Screening for Dysfunction to Promote Multidisciplinary Intervention by Using the University of Washington Quality of Life Questionnaire | Cancer Screening, Prevention, Control | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
April 2009

Screening for Dysfunction to Promote Multidisciplinary Intervention by Using the University of Washington Quality of Life Questionnaire

Author Affiliations

Author Affiliations: Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, and Evidence-Based Practice Research Centre, Faculty of Health, Edge Hill University, Ormskirk, England.

Arch Otolaryngol Head Neck Surg. 2009;135(4):369-375. doi:10.1001/archoto.2009.7
Abstract

Objective  To investigate the potential of the University of Washington Quality of Life Questionnaire (UW-QOL) in routine clinics as a quick screening tool for possible dysfunction in patients after treatment of head and neck cancer.

Design  Retrospective analysis.

Setting  Regional Maxillofacial Unit, Aintree University Hospitals National Health Service Foundation Trust Liverpool, a National Health Service teaching hospital.

Patients  Consecutive disease-free patients with oral or oropharyngeal squamous cell carcinoma, who had undergone primary surgery with or without adjuvant radiotherapy, for whom UW-QOL version 4 data from 2000 to May 2006 were available in our research database; and consecutive patients from previous studies (4 postal surveys of disease-free patients with oral or oropharyngeal squamous cell carcinoma, 1 clinic-based study that targeted speech and swallowing in patients with oropharyngeal disease, 1 that evaluated shoulder function in patients with various diagnoses, and 1 that recruited patients without cancer attending a general dental practice).

Main Outcome Measures  Cutoff strategies for further evaluation/intervention derived from studies using the UW-QOL in parallel with 13 other established questionnaires. Effects of preferred cutoffs on trigger variation were assessed with the use of all available UW-QOL version 4 data (615 patients).

Results  Trigger rates for further intervention fell between 9% (recreation and speech) and 16% (swallowing). Eighty-one percent of patients with free-flap surgery and adjuvant therapy for T3 or T4 tumors met the trigger criteria at around 2 years, with 42% meeting the trigger on 3 or more domains.

Conclusion  The fourth version of the UW-QOL is suitable for routine screening in clinical practice.

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