Improving the measurement of oral health-related quality of life: Rasch model of the oral health impact profile-14.

Autor: Omara M; Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria., Salzberger T; Institute for Statistics and Mathematics, University of Economics and Business, Welthandelsplatz 1, 1020, Vienna, Austria., Boecker M; RWTH Aachen University, Institute for Medical Psychology and Medical Sociology, Pauwelsstrasse 19, 52074, Aachen, Germany., Bekes K; Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria., Steiner G; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria; Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria., Nell-Duxneuner V; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria; Klinikum Peterhof, Austrian Social Health Insurance Fund, Baden, Austria., Ritschl V; Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria., Mosor E; Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Kloppenburg M; Department of Rheumatology, Leiden University Medical Center, Leiden, Netherlands., Sautner J; LK Stockerau Korneuburg, 2. Med. Department, Lower Austria, Austria., Steinecker-Frohnwieser B; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Saalfelden, branch Gröbming, Austria., Stamm T; Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, 1090, Vienna, Austria. Electronic address: tanja.stamm@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: Journal of dentistry [J Dent] 2021 Nov; Vol. 114, pp. 103819. Date of Electronic Publication: 2021 Sep 21.
DOI: 10.1016/j.jdent.2021.103819
Abstrakt: Objectives: The 14-item Oral Health Impact Profile (OHIP-14) is the most frequently used instrument to measure oral health-related quality-of-life (OHRQoL) in adults. Despite its popularity, its psychometric properties have been predominantly investigated based on the classical test theory while the fundamental principles of measurement have not been fully assessed. Therefore, our aim was to investigate to what extent the OHIP-14 meets the fundamental requirments of measurements.
Methods: We used the Rasch model to explore person-item-targeting, unidimensionality, local independence of items, invariance (differential-item-functioning, DIF), and the order of thresholds between response-options in the German version OHIP-14. We used data from osteoarthritis patients because hand disabilities and joint pain might influence oral hygiene. Furthermore, osteoarthritis in the temporomandibular-joint directly affects oral functioning.
Results: Five-hundred sixteen patients were included (mean age 66.5 years [±10.2; ranging from 34 to 89]; 71.3% [368] females). The OHIP-14 median total score was 0 (interquartile-range from 0 to 4), indicating a right-skewed distribution because many patients reported good OHRQoL. The instrument was found unidimensional. However, there was strong evidence of local dependency, disordered thresholds between response-options, and age-related DIF for item 5. A revised scoring scheme with three instead of five answer-options in all items and eliminating two items resolving local dependency, the newly adapted OHIP-12, showed better reliability and item-fit to the Rasch model than the original OHIP-14.
Conclusions: This study assesses, for the first time, the OHIP-14 in terms of fundamental principles of measurement and proposes an item-reduced OHIP-12 as a psychometrically more accurate version of the instrument.
Clinical Significance: The Rasch model is essential to ensure instruments' precision and clinical meaningfulness when measuring OHRQoL in clinical practice and research. The OHIP-12, derived from the OHIP-14 by deleting two items due to local dependency, with a revised scoring scheme for all items distinguishing three answer-options instead of five, represents a psychometrically improved version of the instrument.
(Copyright © 2021. Published by Elsevier Ltd.)
Databáze: MEDLINE
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