[Development of an ICF-based clinical practice guideline for the assessment of function in head and neck cancer].
BACKGROUND
Functional outcome following head and neck cancer is not regularly assessed in a standardized way in clinical practice. Clinical trials assessing functional outcome apply many different instruments. Therefore, results are not always comparable and have limited clinical implications. Aim of this study was the identification, interdisciplinary evaluation, and recommendation of functional outcome instruments for use in clinical practice and clinical trials in patients with HNC.


METHODS
Preparatory studies came up with a shortlist of outcome instruments on the basis of previously determined criteria. An interdisciplinary expert group evaluated these instruments and decided on which ones can be recommended for use in 3 application areas: screening, therapy evaluation/planning, and clinical trials. Decision making health professionals included physicians (ENT and maxillofacial surgeons, radiotherapists, oncologists), medical psychologists, speech and language therapists, physiotherapists, and social workers.


RESULTS
98 instruments were presented at the consensus conference. Altogether 21 participants recommended for each of the 3 application areas a basic set of measures for the evaluation of impairment in 6 functional domains: follow-up therapy monitoring, pain, ingestion, voice/speaking, other organic problems, and psychosocial problems.


CONCLUSIONS
A multi-professional expert's pool discussed and adopted recommendations for the use of functional outcome instruments in clinical praxis and/or in research. The re-commended instruments are now available for use in clinical routine.
Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum der Universität München, München, Germany.
U
U
Tschiesner
M
M
Stier-Jarmer
S
S
Strieth
S
S
Singer
A
A
Dietz
R
R
Fietkau
B
B
Wollenberg
G
G
Mast
A
A
Cieza
U A
UA
Harréus
D002986:Clinical Trials as Topic; D003299:Cooperative Behavior; D003680:Deglutition Disorders / Q000175:diagnosis; D004185:Disability Evaluation; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D008403:Mass Screening; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010149:Postoperative Pain / Q000175:diagnosis; D011183:Postoperative Complications / Q000175:diagnosis*; D011788:Quality of Life; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D014832:Voice Disorders / Q000175:diagnosis