Quality assessment of oral health-related quality-of-life questionnaires in children and adolescents

Article type
Authors
Zaror C1, Pardo Y2, Martinez-Zapata MJ3, Espinoza G4, Muñoz-Millán P5, Ferrer M2
1CIGES, Faculty of Medicine, Universidad de la Frontera, Chile
2Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Spain
3Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), Spain
4Department of Public Health, Faculty of Medicine, Universidad de la Frontera, Chile
5Department of Pediatric Dentistry and Orthodontic, Faculty of Dentistry, Universidad de la Frontera, Chile
Abstract
Background: Oral health–related quality of life (OHRQoL) is a multidimensional construct that includes a subjective evaluation of the individual’s oral health, functional well-being, expectations and satisfaction with care, and sense of self. The development and validating of specific instruments for children of different ages has allowed better capture of effects related to children’s oral health problems, but only a little is known about the quality of them.
Objectives: To perform a quality evaluation of the available evidence on the development process and metric properties of OHRQoL questionnaires in children and adolescents.
Methods: To identify all available OHRQoL questionnaires a systematic literature search was performed in MEDLINE, EMBASE, Cochrane, SciELO, and LILACS. The search was complemented through manual review of the references of included articles. Both selection and data extraction were conducted by two researchers independently. Two experts independently assessed all the articles identified for one instrument and applied the Evaluating Measures of Patient Reported Outcomes (EMPRO) tool, which was designed to assess the quality of OHRQoL questionnaires in a standardized way. An overall EMPRO score and six attribute-specific scores were calculated (range, 0 to 100) to describe the quality of instrument performance.
Results: The search revealed 2465 articles, of which 321 were duplicates, with 177 full-texts examined after selection based on titles and abstracts. Eleven articles were identified by handsearching. Finally 18 questionnaires and 156 associated studies of their metric properties were identified for evaluation with the EMPRO tool. Eleven were generic instruments to measure QHRQoL, one for patients with hypodontia, one for patients with Down syndrome, one for patients with fixed appliances, two for discomfort and two evaluate impact of OHRQoL on parents and families.
Conclusions: Knowing the quality of the instruments used to assess the OHRQoL allow us to apply the most appropriate for clinical practice and research. We plan to present the complete results and definitive conclusions at the Cochrane Colloquium 2015.