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Nagar N, Wade N, Kenny RPW, Paul N, Rolland S, Germain P, Robson S. A COnsensus-based Standards for the selection of health Measurement INstruments systematic review of orthognathic patient-reported outcome measures. Am J Orthod Dentofacial Orthop 2023; 164:476-490. [PMID: 37409989 DOI: 10.1016/j.ajodo.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/01/2023] [Accepted: 06/01/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION This systematic review aimed to identify and appraise the validity studies of patient-reported outcome measures (PROMs) reporting the outcomes of combined orthodontic-orthognathic surgery in treating dentofacial deformity. METHODS The search strategy was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Systematic Review methodology. The following databases were searched for original studies outlining the development and/or validation of PROMs produced to measure the outcomes of combined orthognathic-orthodontic treatment: EMBASE, MEDLINE, PsycInfo and Scopus. Publications were limited to the English language. Eligibility criteria were applied when considering the studies. Primarily, the psychometric properties and quality of orthognathic-specific PROMs were investigated. Screening of eligible studies was conducted independently by 2 reviewers. Assessment of the methodological quality of the studies and data extraction was conducted by 1 reviewer and assisted by a second reviewer. The COSMIN methodology guided data extraction and analysis, which were divided into 3 stages-a synopsis of studies, evaluation of methodological quality, and summary of evidence. RESULTS A total of 8695 papers were found; 12 studies met the criteria for inclusion. Regarding the COSMIN Checklist for Assessing Study Qualities, there was evidence that the Orthognathic Quality of Life Questionnaire was the most extensively tested orthognathic-specific PROM in the current literature. The reported evidence was incomplete, as not all psychometric properties had been reliably tested. CONCLUSIONS Clinicians must use validated PROMs when analyzing patient-reported outcomes. The Orthognathic Quality of Life Questionnaire was shown to be the highest quality orthognathic-specific PROM in the literature but requires contemporary evaluation to suitably reflect the COSMIN guidance.
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Affiliation(s)
| | - Nicola Wade
- Cumberland Infirmary, Carlisle, United Kingdom
| | - Ryan P W Kenny
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ninu Paul
- Newcastle Dental Hospital, Newcastle upon Tyne, United Kingdom
| | - Sarah Rolland
- Newcastle Dental Hospital, Newcastle upon Tyne, United Kingdom
| | | | - Sarah Robson
- Newcastle Dental Hospital, Newcastle upon Tyne, United Kingdom
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Benson PE, Alshawy E, Kettle JE, Gilchrist F. Development of the Orthodontic Treatment Impact Questionnaire: Cross-sectional validation. Am J Orthod Dentofacial Orthop 2022; 162:e183-e191. [PMID: 35970689 DOI: 10.1016/j.ajodo.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION The need to involve patients in developing and evaluating health care interventions is now well-recognized. This study assesses and refines the Orthodontic Treatment Impact Questionnaire for use as a patient-reported outcome in an interventional clinical trial to evaluate and compare any orthodontic interventions. METHODS The face and content validity of a previously developed questionnaire were tested in 2 focus groups involving adolescents aged 11-17 years. They were wearing a range of orthodontic appliances and at different treatment stages. A similar cross-sectional convenience sample completed the questionnaire during routine appliance adjustment appointments. A Rasch model, using item response theory, was used for item reduction, assessment of the response format, and differential item functioning. Spearman's rank correlation was used to assess construct validity, Cronbach α for internal consistency and reliability, and intraclass correlation coefficient for test-retest reliability. RESULTS Seven adolescents (4 females, 3 males) were involved in the initial testing; 181 (117 females, 64 males; mean age, 14.7 ± 1.5 years) completed the questionnaire once and 41 twice. The initial measure demonstrated a misfit to the Rasch model. Ten of the original 31 items had disordered thresholds and were removed. The 5-point scale was changed to a 3-point scale. None of the participants demonstrated a misfit to the model. Construct validity (P = 0.480), internal consistency (Cronbach α = 0.827) and test-retest reliability (intraclass correlation coefficient = 0.85; 95% confidence interval, 0.73-0.92) were good. CONCLUSIONS The initial Orthodontic Treatment Impact Questionnaire was tested and modified using item response theory. The modified questionnaire demonstrated good construct validity, reliability, and internal consistency. Further testing to assess generalizability and longitudinal responsiveness is required.
