TY - JOUR
T1 - Validation of a Novel, Multidomain Head and Neck Cancer Appearance- and Function-Distress Patient-Reported Outcome Measure
AU - Graboyes, Evan M.
AU - Hand, Brittany N.
AU - Ellis, Mark A.
AU - Huang, Andrew T.
AU - Nilsen, Marci L.
AU - Pipkorn, Patrik
AU - Marsh, Courtney H.
AU - Maurer, Stacey
AU - Day, Terry A.
AU - Sterba, Katherine R.
N1 - Funding Information:
We thank W. Greer Albergotti, MD, Vasu Divi, MD, Jeff Houlton, MD, Sobia Khaja, MD, Brian Nussenbaum, MD, MHCM, Nitin Pagedar, MD, MPH, Megan Scallion, MSW, MPH, Tiffany K. Garris, NP-C, and Joseph Zenga, MD, for their critical feedback on the question-writing portion of the scale development.
Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2020.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Objectives: Distress with self-perceived changes in appearance and function can result in body image disturbance (BID), which is common in head and neck cancer (HNC) survivors and a major source of psychosocial morbidity. To address the lack of psychometrically sound patient-reported outcome measures (PROMs) of HNC-related BID, we aim to create and validate the Inventory to Measure and Assess imaGe disturbancE–Head & Neck (IMAGE-HN). Study Design: Survey study. Setting: Multiple academic centers. Subjects and Methods: Following item development, HNC survivors from 4 academic centers completed the IMAGE-HN. Item responses were psychometrically analyzed using confirmatory factor analysis (CFA) and Rasch analysis. Results: Item development resulted in a 31-item PROM consisting of 5 individual domains and a global domain. In total, 305 HNC survivors of diverse ages, HNC subsites, and reconstructive paradigms completed the initial items. After removal of 3 items for local dependence, CFA confirmed the unidimensionality and local independence (item residual correlations <|0.20|) for each domain. Rasch analysis indicated acceptable fit (infit and outfit mean squares <2.0), monotonicity of all rating scale categories, and low person misfit (<4%). Person separation indices and person reliability were adequate for each domain except appearance concealment, which was removed (4 items). This resulted in the IMAGE-HN, a psychometrically acceptable 24-item PROM of HNC-related BID consisting of a global scale and 4 subscales measuring unique constructs and comprised independent items. Conclusions: IMAGE-HN is a novel, psychometrically sound, multidomain PROM of HNC-related BID for use in clinical and research settings.
AB - Objectives: Distress with self-perceived changes in appearance and function can result in body image disturbance (BID), which is common in head and neck cancer (HNC) survivors and a major source of psychosocial morbidity. To address the lack of psychometrically sound patient-reported outcome measures (PROMs) of HNC-related BID, we aim to create and validate the Inventory to Measure and Assess imaGe disturbancE–Head & Neck (IMAGE-HN). Study Design: Survey study. Setting: Multiple academic centers. Subjects and Methods: Following item development, HNC survivors from 4 academic centers completed the IMAGE-HN. Item responses were psychometrically analyzed using confirmatory factor analysis (CFA) and Rasch analysis. Results: Item development resulted in a 31-item PROM consisting of 5 individual domains and a global domain. In total, 305 HNC survivors of diverse ages, HNC subsites, and reconstructive paradigms completed the initial items. After removal of 3 items for local dependence, CFA confirmed the unidimensionality and local independence (item residual correlations <|0.20|) for each domain. Rasch analysis indicated acceptable fit (infit and outfit mean squares <2.0), monotonicity of all rating scale categories, and low person misfit (<4%). Person separation indices and person reliability were adequate for each domain except appearance concealment, which was removed (4 items). This resulted in the IMAGE-HN, a psychometrically acceptable 24-item PROM of HNC-related BID consisting of a global scale and 4 subscales measuring unique constructs and comprised independent items. Conclusions: IMAGE-HN is a novel, psychometrically sound, multidomain PROM of HNC-related BID for use in clinical and research settings.
KW - PROMIS
KW - appearance
KW - body image
KW - disfigurement
KW - head and neck cancer
KW - patient reported outcome measure
KW - pyscho-oncology
KW - survivorship
UR - http://www.scopus.com/inward/record.url?scp=85085893445&partnerID=8YFLogxK
U2 - 10.1177/0194599820927364
DO - 10.1177/0194599820927364
M3 - Article
C2 - 32482151
AN - SCOPUS:85085893445
VL - 163
SP - 979
EP - 985
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
SN - 0194-5998
IS - 5
ER -