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Shao CH, Tuomi L, Finizia C, Wu CY, Chen RH, Chan CJ, Chen YJ, Lee CH, Chang WC, Tsai SC, Huang TW. Trismus in head and neck cancer: translation and validation of the Chinese version of the Gothenburg Trismus Questionnaire-2 (C-GTQ-2). Clin Oral Investig 2024; 28:146. [PMID: 38351210 DOI: 10.1007/s00784-024-05537-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES Trismus, marked by restricted mouth opening, significantly affects patients with temporomandibular disorder (TMD) and head and neck cancer (HNC). Despite its prevalence, specialized questionnaires for trismus assessment are scarce. This study aims to fill this gap by translating and validating the Gothenburg Trismus Questionnaire version 2 (GTQ-2) into Chinese (C-GTQ-2), enhancing the evaluation of trismus in HNC and TMD patients. MATERIALS AND METHODS The study involved 78 HNC patients, 75 TMD patients, and a control group of 150 individuals without trismus symptoms. Participants were asked to complete the C-GTQ-2 and other health-related quality of life (HRQL) instruments. A subset of 30 individuals retook the questionnaire within two weeks to assess test-retest reliability. RESULTS The C-GTQ-2 demonstrated remarkable reliability, with Cronbach's alpha values exceeding 0.70 in three of the four domains, indicating high internal consistency. The instrument also showcased high intra-class correlations in the test-retest, affirming its reliability. Furthermore, it exhibited strong convergent validity, aligning well with other HRQL instruments, and effectively discriminated between patients with and without trismus, establishing its discriminant validity. CONCLUSIONS The C-GTQ-2 emerges as a valid and reliable tool for assessing trismus in HNC and TMD patients, promising to significantly enhance both clinical and research approaches to managing trismus-related complications in the Chinese-speaking demographic. CLINICAL RELEVANCE C-GTQ-2 proves effective for trismus assessment in head and neck cancer and temporomandibular disorder patients, offering enhanced clinical and research utility.
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Affiliation(s)
- Chia-Hui Shao
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Lisa Tuomi
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra GötalandSahlgrenska University Hospital, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra GötalandSahlgrenska University Hospital, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Chia-Yu Wu
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Rou-Han Chen
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
| | - Chia-Jung Chan
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ya-Jen Chen
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
| | - Chia-Hsin Lee
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wei-Chin Chang
- Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan
| | - Shu-Chun Tsai
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
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Liu YC, Shih MC, Tu YK. USING DENTAL PATIENT-REPORTED OUTCOMES (dPROs) IN META-ANALYSES: A SCOPING REVIEW AND METHODOLOGICAL INVESTIGATION. J Evid Based Dent Pract 2022; 22:101658. [PMID: 35063181 DOI: 10.1016/j.jebdp.2021.101658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/07/2021] [Accepted: 10/12/2021] [Indexed: 12/16/2022]
Abstract
Many studies use dental patient-reported outcomes (dPROs) to evaluate treatments and interventions. However, the consensus on the methodology for combining results of dPROs for meta-analysis has not yet been fully established or widely discussed. The aim of this study is to conduct a scoping review for the methodological issues and difficulties specific to meta-analysis of dPROs and to put forward recommendations for improving quality of meta-analyses of dPRO. We searched the Google Scholar and PubMed databases and identified meta-analysis with dPROs in English. A total of 22 meta-analyses were included in our scoping review, and their characteristics, such as reported outcomes, questionnaires, and effect measures, were extracted. We identified several methodological issues within current literature: (1) synthesizing results from studies with different rating scales; (2) meta-analyses with few studies; (3) the interpretation of standardized mean difference; (4) including studies of different cut-off values in a meta-analysis; and (5) systematic errors due to different instruments. According to each issue mentioned, we provided guidance and recommendations on how to resolve those issues, including using the same Likert scale, conducting an overall and subgroup meta-analysis, using a random-effects model in a meta-analysis, etc. More efforts are required to improve the conduct and interpretation of meta-analyses on dPROs.
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Affiliation(s)
- Yun-Chen Liu
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ming-Chieh Shih
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Kang Tu
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
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Lokhorst MM, Horbach SER, Waner M, O TM, van der Vleuten CJM, Mokkink LB, van der Horst CMAM, Spuls PI. Responsiveness of quality-of-life measures in patients with peripheral vascular malformations: the OVAMA project. Br J Dermatol 2019; 182:1395-1403. [PMID: 31628861 PMCID: PMC7318211 DOI: 10.1111/bjd.18619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2019] [Indexed: 12/20/2022]
Abstract
Background The OVAMA (Outcome Measures for Vascular Malformations) project determined quality of life (QoL) as a core outcome domain for patients with vascular malformations. In order to measure how current therapeutic strategies alter QoL in these patients, a patient‐reported outcome measurement (PROM) responsive to changes in QoL is required. Objectives To assess the responsiveness of two widely used generic QoL PROMs, the Medical Outcomes Study Short Form 36 (SF‐36) and Skindex‐29, in adult patients with vascular malformations. Methods In an international multicentre prospective study, treated and untreated patients completed the SF‐36 and Skindex‐29 at baseline and after a follow‐up period of 6–8 weeks. Global rating of change (GRC) scales assessing various QoL‐related outcome domains were additionally completed. Per subscale, responsiveness was assessed using two methods: by testing hypotheses on expected correlation strength between change scores of the questionnaires and the GRC scales, and by calculating the area under the receiver operating characteristics curve (AUC). The questionnaires were considered responsive if ≥ 75% of the hypotheses were confirmed or if the AUC was ≥ 0·7. Results Eighty‐nine participants were recruited in three centres in the Netherlands and the U.S.A., of whom 67 completed all baseline and follow‐up questionnaires. For all subscales of the SF‐36 and Skindex‐29, < 75% of the hypotheses were confirmed and the AUC was < 0·7. Conclusions Our findings suggest that the SF‐36 and Skindex‐29 seemed unresponsive to change in QoL. This suggests that alternative PROMs are needed to measure – and ultimately improve – QoL in patients with vascular malformations. What's already known about this topic? Quality of life is often impaired in patients with vascular malformations. Quality of life is considered a core outcome domain for evaluating treatment of vascular malformations. To measure the effect of treatment on quality of life, a patient‐reported outcome measure is required that is responsive to changes in quality of life.
What does this study add? This is the first study assessing the responsiveness of quality‐of‐life measures in patients with vascular malformations. The results seem to indicate that the Medical Outcomes Study Short Form 36 (SF‐36) and Skindex‐29 are not responsive to changes in quality of life in patients with vascular malformations.
What are the clinical implications of this work? Medical Outcomes Study Short Form 36 (SF‐36) and Skindex‐29 are not ideal to assess the effect on quality of life over time, of treatment strategies for peripheral vascular malformations.
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Affiliation(s)
- M M Lokhorst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - S E R Horbach
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - M Waner
- Department of Otolaryngology, Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals, New York, NY, U.S.A
| | - T M O
- Department of Otolaryngology, Vascular Birthmark Institute of New York, Lenox Hill and Manhattan Eye, Ear, and Throat Hospitals, New York, NY, U.S.A
| | - C J M van der Vleuten
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - L B Mokkink
- Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - C M A M van der Horst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - P I Spuls
- Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, the Netherlands
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