Instruments for assessing oral health-related quality of life (OHRQoL) in older adults: A meta-research study with standardized evaluation
Authors:
Jiang, C. M., Chau, R. C. W., McGrath, C., Su, N., and Lo, E. C. M.
Abstract:
OBJECTIVE: This study aimed to identify available instruments for assessing oral health-related quality of life (OHRQoL) in older adults, and to make standardized evaluation and comparison based on the currently available evidence.
DATA AND SOURCES: A systematic literature search was conducted in databases PubMed, Scopus, and Web of Science from inception until December 2024. Publications reporting on the development process, psychometric properties (reliability, validity and responsiveness), and administration feasibility of instruments measuring older adults' OHRQoL were included. The Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool consisting of eight attributes was employed to assess the instruments systematically. Scores of each attribute and overall EMPRO (ranged from 0 to 100) were calculated.
STUDY SELECTION: A total of 56 articles reporting on eight OHRQoL instruments were identified. The overall EMPRO scores of the identified instruments ranged from 24 to 71, and the Oral Health Impact Profile (OHIP) had the highest overall EMPRO score (71), followed by the Geriatric Oral Health Assessment Index (GOHAI; 68), Oral Health Impact on Daily Living (OHIDL; 59) and Oral Impacts on Daily Performances Scale (OIDP; 50). The identified instruments presented with a high score (above 50) regarding the attribute "conceptual and measurement model", but only GOHAI (94), OHIP (83) and OIDP (67) had a high score on the attribute "cultural and language adaptations". In terms of "responsiveness", OHIP (78) had the highest attribute score (78).
CONCLUSION: Multiple validated instruments are available to assess OHRQoL in older adults. In general, OHIP, GOHAI, OHIDL and OIDP have demonstrated good overall performance. Nonetheless, selecting an appropriate OHRQoL instrument depends on multiple factors such as psychometric quality of the instrument, alignment with study objectives and adaptation to population's cultural and social context, in addition to psychometric quality of the instrument.
CLINICAL SIGNIFICANCE: This review provides up-to-date evidence on the currently available instruments assessing OHRQoL in older adults. The findings facilitate decision making by clinicians, researchers and policymakers on the selection of an appropriate instrument to assess OHRQoL in older population.