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What Are We Really Measuring? A Content Comparison of Swallowing Outcome Measures for Head and Neck Cancer Based on the International Classification of Functioning, Disability and Health (ICF)

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Abstract

A combination of outcome measures are required to provide important information on the physiological profile and associated impact of dysphagia in head and neck cancer (HNC). Choosing the most appropriate tool can be a difficult and time-consuming process. The aim of this study was to identify and then compare the content of tools commonly used to assess swallowing post HNC care using the International Classification of Functioning Disability and Health (ICF) as a reference. A literature audit of 11 databases was conducted for relevant articles published between January 2004 and June 2017 and total of 502 papers met the inclusionary criteria. These papers were audited and 27 tools were identified which met the study criteria. The meaningful concepts contained in each tool were mapped to the ICF. Within the 27 tools, 898 meaningful concepts were identified and matched to 60 ICF categories. The most frequently matched ICF categories related to body functions, while comparatively few concepts matched to activity and participation and environmental factors. This study has identified that a large number of tools are currently being used in HNC research to measure swallowing outcomes. The sheer number of tools available to explore dysphagia post HNC highlights the lack of a uniform approach to outcome measurement which limits the potential to compare and combine research studies in order to strengthen treatment evidence. There is a need to develop an international consensus for a core outcome set of swallowing related measures, that capture the holistic impact of dysphagia, for HNC.

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Authors and Affiliations

  1. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia

    Rebecca Louise Nund, Bena Brown & Elizabeth Celeste Ward

  2. Centre for Functioning and Health Research, Metro South Hospital and Health Service, Buranda, QLD, 4102, Australia

    Rebecca Louise Nund, Bena Brown & Elizabeth Celeste Ward

  3. Speech Pathology Department, Princess Alexandra Hospital, Wooloongabba, QLD, 4102, Australia

    Bena Brown

  4. Cancer Care Centre, St George Hospital, Kogarah, NSW, 2217, Australia

    Julia Maclean

  5. University of New South Wales, Sydney, NSW, Australia

    Julia Maclean

  6. Department of Speech and Language Therapy, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK

    Justin Roe

  7. Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK

    Justin Roe

  8. Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, St Dunstan’s Road, London, W6 8RP, UK

    Justin Roe

  9. Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK

    Joanne M. Patterson

  10. Speech and Language Therapy Department, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK

    Joanne M. Patterson

  11. Department of Speech Language Pathology, Rehabilitation Sciences Institute, Toronto, ON, Canada

    Rosemary Martino

  12. Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Rosemary Martino

  13. Krembil Research Institute, University Health Network, Toronto, ON, Canada

    Rosemary Martino

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  1. Rebecca Louise Nund
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  2. Bena Brown
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Nund, R.L., Brown, B., Ward, E.C. et al. What Are We Really Measuring? A Content Comparison of Swallowing Outcome Measures for Head and Neck Cancer Based on the International Classification of Functioning, Disability and Health (ICF). Dysphagia 34, 575–591 (2019). https://doi.org/10.1007/s00455-019-10005-0

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