS

Patients with chronic periodontitis (n=83, 54% females and 46% males, mean age 49.1±9.5 years) completed the OHIP-49 using two modes of administration (manual self-complete and telephone interview) in a randomly assigned order, with a minimum washout period of 2 weeks between modes, both episodes occurring prior to any periodontal treatment being provided. To assess convergent validity, after each mode of administration, the patients were additionally asked a global question about their oral health-related quality of life (OHRQoL).

RESULTS

Median OHIP-49 scores recorded by manual self-complete (median 36 [IQR=20-70]) were significantly higher than those recorded by telephone interview (median 27 [IQR=11-61]) (p<0.01). The global question was well correlated to the OHIP domains, but did not reveal any evidence of an order effect such as was seen with OHIP-49 itself (which showed a higher impact on OHRQoL during the first administration in either mode).

CONCLUSIONS

The mode of administration (manual-self complete versus telephone interview) did substantially influence the OHIP-49 scores in patients with chronic periodontitis. The OHRQoL differed between the two modes of administration, with significantly higher scores (indicating poorer OHRQoL) when the questionnaire was manually self-completed.

CLINICAL SIGNIFICANCE

The mode of administration of quality of life questionnaires such as OHIP-49 could potentially affect the outcome scores derived. This study investigated whether there is a difference in outcome scores if OHIP-49 is delivered via manual self-complete or by telephone interview in patients with chronic periodontitis. We found that there was a significant difference between the two modes: manual self-completion by the patients yielded significantly higher scores than completion by telephone interview. It is therefore important to be consistent in the mode of completion of OHIP-49, as mixing modes could introduce additional error into clinical studies that utilise this instrument.

Test--retest reliability of Oral Health Impact Profile (OHIP-49) in adults with systemic sclerosis

PURPOSE

To assess the test-retest reliability of the Oral Health Impact Profile (OHIP) in 3-month intervals among people with systemic sclerosis (SSc).

METHODS

Thirty-nine adults with SSc completed the OHIP-49 at baseline, 3 and 6 months. Intraclass correlation (ICC), standard error of measurement (SEM), SEM%, coefficient of repeatability (CoR), and 95% limits of agreement (LoA) were used to assess test-retest reliability and measurement variability.

RESULTS

The ICC of the OHIP for the first time point (baseline to 3-month) was excellent (>.80), and the second time point (3-month to 6-month) demonstrated good reproducibility (>.60). However, the large SEM, SEM%, CoR, and 95% LoA indicated that the OHIP was neither a precise measurement nor sensitive to change in response to interventions.

CONCLUSION

The values of the ICC indicated that the OHIP scores demonstrated acceptable stability across each of the two 3 months' retest duration, supporting the reliability of the OHIP for group-level comparisons. However, using the OHIP as a measure of an individual's oral health-related quality of life in adults with SSc is not recommended.

Interpreting one oral health impact profile point

Background

Interpretation of scores from oral health-related quality of life (OHRQoL) instruments, such as the Oral Health Impact Profile (OHIP) is challenging. It was the aim of this study to determine how many oral impacts correspond to one point of the 49-item OHIP using a new approach which translates numeric problem counts into the traditionally used ordinal OHIP response categories.

Methods

A sample of 145 consecutively recruited prosthodontic patients seeking treatment or having a routine examination completed the German version of the 49-item OHIP with the original ordinal response format as a self-administered questionnaire. In addition, the numerical frequencies of impairment during the previous month were requested in personal interviews. Based on a multilevel mixed-effects linear regression, we estimated the mean difference with 95% confidence interval (CI) in numerical frequency between two adjacent ordinal responses.

Results

A numerical frequency of 15.2 (CI: 14.8 – 15.7) impacts per month corresponded to one OHIP point. This translates to approximately one impact every other day in the past month.

Conclusions

The oral problem count per day that corresponds to one OHIP-49 point can be used to interpret this instrument’s scores in cross-sectional and longitudinal studies. This number can help to better understand OHRQoL burden for patients, clinicians, and researchers alike.

Changes in young children's OHRQoL after dental treatment under general anaesthesia

OBJECTIVE

To use the Parental-Caregivers Perceptions Questionnaire (P-CPQ) and Family Impact Scale (FIS) to determine whether dental treatment of young Auckland children under general anaesthesia (GA) improved oral-health-related quality of life (OHRQoL) for them and their families.

DESIGN

A pretest/post-test design, with a consecutive clinical sample of parents/caregivers of children (10 years or younger) treated under GA. More than half of the children were Māori or Pacific Islanders.

RESULTS

Of the 157 children in the baseline sample, 144 (91.7%) were followed up. The overall P-CPQ score showed a large decrease following treatment, along with an increase in the number scoring 0 (no impact). Similar relative changes were observed in the oral symptoms and emotional well-being subscales, whereas the other two subscales showed moderate decreases. All post-treatment FIS scores were lower than pre-treatment ones; all showed moderate effect sizes. The greatest relative changes were seen in the parental/family activity and parental emotions subscales.

CONCLUSIONS

The dental treatment of young children under GA is associated with considerable improvement in their OHRQoL. The P-CPQ and the FIS are valid and responsive to treatment-associated changes in young children with early childhood caries (ECC).