The Groningen Radiotherapy-Induced Xerostomia questionnaire: development and validation of a new questionnaire.
OBJECTIVE
The purpose of this study was to develop and validate a questionnaire (Groningen Radiotherapy-Induced Xerostomia (GRIX) questionnaire) that has the ability to distinguish between patient-rated xerostomia during day and night and can be used to evaluate the impact of emerging radiation delivery techniques aiming at prevention of xerostomia in more detail.


METHODS
All questions in the GRIX were generated from an exhaustive list of relevant questions according to xerostomia as reported in the literature and reported by patients and health care providers. Finally the GRIX was reduced from 56 questions to a 14-item questionnaire, with four subscales; xerostomia during day and night and sticky saliva during day and night. 315 patients filled out 2936 questionnaires and the GRIX was evaluated by calculating Crohnbach's α for all subscales. Criterion validity was evaluated to compare the GRIX with patient-rated xerostomia scored with the EORTC QLQ-HN35 and physician-rated xerostomia, test-retest analysis and responsiveness were also tested.


RESULTS
Crohnbach's α varied for all subscales between 0.88 and 0.94. The GRIX scored well for criterion-related validity on all subscales with high correlations with the EORTC QLQ-HN35 xerostomia and sticky saliva scale as well with physician-rated toxicity scoring. No significant differences were found between test and retest score and the GRIX showed good responsiveness with different time points for all subscales.


CONCLUSIONS
The GRIX is a validated questionnaire which can be used in future research focusing on patient-rated xerostomia and sticky saliva during day and night in relation with the impact of emerging radiation delivery techniques aiming at reduction of xerostomia.
Beetz
Ivo
I
Department of Radiation Oncology, University of Groningen, Groningen, The Netherlands. i.beetz@rt.umcg.nl
Burlage
Fred R
FR
Bijl
Henk P
HP
Hoegen-Chouvalova
Olga
O
Christianen
Miranda E M C
ME
Vissink
Arjan
A
van der Laan
Bernard F A M
BF
de Bock
Geertruida H
GH
Langendijk
Johannes A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D015203:Reproducibility of Results; D012469:Salivary Glands / Q000528:radiation effects; D011795:Surveys and Questionnaires; D014987:Xerostomia / Q000209:etiology*