Development of a PROMIS measure for adult dental patients

14年前，创建了患者报告结果测量信息系统PROMIS 作为最先进的患者报告结果(PRO)测量系统。它承诺高效、可靠和 对患者如何看待他们的健康的有效评估；然而，没有专门针对口腔健康的衡量标准 可用。这种情况阻碍了牙科的固体PRO测量，也阻止了PROMIS捕获 更全面的健康。我们建议为成年人开发一套四种口腔保健仪器，使用 PROMIS方法，基于最近确定的与口腔健康相关的生活质量的维度， OHRQOL(口腔功能、口腔面部疼痛、口腔外观、心理社会影响)。这些维度 代表了患者感受到口腔疾病影响的主要领域。超过53名患者-报告 成年患者的口腔健康仪器将合并为标准化、灵活和精确的测量标准 口腔健康对口腔条件和牙科环境的影响。四个分数的档案，基于四个分数 维度，将形成患者报告的口腔健康指标，并表征患者在空间中的站立 患者报告的口腔健康的四个“坐标”--每个维度一个。这项提议的目标是 (I)探讨现有仪器在多大程度上涵盖四名患者报告的口腔健康 口腔功能、口腔疼痛、口腔容貌和心理社会影响，(Ii)发展四个维度 初步题库，每个维度一个，(3)建立四个期末题库，每个维度一个， 以及(4)根据题库开发四个固定长度的工具，每个维度一个。 现有的OHRQOL和来自2,115名牙科患者的其他患者报告的口腔健康数据将用于次要数据 数据分析，以探索患者报告的四个口腔健康维度的严重程度及其程度 可用的调查问卷项目涵盖了这一范围。来自53个已确定的自我报告的调查问卷项目 此外，还将有系统地寻找新的调查表/项目作为补充。所有标识的项目都将 采用混合方法，通过焦点小组和认知访谈进行综合 有代表性的患者群体。我们的过程将遵循PROMIS定性项目评审方法来识别， 评估和修改试题以创建四个初步题库。接下来，在2000名牙科患者的新样本中 涵盖与以下方面有关的所有功能性、痛苦、美观和更广泛的心理社会问题 口腔紊乱，之前生成的四个初步题库将使用以下工具进行调查和校准 项目反应理论分析得出四个期末题库。一个固定长度的乐器将从每个 题库，并对其心理测量学特性进行评估。 这个项目将把PROMIS方法学引入到一个重要的患者群体--成人牙科患者。四 表征口腔功能、口腔面部疼痛、口腔面部外观和心理社会影响的分数将 成为从成人患者的角度评估口腔状况和治疗效果的标准工具。

Fourteen years ago, PROMIS, the Patient Reported Outcome Measurement Information System, was created as the most advanced system of patient-reported outcome (PRO) measures. It promises efficient, reliable, and valid assessments of how patients perceive their health; however, no measures specific to oral health are available. This situation impedes solid PRO measurement in dentistry and also prevents PROMIS from capturing health more comprehensively. We propose to develop for adults a set of four oral health instruments using PROMIS methodology, based on the recently determined dimensions of oral health-related quality of life, OHRQoL (Oral Function, Orofacial Pain, Orofacial Appearance, Psychosocial Impact). These dimensions represent the main areas where patients perceive the impact of oral disorders. More than 53 patient-reported oral health instruments for adult patients would merge into a standardized, flexible and precise metric to measure oral health impact across oral conditions and dental settings. A profile of four scores, based on the four dimensions, would form the patient-reported oral health metric and characterize a patient’s standing in the space of patient-reported oral health with four “coordinates” – one for each dimension. The goals of this proposal are (i) to explore how well available instruments cover the spectrum of the four patient-reported oral health dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, (ii) to develop four preliminary item banks, one for each dimension, (iii) to develop four final item banks, one for each dimension, and (iv) to develop four fixed-length instruments based on the item banks, one for each dimension. Existing OHRQoL and other patient-reported oral health data from 2,115 dental patients will be used in secondary data analyses to explore the severity spectrum of the four patient-reported oral health dimensions and how well available questionnaire items cover this spectrum. Questionnaire items from 53 already identified self-report instruments will be supplemented by a systematic search for new questionnaires/items. All identified items will undergo a mixed-methods approach to be synthesized through focus groups and cognitive interviews with representative patient groups. Our process will follow the PROMIS Qualitative Item Review method to identify, evaluate, and revise items to create four preliminary item banks. Next, in a new sample of 2,000 dental patients covering the entire spectrum of functional, painful, aesthetical, and broader psychosocial problems related to oral disorders, the previously generated four preliminary item banks will be investigated and calibrated using item response theory analyses to derive four final item banks. A fixed-length instrument will be derived from each item bank, and its psychometric properties will be evaluated. This project will introduce PROMIS methodology to an important patient population, adult dental patients. Four scores characterizing Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact would become the standard tool for assessing oral conditions and treatment effects from the adult patient’s perspective.