Dimensions of Oral Health-Related Quality of Life

描述（由申请人提供）：在牙科研究和临床实践中，患者如何感知牙科干预措施的效果是至关重要的，应该有一个标准的仪器来测量和比较这些效果。在这里，口腔健康相关的生活质量（OHRQoL）是最有前途的概念。最广泛使用的成人口腔健康质量评估工具是49项口腔健康影响量表（OHIP），它将项目组合成7个分数，假定测量感知口腔健康的7个潜在维度。这套7分的评分已经使用了近20年，但从未被验证过。事实上，最近的证据表明，OHIP的维度结构是不正确的，这给使用OHIP评估OHRQoL带来了一个根本性的测量问题。本提案的主要目标是：(i)确定存在哪些OHRQoL维度并派生出新的OHIP维度结构，（ii）基于这些修订的维度派生出2个新的OHIP简短形式和计算机自适应测试版本，以及（iii）验证修订后的OHIP维度结构和新派生的版本。来自6个国家的6,628名普通人群和2,502名牙科患者的现有OHIP数据将被用于通过应用因素分析得出修订的OHIP维度，并对新确定的维度进行测试。此外，将利用项目反应理论开发2个新的更短的OHIP表格和一个计算机自适应测试版本（都旨在减少自我报告的负担）。最后，将使用明尼苏达州2000名牙科患者的新样本，通过使用其他自我报告的口腔健康和临床口腔健康指标的测量方法，在横断面和纵向分析中验证衍生的OHIP维度和新的OHIP表格。在验证过程中，其他2台OHRQoL仪器的项目将被整合到仪器中，以创建一个标准OHRQoL仪器。将建立一个基于OHIP的OHRQoL评估的统一框架，项目反应理论和双因素分析等方法将确保新衍生的简短OHIP版本的分数与较长的OHIP版本的分数兼容（分数相等）。OHIP评分与健康相关生活质量结果测量的关系将使用来自NIH患者报告结果测量信息系统（PROMIS）的方法进行探索。修订后的OHIP将使用一组有效的OHIP维度评分来测量感知的口腔健康，这些评分来自不同长度的仪器，但在不同设置下是兼容的。声音OHIP维度分数的概况可以成为牙科的标准工具，从患者的角度评估口腔健康和治疗效果。修订后的OHIP将使所有口腔干预措施的效果具有可比性，帮助牙医和患者评估治疗方案，并为卫生保健系统设置资源优先级提供信息。

DESCRIPTION (provided by applicant): In both dental research and clinical practice, how patients perceive the effects of dental interventions is essential, and one standard instrument should exist to measure and compare these effects. Here, oral health- related quality of life (OHRQoL) is the most promising concept. The most widely used OHRQoL instrument for adults, the 49-item Oral Health Impact Profile (OHIP), combines items into 7 scores that putatively measure 7 latent dimensions of perceived oral health. This set of 7 scores has been used for almost 20 years but has never been validated. In fact, recent evidence indicates that the OHIP dimensional structure is not correct, which creates a fundamental measurement problem for the assessment of OHRQoL using OHIP. The major goals of this proposal are (i) to determine which OHRQoL dimensions exist and to derive a new OHIP dimensional structure, (ii) to derive 2 new OHIP short forms and a computer adaptive testing version based on these revised dimensions, and (iii) to validate the revised OHIP dimensional structure and the newly derived versions. Existing OHIP data from 6,628 general-population subjects and 2,502 dental patients from 6 countries will be used both to derive revised OHIP dimensions by applying factor analysis and to test the newly identified dimensions. In addition, 2 new shorter OHIP forms and a computer adaptive testing version (all aimed at reducing self-reporting burden) will be developed using item response theory. Finally, a new sample of 2,000 dental patients in Minnesota will be used to validate the derived OHIP dimensions and new OHIP forms in cross-sectional and longitudinal analyses using other measures of self-reported oral health and clinical oral-health indicators. During the validation process, items from 2 other OHRQoL instruments will be integrated into the instrument to create one standard OHRQoL instrument. A unified framework for OHRQoL assessment based on OHIP will be created, and methodologies such as item response theory and bifactor analysis will ensure that scores from newly derived short-form OHIP versions are compatible with scores from longer OHIPs (score equating). The relationship of OHIP scores to health-related quality of life outcome measures will be explored using methodology from NIH's Patient-Reported Outcomes Measurement Information System (PROMIS). The revised OHIP will measure perceived oral health with a valid set of OHIP dimension scores from instruments with different lengths that will nevertheless be compatible across settings. A profile of sound OHIP dimension scores can become dentistry's standard tool for assessing oral health and treatment effects from the patient's perspective. The revised OHIP will allow effects from all oral interventions to become comparable, aiding dentists and patients in their evaluation of treatment alternatives and informing health care systems for setting resource priorities. PUBLIC HEALTH RELEVANCE: How people perceive their oral health and the effects of dental treatments on their oral health is often assessed with specialized questionnaires. The proposed study aims to revise the most widely used questionnaire in this area, the Oral Health Impact Profile, and to combine it with 2 other often-used questionnaires. This work will lead to the development of an improved, standard questionnaire that researchers, health care systems, and dentists will be able to use to measure and compare individuals' perceptions of their oral health.