Dejaco Daniel, Riedl David, Gasser Sebastian, Schartinger Volker Hans, Innerhofer Veronika, Gottfried Timo, Steinbichler Teresa Bernadette, Riechelmann Felix, Moschen Roland, Galvan Oliver, Stigler Robert, Gassner Robert, Rumpold Gerhard, Lettenbichler-Haug Anna, Riechelmann Herbert
Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Cancers (Basel). 2021 Nov 3;13(21):5529. doi: 10.3390/cancers13215529.
Head and neck cancer (HNC) and its treatment can lead to various functional impairments. We developed and validated an instrument for rapid physician-rated assessment of basic functional outcomes in HNC patients. HNC-relevant functional domains were identified through a literature review and assigned to verbal ratings based on observable criteria. The instrument draft was subjected to systematic expert review to assess its face and content validity. Finally, the empirical validity, reliability, and responsiveness of the expert-adapted Functional Integrity in Head and Neck Cancer (HNC-FIT) scales were assessed in healthy controls and in HNC patients. A matrix of the 6 functional domains of oral food intake, respiration, speech, pain, mood, and neck and shoulder mobility was created, each with 5 verbal rating levels. Face and content validity levels of the HNC-FIT scales were judged to be adequate by 17 experts. In 37 control subjects, 24 patients with HNC before treatment, and in 60 HNC patients after treatment, the HNC-FIT ratings in the 3 groups behaved as expected and functional domains correlated closely with the outcome of corresponding scales of the EORTC-HN35-QoL questionnaire, indicating good construct and criterion validity. Interrater reliability (rICC) was ≥0.9 for all functional domains and retest reliability (rICC) was ≥0.93 for all domains except mood (rICC = 0.71). The treatment effect size (eta-square) as a measure of responsiveness was ≥0.15 ( < 0.01) for fall domains except for breathing and neck and shoulder mobility. The median HNC-FIT scale completion time was 1 min 17 s. The HNC-FIT scale is a rapid tool for physician-rated assessment of functional outcomes in HNC patients with good validity, reliability, and responsiveness.
头颈癌（HNC）及其治疗可导致各种功能障碍。我们开发并验证了一种工具，用于医生对头颈癌患者基本功能结局进行快速评估。通过文献综述确定了与头颈癌相关的功能领域，并根据可观察到的标准为其赋予了语言评分。该工具草案经过系统的专家评审，以评估其表面效度和内容效度。最后，在健康对照者和头颈癌患者中评估了专家调整后的头颈癌功能完整性（HNC-FIT）量表的实证效度、信度和反应度。创建了一个包含口腔食物摄入、呼吸、言语、疼痛、情绪以及颈部和肩部活动度这6个功能领域的矩阵，每个领域有5个语言评分等级。17位专家认为HNC-FIT量表的表面效度和内容效度水平是足够的。在37名对照受试者、24名治疗前的头颈癌患者以及60名治疗后的头颈癌患者中，三组的HNC-FIT评分表现符合预期，并且功能领域与欧洲癌症研究与治疗组织-头颈35生活质量问卷（EORTC-HN35-QoL）相应量表的结果密切相关，表明具有良好的结构效度和效标效度。所有功能领域的评分者间信度（rICC）≥0.9，除情绪领域（rICC = 0.71）外，所有领域的重测信度（rICC）≥0.93。作为反应度衡量指标的治疗效应大小（eta平方），除呼吸以及颈部和肩部活动度外，所有领域均≥0.15（<0.01）。HNC-FIT量表完成的中位时间为1分17秒。HNC-FIT量表是一种用于医生对头颈癌患者功能结局进行评估的快速工具，具有良好效度、信度和反应度。
