Assessing oral health-related quality of life in children and adolescents: a systematic review and standardized comparison of available instruments

  • Carlos Zaror
  • Yolanda Pardo
  • Gerardo Espinoza-Espinoza
  • Àngels Pont
  • Patricia Muñoz-Millán
  • María José Martínez-Zapata
  • Gemma Vilagut
  • Carlos G. Forero
  • Olatz Garin
  • Jordi Alonso
  • Montse Ferrer
Original Article
  • 87 Downloads

Abstract

Objectives

To obtain a systematic and standardized evaluation of the current evidence on development process, metric properties, and administration issues of oral health-related quality of life instruments available for children and adolescents.

Materials and methods

A systematic search until October 2016 was conducted in PubMed, Embase, Lilacs, SciELO, and Cochrane databases. Articles with information regarding the development process, metric properties, and administration issues of pediatric instruments measuring oral health-related quality of life were eligible for inclusion. Two researchers independently evaluated each instrument applying the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0–100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms.

Results

We identified 18 instruments evaluated in 132 articles. From five instruments designed for preschoolers, the Early Childhood Oral Health Impact Scale (ECOHIS) obtained the highest overall EMPRO score (82.2). Of nine identified for schoolchildren and adolescents, the best rated instrument was the Child Perceptions Questionnaire 11–14 (82.1). Among the four instruments developed for any age, the Family Impact Scale (FIS) obtained the highest scores (80.3).

Conclusion

The evidence supports the use of the ECOHIS for preschoolers, while the age is a key factor when choosing among the four recommended instruments for schoolchildren and adolescents. Instruments for specific conditions, symptoms, or treatments need further research on metric properties.

Clinical relevance

Our results facilitate decision-making on the correct oral health-related quality of life instrument selection for any certain study purpose and population during the childhood and adolescence life cycle.

Keywords

Oral health Quality of life Questionnaires Psychometrics Outcome assessment Child 

Notes

Acknowledgements

We would like to acknowledge Aurea Martin for her help in the English editing process and figure edition of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Carlos Zaror
    • 1
    • 2
    • 3
  • Yolanda Pardo
    • 3
    • 4
    • 5
  • Gerardo Espinoza-Espinoza
    • 2
    • 6
  • Àngels Pont
    • 4
    • 5
  • Patricia Muñoz-Millán
    • 1
    • 2
  • María José Martínez-Zapata
    • 5
    • 7
  • Gemma Vilagut
    • 4
    • 5
  • Carlos G. Forero
    • 4
    • 5
    • 8
  • Olatz Garin
    • 4
    • 5
    • 8
  • Jordi Alonso
    • 4
    • 5
    • 8
  • Montse Ferrer
    • 3
    • 4
    • 5
  1. 1.Department of Pediatric Dentistry and Orthodontics, Faculty of DentistryUniversidad de La FronteraTemucoChile
  2. 2.Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of DentistryUniversidad de La FronteraTemucoChile
  3. 3.Universitat Autònoma de BarcelonaBarcelonaSpain
  4. 4.Health Services Research GroupIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
  5. 5.CIBER Epidemiología y Salud Pública (CIBERESP)BarcelonaSpain
  6. 6.Department of Public Health, Faculty of MedicineUniversidad de La FronteraTemucoChile
  7. 7.Iberoamerican Cochrane CentreBiomedical Research Institute Sant Pau (IIB Sant Pau)BarcelonaSpain
  8. 8.Universitat Pompeu Fabra (UPF)BarcelonaSpain

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