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Affiliation(s)
- Philip E Benson
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
| | - Ebrahim Alshawy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Jennifer E Kettle
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Fiona Gilchrist
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
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Benson PE, Gilchrist F, Farella M. The Malocclusion Impact Questionnaire (MIQ): Cross-Sectional Validation in a Group of Young People Seeking Orthodontic Treatment in New Zealand. Dent J (Basel) 2019; 7:dj7010024. [PMID: 30836682 PMCID: PMC6473747 DOI: 10.3390/dj7010024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to test the validity of the Malocclusion Impact Questionnaire (MIQ) in a NZ sample and to evaluate possible cross-cultural differences in MIQ data between a NZ and a UK sample. A cross-sectional, non-random sample of young people, aged 10–16 years, attending their first appointment at the orthodontic clinic of New Zealand’s National Centre for Dentistry were asked to complete a questionnaire. This consisted of the 17 item MIQ, the short form CPQ11-14-ISF16 and two global questions. Some basic demographic and clinical data were collected. Sixty-six participants completed the questionnaire; however, the data for 2 were excluded due to the number of incomplete responses. MIQ was found to have excellent internal consistency (Cronbach’s alpha 0.924), good construct validity (Spearman’s rho, 0.661 global Q1 ‘Overall, how much do your teeth bother you?’; 0.583 global Q2 ‘Overall, how much do your teeth affect your life?’). MIQ also demonstrated good criterion validity with CPQ11-14-ISF16 (Pearson rho, 0.625). The Rasch analysis confirmed that the questionnaire performed similarly and there was no differential item functioning between the two populations. The main differences between the samples were that the young people in NZ were less concerned about their malocclusion and reported lower item-impact scores compared with the young people in the UK.
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Affiliation(s)
- Philip E Benson
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK.
| | - Fiona Gilchrist
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK.
| | - Mauro Farella
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin 9054, New Zealand.
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Almeida ABD, Leite ICG, Silva GAD. Evidence in Orthodontics related to qualitative research. Dental Press J Orthod 2018; 23:64-71. [PMID: 30304155 PMCID: PMC6150700 DOI: 10.1590/2177-6709.23.4.064-071.oar] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 08/06/2017] [Indexed: 11/22/2022] Open
Abstract
Introduction: Research in Orthodontics has historically followed the positivist model based on the direct relationship of cause and effect between diseases and their specific etiological factors. Despite the objectivity and the great potential of statistical procedures, quantitative methods have progressively been sharing space with other models that can encompass the multiplicity of factors that affect the health-disease process, which until such time was reduced to its biological dimension. Objectives: This study aims, through an integrative review, to identify orthodontics articles published over a 10-year period that have used, exclusively or not, some method of qualitative research, and analyze the main aspects of their content. Methods: A survey was performed on Pubmed, Medline, Scopus, and Lilacs databases from 2007 to 2016 with a focus on the applicability of the qualitative methodology in orthodontic research. Results: The 27 articles selected showed a trend to increase in publications, with the most recent four years concentrating almost 60% of them. Most studies were from Europe, particularly the UK, and the more frequent study objectives were related to the perception of people about the reasons for orthodontic treatment, about the aesthetic and psychosocial impact of malocclusion or orthodontic treatment, and the implications of these factors for their quality of life. Conclusions: Because of its potential to explore behaviours and socio-cultural attitudes sustained in subjectivity, qualitative research offers new possibilities for orthodontic studies and can be used in an exclusive or complementary way in relation to quantitative methods.
