Shoulder-Specific Patient-Reported Outcome Measures for Use in Patients With Head and Neck Cancer: An Assessment of...

Area of Science:

• Orthopedics and Sports Medicine
• Oncology
• Psychometrics

Background:

• Patient-reported outcome (PRO) measures are crucial for assessing shoulder function in head and neck cancer patients.
• Existing PRO measures require rigorous validation for specific patient populations.

Purpose of the Study:

• To evaluate the construct validity and appropriateness of four shoulder-related PRO measures for head and neck cancer patients.
• To utilize Rasch analysis for objective psychometric assessment of PRO measures.

Main Methods:

• Rasch analysis was applied to data from 182 patients who underwent neck dissection.
• Investigated were scale dimensionality, hierarchy, response structure, and reliability of DASH, QuickDASH, SPADI, and NDII.

Main Results:

• Disabilities of the Arm, Shoulder and Hand (DASH) did not meet unidimensionality criteria and was deemed inappropriate.
• QuickDASH, SPADI, and NDII were found to be unidimensional, with NDII meeting most Rasch analysis requirements.
• All measures met reliability thresholds, but issues with person/item misfit and differential item functioning were noted.

Conclusions:

• The Neck Dissection Impairment Index (NDII) is the most appropriate PRO measure for this population.
• QuickDASH and SPADI are recommended with reservations.
• DASH is not recommended for use in head and neck cancer patients post-neck dissection.