title: The Toronto outcome measure for craniofacial prosthetics: reliability and validity of a condition-specific quality-of-life instrument.
abstract: OBJECTIVE
  The purpose of this study was to refine the Toronto Outcome Measure for Craniofacial Prosthetics (TOMCP), present evidence for its reliability and validity, and use the instrument to explore differences in quality of life between prostheses made with chlorinated polyethylene (CPE) (experimental) and silicone (control).
  
  
  METHODS
  As part of a multicenter prospective controlled randomized double-blind single-crossover clinical trial of the two materials, the TOMCP was administered at the start and end of two 4-month study arms, during which 42 patients wore prostheses made from one material then the other. Reliability was assessed at the crossover. To determine validity of the TOMCP, the Linear Analogue Self-Assessment (LASA-12) and the Short-Form 8 (SF-8) were also administered with the TOMCP. The TOMCP was reduced by removing items that were unreliable, had poorly distributed answers, showed increased internal consistency after their removal, or were too highly correlated with more than one other item. The tests of reliability and validity were then repeated. Finally, the reduced instrument was used to test for differences in quality of life between prostheses made of the two materials.
  
  
  RESULTS
  The item reduction tactics pared the 52-item instrument down to 27 items. The correlations of both TOMCP versions with the LASA-12 and the SF-8 were found to be statistically significant, providing evidence of the validity of the TOMCP. The instrument revealed significantly better quality of life with silicone rather than CPE prostheses.
  
  
  CONCLUSIONS
  Both versions of the TOMCP were found to be reliable and valid. The instrument was able to show differences in quality of life between two materials.
authors.affiliation: Craniofacial Prosthetic Unit, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada. jimanderson519@yahoo.com
authors.forename: James D
authors.initials: JD
authors.lastname: Anderson
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Johnston
authors.forename: Gil S
authors.initials: GS
authors.lastname: Haugh
authors.forename: Sudarat
authors.initials: S
authors.lastname: Kiat-Amnuay
authors.forename: Lawrence
authors.initials: L
authors.lastname: Gettleman
mesh_terms: D000328:Adult; D000368:Aged; D001828:Body Image / Q000523:psychology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008447:Maxillofacial Prosthesis / Q000523:psychology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011095:Polyethylenes; D011446:Prospective Studies; D019736:Prostheses and Implants; D011788:Quality of Life; D015203:Reproducibility of Results; D012828:Silicones; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D011095:Polyethylenes; D012828:Silicones; C045578:polyethylene chloride