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的效果是至关重要的，应该有一个标准的仪器来衡量和比较这些影响。在这里，口腔健康相关生活质量(OHRQOL)是最有前途的概念。最广泛使用的成人OHRQOL工具，由49个项目组成的口腔健康影响概况(OHIP)，将项目组合成7个分数，推测衡量感知的口腔健康的7个潜在维度。这套7分的分数已经使用了近20年，但从未得到验证。事实上，最近的证据表明，OHIP的维度结构不正确，这为使用OHIP评估OHRQOL造成了一个根本性的测量问题。该建议的主要目标是(I)确定存在哪些OHRQOL维度并推导出新的OHIP维度结构，(Ii)基于这些修订维度推导出两个新的OHIP缩写形式和一个计算机自适应测试版本，以及(Iii)验证修订后的OHIP维度结构和新得出的版本。来自6个国家的6,628名普通人群受试者和2,502名牙科患者的现有OHIP数据将被用于通过应用因子分析得出修订的OHIP维度，并测试新确定的维度。此外，将利用项目反应理论开发两个新的较短的OHIP表格和一个计算机自适应测试版本(所有这些都是为了减少自我报告负担)。最后，明尼苏达州2000名牙科患者的新样本将被用来在横断面和纵向分析中验证推导出的OHIP维度和新的OHIP表格，使用其他自我报告的口腔健康指标和临床口腔健康指标。在验证过程中，来自人事厅其他2个工具的物品将被整合到该工具中，以创建一个标准的人力厅工具。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得出的简短OHIP版本的分数与较长OHIP的分数兼容(分数相等)。将使用美国国立卫生研究院患者报告结果测量信息系统(PROIS)的方法来探索OHIP评分与健康相关生活质量结果测量的关系。修订后的OHIP将使用一组有效的OHIP维度分数来衡量感知的口腔健康，这些分数来自不同长度的仪器，但仍将在不同的设置中兼容。一个合理的OHIP维度评分的档案可以成为牙科从患者的角度评估口腔健康和治疗效果的标准工具。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替代治疗方案，并告知卫生保健系统设定资源优先顺序。

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.