Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Department of Prosthodontics and Materials Science, School of Dentistry, University of Leipzig, Leipzig, Germany.
Qual Life Res. 2018 Mar;27(3):775-782. doi: 10.1007/s11136-017-1725-z. Epub 2017 Oct 23.
Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance.
In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments.
Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment.
Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.
本探索性研究旨在调查使用 Oral Health Impact Profile（OHIP）对口腔健康相关生活质量（OHRQoL）进行回顾性评估是否容易受到偏见的影响，例如变化的内隐理论和认知失调。
在这项前瞻性临床研究中，连续招募了 126 名需要修复治疗的成年患者（年龄 17-83 岁，女性占 49%）作为样本。在基线和随访时使用包含 49 个条目的 OHIP 评估 OHRQoL。此外，在随访时，要求患者回顾性地评估他们在基线时的口腔健康状况（回顾性预测试或测试后），并使用全球过渡问题评估口腔健康状况的变化。此外，患者对总体口腔健康和一般健康的评分被用作 OHRQoL 评估的有效性标准。响应转移是通过将初始和回顾性基线评估之间的差异计算得出的。
基线和回顾性预测试在内部一致性和收敛效度方面没有显著差异。当患者在治疗过程中感知到 OHRQoL 发生较大变化时，响应转移更为明显。回顾性预测试与基线的相关性高于与随访评估的相关性。
研究结果表明，使用 OHIP-49 进行的 OHRQoL 回顾性评估容易受到偏见的影响。认知失调比变化的内隐理论更有可能成为偏见的来源。