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Affiliation(s)
- Anderson Barbosa de Almeida
- Universidade Federal de Juiz de Fora, Faculdade de Medicina, Departamento de Saúde Coletiva, Programa de Pós-graduação em Saúde, ênfase em Saúde Brasileira (Juiz de Fora/MG, Brazil)
| | | | - Girlene Alves da Silva
- Universidade Federal de Juiz de Fora, Faculdade de Medicina, Departamento de Saúde Coletiva (Juiz de Fora/MG, Brazil)
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Porritt J, Morgan A, Rodd H, Gupta E, Gilchrist F, Baker S, Newton T, Creswell C, Williams C, Marshman Z. Development and evaluation of the children's experiences of dental anxiety measure. Int J Paediatr Dent 2018; 28:140-151. [PMID: 29436092 DOI: 10.1111/ipd.12315] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Existing measures of children's dental anxiety have not been developed with children or based on a theoretical framework of dental anxiety. AIM To develop the children's experiences of dental anxiety measure (CEDAM) and evaluate the measure's properties. DESIGN The measure was developed from interviews with dentally anxious children. Children recruited from a dental hospital and secondary school completed the CEDAM and Modified Child Dental Anxiety Scale (MCDAS). A subgroup of children completed the CEDAM before and after receiving an intervention to reduce dental anxiety to examine the measure's responsiveness. Rasch and Classical test analyses were undertaken. RESULTS Children were aged between 9 and 16 years (N = 88 recruited from a dental hospital and N = 159 recruited from a school). Rasch analysis confirmed the measure's unidimensionality. The CEDAM correlated well with the MCDAS (rho = 0.67, P < 0.01) and had excellent internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (ICC = 0.98). The CEDAM was also able to detect changes in dental anxiety following the intervention (baseline mean = 22.36, SD = 2.57 and follow-up mean = 18.88, SD = 2.42, t(df = 37) = 9.54, P < 0.01, Cohen's d = 1.39). CONCLUSIONS The results support the reliability, validity and responsiveness of the CEDAM. Initial findings indicate it has potential for use in future intervention trials or in clinical practice to monitor children's dental anxiety.
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Affiliation(s)
- Jenny Porritt
- Department of Psychology, Sociology, and Politics, Sheffield Hallam University, Sheffield, UK
| | - Annie Morgan
- Paediatric Dentistry Department, Charles Clifford Dental Hospital, Sheffield, UK
| | - Helen Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Ekta Gupta
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Fiona Gilchrist
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sarah Baker
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Tim Newton
- Oral Health Services Research and Dental Public Health, King's College London, London, UK
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, Berkshire, UK
| | - Christopher Williams
- Institute of Health and Wellbeing, Mental Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Benson PE, Cunningham SJ, Shah N, Gilchrist F, Baker SR, Hodges SJ, Marshman Z. Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 2 - cross-sectional validation. J Orthod 2016; 43:14-23. [PMID: 26745783 PMCID: PMC4867872 DOI: 10.1080/14653125.2015.1114223] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: To test the items, identified through qualitative inquiry that might form the basis of a new Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life (OHQoL) of young people with malocclusion. Methods: Piloting with 13 young people reduced the number of items from 37 to 28. Cross-sectional testing involved a convenience sample aged 10–16 years, attending the Orthodontic Department of the Charles Clifford Dental Hospital, Sheffield. The fit and function of the initial MIQ questions were examined using item response theory. Results: 184 participants (113 females; 71 males) completed a questionnaire (response 85%), seven participants were excluded due to missing responses. The mean age of participants was 12·9 years (SD 1·4) and they had a wide range of malocclusions. The majority were White British (67·4%). Data from 47 participants were used to analyse test–retest reliability. Rasch analysis was undertaken, which further reduced the number of items in the questionnaire from 28 to 17. Unidimensionality of the scale was confirmed. The analysis also identified that the original 5-point response scale could be reduced to three points. The new measure demonstrated good criterion validity (r = 0·751; P < 0·001) and construct validity with the two global questions (‘Overall bother’ ρ = 0·733 and ‘Life overall’ ρ = 0·701). Internal consistency (Cronbach's alpha = 0·906) and test–retest reliability Intraclass correlation coefficient (ICC = 0·78; 95% CI 0·61–0·88) were also good. Conclusion: Cross-sectional testing has shown the new MIQ to be both valid and reliable. Further evaluation is required to confirm the generalisability as well as the ability of the new measure to detect change over time (responsiveness).
