Development of a Patient-Centered Functional Outcomes Questionnaire in Head and Neck Cancer

Area of Science:

• Reconstructive Surgery
• Patient-Reported Outcomes
• Head and Neck Oncology

Background:

• Patient perspectives are increasingly vital in assessing functional outcomes after reconstructive surgery.
• Existing measures may not fully capture the functional concerns of head and neck cancer patients.

Purpose of the Study:

• To develop and validate the Edmonton-33, an instrument measuring key functional areas for head and neck cancer patients.
• To ensure the instrument reflects patient-reported outcomes in swallowing, speech, dry mouth, and chewing.

Main Methods:

• A 4-phase mixed-methods qualitative study conducted across international sites (Canada, USA, Finland).
• Involved patients (n=45) diagnosed with squamous cell carcinoma of the head and neck, at least one year post-treatment.
• Utilized correlation analyses to validate the Edmonton-33 against established swallowing, speech, and quality of life measures.

Main Results:

• The Edmonton-33 demonstrated strong correlations with validated measures for swallowing (e.g., MD Anderson Dysphagia Inventory, r=0.77) and speech (e.g., Speech Handicap Index, r=-0.64).
• Significant correlations were also found for dry mouth and chewing domains, with factor loadings exceeding 0.3 for all domains.
• High mean factor loadings for swallowing (0.71) and speech (0.76) items indicate robust measurement properties.

Conclusions:

• The Edmonton-33 is a validated instrument enabling head and neck cancer patients to report their functional outcomes.
• This tool can serve as a comprehensive, patient-centered measure for functional assessment in head and neck oncology.
• Its validation supports its use in clinical practice and research for evaluating reconstructive surgery effectiveness.