Do the existing quality-of-life tools appropriately measure oral health-related quality of life in head and neck cancer? A scoping review

Abstract

Head and neck cancers and their respective treatments have a profound impact on quality of life. Many oropharyngeal and oral cancers are likely to have implications for oral health-related quality of life (OHRQoL), but research investigating tools to measure this are lacking. We conducted a scoping review to ascertain the available tools for measuring OHRQoL in head and neck cancer patients. The primary objective was to compile a summary of the existing tools and determine their completeness, validity, and reliability. The literature search yielded 1239 articles. Thirty-one studies were included in the review and multiple tools were identified. None of the tools assessed all potential OHRQoL impacts, and none had undergone comprehensive testing using a range of assessments. Most of the tools did not adhere to published guidance, with only the European Organisation for Research and Treatment of Cancer (EORTC) citing methodological guidance in their survey tool development protocols. All tools achieved recommended readability scores in English. Due to methodological flaws in the evidence base, it was not possible to definitively establish the completeness of any available tool. There was discordance between tools regarding the relevant OHRQoL impacts. Several tools failed to assess accepted domains of OHRQoL, calling into question their concordance with the construct of OHRQoL. In addition, there was a lack of adherence to published standards regarding both the construction and testing methods for quality-of-life instruments. Studies reporting on OHRQoL in head and neck cancer may, therefore, not comprehensively assess the actual impacts of the disease and its treatment.