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The Carcinologic Handicap Index (CHI): A disability self-assessment questionnaire for head and neck cancer patients
M Balaguer1, J Percodani1, V Woisard1
1Unité de la voix et de la déglutition, service d'ORL et de chirurgie cervicofaciale, hôpital Larrey, CHU de Toulouse, TSA 30030, 31100 Toulouse, France.
Introduction:
The present prospective study sought to draw up and validate a self-assessment questionnaire for disability following head and neck cancer treatment.
Material And Method:
The Carcinologic Handicap Index (CHI) was designed empirically based on the Voice Handicap Index. It comprises 9 dimensions, self-assessed by the patient: pain, swallowing, feeding, respiration, phonation, hearing, vision, olfaction-gustation, and psychosocial. For each dimension, 4 items are scored in terms of frequency, providing dimension and global scores. The CHI was tested on 86 head and neck cancer patients (pathologic group: male predominance; mean age, 59 years) and 18 control subjects, for validation.
Results And Discussion:
Global internal coherence was 0.905 (Cronbach alpha); content validity (r, between questionnaire scores and corresponding visual analog scales) ranged between 0.6 and 0.8 except for the vision dimension and for total score compared to general health rating on VAS (r≤0.5: i.e., the pathology did not directly impair vision and was only one factor among others affecting general health status); temporal validity was satisfactory (r>0.7; P<0.0001) except on the respiration dimension (r=0.624, probably due to fluctuation in pulmonary congestion). Impact on swallowing, feeding and respiration varied with lesion site. There were no significant differences between patients and controls on the pain, hearing and vision dimensions.
Conclusion:
The CHI showed acceptable psychometric qualities and can be considered as an authentic clinical tool for health professionals, assessing the impact of ENT pathology on quality of life, mainly in the functional domains directly affected by the pathology or treatment.
