COSMIN database

Psychometric characteristics of health-related quality-of-life questionnaires in oropharyngeal dysphagia

Timmerman, A. A., Speyer, R., Heijnen, B. J., and Klijn-Zwijnenberg, I. R.
Dysphagia can have severe consequences for the patient's health, influencing health-related quality of life (HRQoL). Sound psychometric properties of HRQoL questionnaires are a precondition for assessing the impact of dysphagia, the focus of this study, resulting in recommendations for the appropriate use of these questionnaires in both clinical practice and research contexts. We performed a systematic review starting with a search for and retrieval of all full-text articles on the development of HRQoL questionnaires related to oropharyngeal dysphagia and/or their psychometric validation from the electronic databases PubMed and Embase published up to June 2011. Psychometric properties were judged according to quality criteria proposed for health status questionnaires. Eight questionnaires were included in this study. Four are aimed solely at HRQoL in oropharyngeal dysphagia: the deglutition handicap index (DHI), dysphagia handicap index (DHI'), M.D. Anderson Dysphagia Inventory (MDADI), and SWAL-QOL, while the EDGQ, EORTC QLQ-STO 22, EORTC QLQ-OG 25 and EORTC QLQ-H&N35 focus on other primary diseases resulting in dysphagia. The psychometric properties of the DHI, DHI', MDADI, and SWAL-QOL were evaluated. For appropriate applicability of HRQoL questionnaires, strong scores on the psychometric criteria face validity, criterion validity, and interpretability are prerequisites. The SWAL-QOL has the strongest ratings for these criteria, while the DHI' is the most easy to apply given its 25 items and the use of a uniform scoring format. For optimal use of HRQoL questionnaires in diverse settings, it is necessary to combine psychometric and utility approaches.
1432-0460 (Electronic)
Publication year:
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the nervous system
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
DHI - Deglutition Handicap Index
DHI - Dysphagia Handicap Index
EDGQ - European Dysphagia Group Questionnaire
EORTC QLQ-H&N35 - European Organization for Research and Treatment of Cancer Quality of Life Questionnaires Head & Neck 35
EORTC QLQ-OG25 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Oesophagus,Oesophago-Gastric Junction and Stomach Module
EORTC QLQ-STO22 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire in patients with gastric cancer 22 item
MDADI - MD Anderson Dysphagia Inventory
SWAL-QOL - Swallowing Quality of Life Questionnaire