title: Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 2 - cross-sectional validation.
abstract: OBJECTIVE
  To test the items, identified through qualitative inquiry that might form the basis of a new Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life (OHQoL) of young people with malocclusion.
  
  
  METHODS
  Piloting with 13 young people reduced the number of items from 37 to 28. Cross-sectional testing involved a convenience sample aged 10-16 years, attending the Orthodontic Department of the Charles Clifford Dental Hospital, Sheffield. The fit and function of the initial MIQ questions were examined using item response theory.
  
  
  RESULTS
  184 participants (113 females; 71 males) completed a questionnaire (response 85%), seven participants were excluded due to missing responses. The mean age of participants was 12·9 years (SD 1·4) and they had a wide range of malocclusions. The majority were White British (67·4%). Data from 47 participants were used to analyse test-retest reliability. Rasch analysis was undertaken, which further reduced the number of items in the questionnaire from 28 to 17. Unidimensionality of the scale was confirmed. The analysis also identified that the original 5-point response scale could be reduced to three points. The new measure demonstrated good criterion validity (r = 0·751; P < 0·001) and construct validity with the two global questions ('Overall bother' ρ = 0·733 and 'Life overall' ρ = 0·701). Internal consistency (Cronbach's alpha = 0·906) and test-retest reliability Intraclass correlation coefficient (ICC = 0·78; 95% CI 0·61-0·88) were also good.
  
  
  CONCLUSIONS
  Cross-sectional testing has shown the new MIQ to be both valid and reliable. Further evaluation is required to confirm the generalisability as well as the ability of the new measure to detect change over time (responsiveness).
authors.affiliation: a Academic Unit of Oral Health & Development, School of Clinical Dentistry , University of Sheffield , UK.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Benson
authors.affiliation: b Orthodontic Department , University College London Eastman Dental Institute , UK.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Cunningham
authors.affiliation: a Academic Unit of Oral Health & Development, School of Clinical Dentistry , University of Sheffield , UK.
authors.forename: Nahush
authors.initials: N
authors.lastname: Shah
authors.affiliation: a Academic Unit of Oral Health & Development, School of Clinical Dentistry , University of Sheffield , UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Gilchrist
authors.affiliation: c Academic Unit of Dental Public Health, School of Clinical Dentistry , University of Sheffield , UK.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Baker
authors.affiliation: b Orthodontic Department , University College London Eastman Dental Institute , UK.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Hodges
authors.affiliation: c Academic Unit of Dental Public Health, School of Clinical Dentistry , University of Sheffield , UK.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Marshman
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008310:Malocclusion; D009909:Oral Health; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Impact; malocclusion; oral health quality of life; orthodontics; questionnaire