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Affiliation(s)
- Philip E Benson
- a Academic Unit of Oral Health & Development, School of Clinical Dentistry , University of Sheffield , UK
| | - Susan J Cunningham
- b Orthodontic Department , University College London Eastman Dental Institute , UK
| | - Nahush Shah
- a Academic Unit of Oral Health & Development, School of Clinical Dentistry , University of Sheffield , UK
| | - Fiona Gilchrist
- a Academic Unit of Oral Health & Development, School of Clinical Dentistry , University of Sheffield , UK
| | - Sarah R Baker
- c Academic Unit of Dental Public Health, School of Clinical Dentistry , University of Sheffield , UK
| | - Samantha J Hodges
- b Orthodontic Department , University College London Eastman Dental Institute , UK
| | - Zoe Marshman
- c Academic Unit of Dental Public Health, School of Clinical Dentistry , University of Sheffield , UK
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Liyue H, Chiang PPC, Sung SC, Tong L. Dry Eye-Related Visual Blurring and Irritative Symptoms and Their Association with Depression and Anxiety in Eye Clinic Patients. Curr Eye Res 2015; 41:590-9. [PMID: 26337790 DOI: 10.3109/02713683.2015.1056804] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Dry eye is a common condition known to have many systemic co-morbidities. We aim to report the frequency of depression and anxiety suspects in eye clinic patients and explore the association between dry eye signs and symptoms with depression and anxiety. MATERIALS AND METHODS Adult outpatients were recruited from dry a public tertiary ophthalmology specialist center. Participants underwent socio-demographic and dry eye symptoms questionnaires, fluorescein dye tear break-up time (TBUT), fluorescein dye corneal staining and Schirmer's test. Rasch analysis was used to internally validate the Hospital Anxiety and Depression Scale (HADS) and the Center for Epidemiologic Studies Depression Scale (CES-D) and determine its psychometric properties. RESULTS A total of 96 participants (mean age 54.5 ± 10.8; 64.1% women) were recruited. The mean score for the CES-D was 12.1 ± 9.8 with 28 participants (31.5%) having a score of above 16 (published threshold). The mean score for depression-associated questions in the HADS was 3.6 ± 3.6 with 13 participants (14.1%) having a score ≥8. The mean score for the anxiety-associated questions in the HADS was 5.3 ± 3.6 with 24 participants (26.1%) having score ≥8. There was a weak inverse correlation between Schirmer's test and CES-D scores. Elevated depression scores from the CES-D were significantly associated with visual blurring but not irritation, in dry eye patients with low TBUT. CONCLUSIONS In conclusion, specific types of dry eye symptoms, particularly those with increased frequency of visual blurring were associated with symptoms of depression. The optical aberrations induced by dry eye, associated with tear instability, may predispose to depressive tendency.
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Affiliation(s)
- Hong Liyue
- a Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - Peggy Pei-Chia Chiang
- b Singapore Eye Research Institute , Singapore , Singapore .,c Duke-NUS Graduate Medical School , Singapore , Singapore .,d University of Melbourne , Parkville , Australia
| | - Sharon C Sung
- c Duke-NUS Graduate Medical School , Singapore , Singapore .,e Institute of Mental Health , Singapore , Singapore and
| | - Louis Tong
- a Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore .,b Singapore Eye Research Institute , Singapore , Singapore .,c Duke-NUS Graduate Medical School , Singapore , Singapore .,f Singapore National Eye Center , Singapore , Singapore
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