Single‐item discrimination of quality‐of‐life–altering dysphagia among 714 long‐term oropharyngeal cancer survivors: Comparison of patient‐reported outcome measures of swallowing

Background

Two patient‐reported outcomes (PROs) of swallowing and their correlation to quality of life (QOL) were compared in long‐term survivors of oropharyngeal cancer (OPC).

Methods

Scores on the single dysphagia item from the 28‐item, multisymptom MD Anderson Symptom Inventory‐Head and Neck (MDASI‐HN‐S) were compared with scores on the dysphagia‐specific composite MD Anderson Dysphagia Inventory (MDADI) and the EuroQol visual analog scale (EQ‐VAS) in 714 patients who had received definitive radiotherapy ≥12 months before the survey. An MDASI‐HN‐S score ≥6 and an MDADI composite score <60 were considered representative of moderate/severe swallowing dysfunction.

Results

Moderate/severe dysphagia was reported by 17% and 16% of respondents on the MDASI‐HN‐S and the composite MDADI, respectively. Both swallow PROs were predictive of QOL, and the MDASI‐HN‐S model was slightly more parsimonious for the discrimination of EQ‐VAS scores compared with MDADI scores (Bayesian information criteria, 6062 vs 6076, respectively). An MDASI‐HN‐S cutoff score of ≥6 correlated best with a declining EQ‐VAS score (P < .0001) and was associated with increased radiotherapy dose to several normal swallowing structures.

Conclusions

In this cohort, the single‐item MDASI‐HN‐S performed favorably for the discrimination of QOL compared with the multi‐item MDADI. A time‐efficient model for PRO measurement of swallowing is proposed in which the MDADI may be reserved for patients who score ≥6 on the MDASI‐HN‐S.

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