Supportive Care in Cancer

, Volume 24, Issue 9, pp 3915–3924 | Cite as

International field testing of the psychometric properties of an EORTC quality of life module for oral health: the EORTC QLQ-OH15

  • Marianne J. HjermstadEmail author
  • Mia Bergenmar
  • Kristin Bjordal
  • Sheila E. Fisher
  • Dirk Hofmeister
  • Sébastien Montel
  • Ourania Nicolatou-Galitis
  • Monica Pinto
  • Judith Raber-Durlacher
  • Susanne Singer
  • Iwona M. Tomaszewska
  • Krzysztof A. Tomaszewski
  • Irma Verdonck-de Leeuw
  • Noam Yarom
  • Julie B Winstanley
  • Bente B. Herlofson
  • on behalf of the EORTC QoL Group
Original Article



This international EORTC validation study (phase IV) is aimed at testing the psychometric properties of a quality of life (QoL) module related to oral health problems in cancer patients.


The phase III module comprised 17 items with four hypothesized multi-item scales and three single items. In phase IV, patients with mixed cancers, in different treatment phases from 10 countries completed the EORTC QLQ-C30, the QLQ-OH module, and a debriefing interview. The hypothesized structure was tested using combinations of classical test theory and item response theory, following EORTC guidelines. Test–retest assessments and responsiveness to change analysis (RCA) were performed after 2 weeks.


Five hundred seventy-two patients (median age 60.3, 54 % females) were analyzed. Completion took <10 min for 84 %, 40 % expressed satisfaction that these issues were addressed. Analyses suggested a revision of the phase III hypothesized scale structure. Two items were deleted based on a high degree of item misfit, together with negative patient feedback. The remaining 15 items formed one eight-item scale named OH-QoL score, a two-item information scale, a two-item scale regarding dentures, and three single items (sticky saliva/mouth soreness/sensitivity to food/drink). Face and convergent validity and internal consistency were confirmed. Test–retest reliability (n = 60) was demonstrated as was RCA for patients undergoing chemotherapy (n = 117; p = 0.06). The resulting QLQ-OH15 discriminated between clinically distinct patient groups, e.g., low performance status vs. higher (p < 000.1), and head-and-neck cancer versus other cancers (p < 0.03).


The EORTC module QLQ-OH15 is a short, well-accepted assessment tool focusing on oral problems and QoL to improve clinical management.

Trial Registration Identifier: NCT01724333.


Oral health Quality of life EORTC QLQ-C30 QLQ-OH15 Patient reported outcomes Validation study 



This project received financial support from the EORTC Quality of Life Group (QLG) Grant No. 001/2012. We express our gratitude to the EORTC QLG Executive Committee for reviewing and approving the phase IV module development report and manuscript.

Special thanks are also given to the study coordinators at the participating centers and the patients who took part in the study, and to Cand. odont. Petter Wilberg for valuable advice in the preparation of this manuscript.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Financial support

This study was supported by Grant No. 001/2012 from the EORTC Quality of Life Group.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Marianne J. Hjermstad
    • 1
    • 2
    Email author
  • Mia Bergenmar
    • 3
    • 4
  • Kristin Bjordal
    • 5
  • Sheila E. Fisher
    • 6
  • Dirk Hofmeister
    • 7
  • Sébastien Montel
    • 8
  • Ourania Nicolatou-Galitis
    • 9
  • Monica Pinto
    • 10
  • Judith Raber-Durlacher
    • 11
  • Susanne Singer
    • 12
  • Iwona M. Tomaszewska
    • 13
  • Krzysztof A. Tomaszewski
    • 14
  • Irma Verdonck-de Leeuw
    • 15
  • Noam Yarom
    • 16
    • 17
  • Julie B Winstanley
    • 18
    • 19
  • Bente B. Herlofson
    • 20
  • on behalf of the EORTC QoL Group
  1. 1.Regional Centre for Excellence in Palliative Care, Department of OncologyOslo University HospitalOsloNorway
  2. 2.European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of MedicineNorwegian University for Science and TechnologyTrondheimNorway
  3. 3.Department of Oncology-PathologyKarolinska InstitutetStockholmSweden
  4. 4.Department of OncologyKarolinska University HospitalStockholmSweden
  5. 5.Oslo University HospitalOsloNorway
  6. 6.University of LeedsLeedsUK
  7. 7.University of LeipzigLeipzigGermany
  8. 8.Department of PsychologyUniversity Paris Saint DenisParisFrance
  9. 9.University of AthensAthensGreece
  10. 10.Rehabilitation Unit, Department of Quality of LifeIstituto Nazionale Tumori “Fondazione G. Pascale”—IRCCSNaplesItaly
  11. 11.Department of Oral and Maxillofacial SurgeryAcademic Medical Center University of AmsterdamAmsterdamNetherlands
  12. 12.Institute of Medical Biostatistics, Epidemiology and InformaticsUniversity Medical CentreMainzGermany
  13. 13.Department of Medical EducationJagiellonian University Medical CollegeKrakowPoland
  14. 14.Department of AnatomyJagiellonian University Medical CollegeKrakowPoland
  15. 15.Department of Otolaryngology—Head and Neck SurgeryVU University Medical CenterAmsterdamNetherlands
  16. 16.Department of Oral and Maxillofacial SurgerySheba Medical CenterRamat GanIsrael
  17. 17.Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv UniversityTel AvivIsrael
  18. 18.Patricia Ritchie CentreUniversity of SydneySydneyAustralia
  19. 19.Osman Consulting Pty LTDSydneyAustralia
  20. 20.Department of Oral Surgery and Oral Medicine, Faculty of DentistryUniversity of OsloOsloNorway

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