Single‐item discrimination of quality‐of‐life–altering dysphagia among 714 long‐term oropharyngeal cancer survivors: Comparison of patient‐reported outcome measures of swallowing

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Abstract
Background: Two patient‐reported outcomes (PROs) of swallowing and their correlation to quality of life (QOL) were compared in long‐term survivors of oropharyngeal cancer (OPC). Methods: Scores on the single dysphagia item from the 28‐item, multisymptom MD Anderson Symptom Inventory‐Head and Neck (MDA S I‐HN‐S) were compared with scores on the dysphagia‐specific composite MD Anderson Dysphagia Inventory (MDA D I) and the EuroQol visual analog scale (EQ‐VAS) in 714 patients who had received definitive radiotherapy ≥12 months before the survey. An MDA S I‐HN‐S score ≥6 and an MDA D I composite score S I‐HN‐S and the composite MDA D I, respectively. Both swallow PROs were predictive of QOL, and the MDA S I‐HN‐S model was slightly more parsimonious for the discrimination of EQ‐VAS scores compared with MDA D I scores (Bayesian information criteria, 6062 vs 6076, respectively). An MDA S I‐HN‐S cutoff score of ≥6 correlated best with a declining EQ‐VAS score ( P < .0001) and was associated with increased radiotherapy dose to several normal swallowing structures. Conclusions: In this cohort, the single‐item MDA S I‐HN‐S performed favorably for the discrimination of QOL compared with the multi‐item MDA D I. A time‐efficient model for PRO measurement of swallowing is proposed in which the MDA D I may be reserved for patients who score ≥6 on the MDA S I‐HN‐S.
Funding Information
  • National Institutes of Health (1R01DE025248-01/R56DE025248-01)
  • National Institutes of Health (1R01CA218148-01)
  • National Institutes of Health (P30CA016672)
  • National Science Foundation (NSF 1557679)
  • Andrew Sabin Family Foundation
  • National Institutes of Health (1R01DE025248-01, R56DE025248-01)
  • National Institutes of Health (BD2K)

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