A systematic review of head and neck cancer quality of life assessment instruments

Abstract

Summary Although quality of life (QOL) is an important treatment outcome in head and neck cancer (HNC), cross-study comparisons have been hampered by the heterogeneity of measures used and the fact that reviews of HNC QOL instruments have not been comprehensive to date. We performed a systematic review of the published literature on HNC QOL instruments from 1990–2010, categorized, and reviewed the properties of the instruments using international guidelines as reference. Of the 2766 articles retrieved, 710 met the inclusion criteria and used 57 different head and neck-specific instruments to assess QOL. A review of the properties of these utilized measures and identification of areas in need of further research is presented. Given the volume and heterogeneity of QOL measures, there is no gold standard questionnaire. Therefore, when selecting instruments, researchers should consider not only psychometric properties but also research objectives, study design, and the pitfalls and benefits of combining different measures. Although great strides have been made in the assessment of QOL in HNC and researchers now have a plethora of quality instruments to choose from, more work is needed to improve the clinical utility of these measures in order to link QOL research to clinical practice. This review provides a platform for head and neck-specific instrument comparisons, with suggestions of important factors to consider in the systematic selection of QOL instruments, and is a first step towards translation of QOL assessment into the clinical scene.

Preradiotherapy dental extractions and health-related quality of life

“…The selected instruments have been taken from different groups, namely the FACT-Head and Neck is a site-specific instrument, and the OHIP-14 is a symptom-specific instrument [8]. It was hypothesised that using instruments from differing paradigms would produce meaningful results.…”

“…In the case of head and neck cancer treated with RT, there can be significant effects on aesthetics, speech, eating and pain, as well as general effects on emotional state, social state and a general functional level [7]. There are numerous quality of life instruments available for the clinician or researcher to use, with a recent review finding 57 separate head and neck specific instruments published [8]. Quality of life instruments attempt to measure the human experience in order to produce a meaningful, thorough and comparable quantity that can be used to ascertain treatment effectiveness beyond the purely biological.…”

On the need for comprehensive assessment of impact of comorbidity in elderly patients with head and neck cancer

“…A large prospective study showed that depressed patients have a higher risk of postoperative complications and worse survival [12,21]. Although several tools, such as the Geriatric Depression Scale, have been developed most studies have employed the psychological domain of different quality of life tests [22]. Beyond clinical relevance, depression has several social implications; thus psychological status is usually evaluated in conjunction with available social support.…”

Impact of Pain and Evaluation of Education and Self-Care in Patients with Head and Neck Cancer

“…The most commonly used HR-QoL questionnaire to date in studies of patients with HNC [181] is the disease-specific European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-head and neck 35 [182,183], the University of Washington Quality of Life Questionnaire [184], and the Functional Assessment of Cancer Therapy Head and Neck Cancer Questionnaire [185]. These questionnaires address emotional, social, and physical well-being, in addition to disease-specific symptoms such as pain, difficulty swallowing, nausea and fatigue.…”