title: A systematic review of patient-reported outcome measures in head and neck cancer surgery.
abstract: OBJECTIVE
  To identify, summarize, and evaluate patient-reported outcome questionnaires for use in head and neck cancer surgery with the view to making recommendations for future research.
  
  
  METHODS
  A systematic review of the English-language literature, with the use of head-and-neck-surgery-specific keywords, was performed in the following databases: Medline, Embase, HAPI, CINAHL, Science/Social Sciences Citation Index, and PsycINFO from 1966 to March 2006. DATA EXTRACTION AND STUDY SELECTION: All English-language instruments identified as patient-reported outcome questionnaires that measure quality of life and/or satisfaction that had undergone development and validation in a head and neck cancer surgery population were included.
  
  
  RESULTS
  Twelve patient-reported outcome questionnaires fulfilled our inclusion criteria. Of these, four were developed from expert opinion alone or did not have a published development process and seven questionnaires lacked formal item reduction. Only three questionnaires (EORTC Head and Neck Module, University of Michigan Head and Neck Quality-of-life Questionnaire, and Head and Neck Cancer Inventory) fulfilled guidelines for instrument development and evaluation as outlined by the Medical Outcomes Trust.
  
  
  CONCLUSIONS
  Rigorous instrument development is important for creating valid, reliable, and responsive disease-specific questionnaires. As a direction for future instrument development, an increased focus on qualitative research to ensure patient input may help to better conceptualize and operationalize the variables most relevant to head and neck cancer surgery patients. In addition, the use of alternative methods of psychometric data analysis, such as Rasch, may improve the value of health measurement in clinical practice for individual patients.
authors.affiliation: Plastic and Reconstructive Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. pusica@mskcc.org
authors.forename: Andrea
authors.initials: A
authors.lastname: Pusic
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Liu
authors.forename: Constance M
authors.initials: CM
authors.lastname: Chen
authors.forename: Stefan
authors.initials: S
authors.lastname: Cano
authors.forename: Kristen
authors.initials: K
authors.lastname: Davidge
authors.forename: Anne
authors.initials: A
authors.lastname: Klassen
authors.forename: Ryan
authors.initials: R
authors.lastname: Branski
authors.forename: Snehal
authors.initials: S
authors.lastname: Patel
authors.forename: Dennis
authors.initials: D
authors.lastname: Kraus
authors.forename: Peter G
authors.initials: PG
authors.lastname: Cordeiro
mesh_terms: D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D011788:Quality of Life; D011795:Surveys and Questionnaires