Patient Reported Outcome Measures for Salivary Function: A Systematic Review
- Authors:
- Gulati, A., Kidane, J., and Chang, J. L.
- Abstract:
- OBJECTIVE: A number of patient-reported outcome measures (PROMs) assess quality of life and symptom severity in patients with salivary gland dysfunction, but many vary in the extent of validation and domain types addressed. We identified PROMs validated to measure salivary gland function and analyzed key properties.
DATA SOURCES: PubMed, Web of Science, Embase, PsycInfo, and CINAHL.
REVIEW METHODS: A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Validated instruments with >1 item to assess salivary gland-related symptoms were included. PROMs were evaluated for developmental methodology, structure, validity, and reliability using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.
RESULTS: A total of 2059 abstracts were retrieved, and 133 full-text articles were reviewed. Sixteen PROMs assessing xerostomia (n = 7), sialadenitis (n = 4), Sjogren's syndrome (n = 2), Parkinson's-associated sialorrhea (n = 2), and oral systemic sclerosis (n = 1) were identified. Most (n = 15) were developed de novo, one was adapted from a pre-existing questionnaire. Eleven PROMs demonstrated "very good" analysis of internal consistency per COSMIN criteria, and 10 included test-retest data. Regarding content validity, four PROMs were developed with both patient and physician input, but none were rated as "adequate." All included comparisons against other questionnaires (n = 7), salivary flow rate (n = 9), and/or healthy controls (n = 3). The most rigorously developed PROM, the Xerostomia Inventory, was rated adequate in 6 out of 7 domains.
CONCLUSIONS: Several PROMs evaluate salivary function. The abilties of these PROMs to meet design and validation standards were variable, with notable limitations in content validity for all tools. New and updated PROMs assessing obstructive and inflammatory salivary symptoms should utilize patient and provider input.
LEVEL OF EVIDENCE: N/A Laryngoscope, 133:1796-1805, 2023. - DOI:
- 10.1002/lary.30550
- Journal:
- Laryngoscope
- issn:
- 0023-852x
- Publication year:
- 2023
- pages:
- 1796-1805
- Symptom status:
- Physical state
- General health perceptions / HRQoL:
- Health-related quality of life
- Age:
- Adults (18-65)
Seniors (65+) - Disease:
- Codes for special purposes
Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the nervous system
Factors influencing health status and contact with health services
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified - PRO / non-PRO:
- Patient Reported Outcome
- Type of measurement instrument:
- 1 - Questionnaires
- Instrument:
- Chronic Obstructive Sialadenitis Symptoms Questionnaire
Fox Xerostomia Questionnaire
GRIX - Groningen Radiotherapy-Induced Xerostomia questionnaire
Liverpool Sicca Index
Manukau Salivary Symptoms Score
Mouth Handicap in Systemic Sclerosis Scale
Multidisciplinary Salivary Gland Society Questionnaire
OHIP - Oral Health Impact Profile (versions: OHIP-49; OHIP-14; Modified OHIP-14; OHIP-20; OHIP-G - German; OHIP-G5; OHIP-G21; OHIP-OFP - OHIP-Oro Facial Pain; OHIP-EDENT - OHIP assessing edentulous)
Profile of Fatigue and Discomfort-Sicca Symptoms Inventory
Regional Oral Dryness Inventory
ROMP - Radboud Oral Motor inventory for Parkinson’s disease
SCS-PD - Sialorrhea Clinical Scale for Parkinson’s Disease
XeQoLS - Xerostomia quality of life scale
Xerostomia Visual Analog Scale OR Visual Analog Scale Xerostomia Questionnaire
XI - Xerostomia Inventory
XQ - Xerostomia Questionnaire