Patient reported dry mouth: Instrument comparison and model performance for correlation with quality of life in head and neck cancer survivors

Publication date: Available online 8 December 2017
Source:Radiotherapy and Oncology
Author(s): Mona Kamal, David I. Rosenthal, Stefania Volpe, Ryan P. Goepfert, Adam S. Garden, Katherine A. Hutcheson, Karine A. Al Feghali, Mohamed Ahmed Mohamed Meheissen, Salman A. Eraj, Amy E. Dursteler, Bowman Williams, Joshua B. Smith, Jeremy M. Aymard, Joel Berends, Aubrey L. White, Steven J. Frank, William H. Morrison, Richard Cardoso, Mark S. Chambers, Erich M. Sturgis, Tito R. Mendoza, Charles Lu, Abdallah S.R. Mohamed, Clifton D. Fuller, G. Brandon Gunn
PurposeTo identify a clinically meaningful cut-point for the single item dry mouth question of the MD Anderson Symptom Inventory-Head and Neck module (MDASI-HN).MethodsHead and neck cancer survivors who had received radiation therapy (RT) completed the MDASI-HN, the University of Michigan Hospital Xerostomia Questionnaire (XQ), and the health visual analog scale (VAS) of the EuroQol Five Dimension Questionnaire (EQ-5D). The Bayesian information criteria (BIC) were used to test the prediction power of each tool for EQ-5D VAS. The modified Breiman recursive partitioning analysis (RPA) was used to identify a cut point of the MDASI-HN dry mouth score (MDASI-HN-DM) with EQ-5D VAS, using a ROC-based approach; regression analysis was used to confirm the threshold effect size.ResultsTwo-hundred seven respondents formed the cohort. Median follow-up from the end of RT to questionnaire completion was 88 months. The single item MDASI-HN-DM score showed a linear relationship with the XQ composite score (ρ = 0.80, p < 0.001). The MDASI-HN-DM displayed improved model performance for association with EQ-5D VAS as compared to XQ (BIC of 1803.7 vs. 2016.9, respectively). RPA showed that an MDASI-HN-DM score of ≥6 correlated with EQ-5D VAS decline (LogWorth 5.5).ConclusionThe single item MDASI-HN-DM correlated with the multi-item XQ and performed favorably in the prediction of QOL. A MDASI-HN-DM cut point of ≥6 correlated with decline in QOL.



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