Measuring Patient-Reported Outcomes Following Traumatic Craniomaxillofacial Injuries: Development of the AO CMF Injury Symptom Battery

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Dec 17

PMID 39685615

Authors

Sally E Jensen

Nan E Rothrock

Leilani Lacson-Soltysiak

Alexis Olsson

Edward Ellis

Affiliations

Soon will be listed here.

Abstract

Traumatic craniomaxillofacial (CMF) injuries are associated with various symptoms/concerns that affect patients' quality of life. The assessment of outcomes from the patient perspective has been limited by the absence of patient-reported outcome (PRO) measures tailored to this patient population. To address this need, we employed a mixed methods, multi-step process to first identify the most important symptoms/concerns and then use this information to construct a PRO symptom battery. CMF clinicians and patients who had sustained traumatic CMF injuries participated in semi-structured interviews to elicit the symptoms/concerns considered the most important. The data were analyzed using an iterative coding procedure and symptom/concern frequency was tabulated. The findings were used to develop a conceptual model of the most important symptoms to include in a PRO battery. Existing items were modified as needed and new items were drafted to ensure adequate coverage of the symptoms. The resulting AO CMF Injury Symptom Battery includes four modules specific to the injury site (oral, ocular, nasopharyngeal, ear) and five universal modules (pain/sensation, cognitive, cosmetic, psychosocial, and injury impact). The AO CMF Injury Symptom Battery offers promise for assessing symptoms only patients can report on in clinical research and practice. Ongoing research will examine the battery's psychometric properties.

References

Bjordal K, Ahlner-Elmqvist M, Tollesson E, Jensen A, Razavi D, Maher E . Development of a European Organization for Research and Treatment of Cancer (EORTC) questionnaire module to be used in quality of life assessments in head and neck cancer patients. EORTC Quality of Life Study Group. Acta Oncol. 1994; 33(8):879-85. DOI: 10.3109/02841869409098450. View

Wong Z, Richards M, Wormald J . Surgical site infection and patient-reported outcomes in surgically treated soft tissue facial injury: A meta-analysis. J Plast Reconstr Aesthet Surg. 2024; 95():319-330. DOI: 10.1016/j.bjps.2024.06.004. View

Worsaae N, Thorn J . Surgical versus nonsurgical treatment of unilateral dislocated low subcondylar fractures: a clinical study of 52 cases. J Oral Maxillofac Surg. 1994; 52(4):353-60; discussion 360-1. DOI: 10.1016/0278-2391(94)90436-7. View

Atchison K, Shetty V, Belin T, Der-Martirosian C, Leathers R, Black E . Using patient self-report data to evaluate orofacial surgical outcomes. Community Dent Oral Epidemiol. 2006; 34(2):93-102. DOI: 10.1111/j.1600-0528.2006.00260.x. View

Kisala P, Tulsky D . Opportunities for CAT applications in medical rehabilitation: development of targeted item banks. J Appl Meas. 2010; 11(3):315-30. PMC: 6445378. View

Shepherd J . Strategies for the study of long-term sequelae of oral and facial injuries. J Oral Maxillofac Surg. 1992; 50(4):390-9. DOI: 10.1016/0278-2391(92)90405-o. View

DeWalt D, Rothrock N, Yount S, Stone A . Evaluation of item candidates: the PROMIS qualitative item review. Med Care. 2007; 45(5 Suppl 1):S12-21. PMC: 2810630. DOI: 10.1097/01.mlr.0000254567.79743.e2. View

Joeris A, Knoll C, Kalampoki V, Blumenthal A, Gaskell G . Patient-reported outcome measurements in clinical routine of trauma, spine and craniomaxillofacial surgeons: between expectations and reality: a survey among 1212 surgeons. BMJ Open. 2018; 8(6):e020629. PMC: 6009470. DOI: 10.1136/bmjopen-2017-020629. View

Rahtz E, Bhui K, Hutchison I, Korszun A . Are facial injuries really different? An observational cohort study comparing appearance concern and psychological distress in facial trauma and non-facial trauma patients. J Plast Reconstr Aesthet Surg. 2017; 71(1):62-71. DOI: 10.1016/j.bjps.2017.08.006. View

10.

Slade G, Spencer A . Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994; 11(1):3-11. View

11.

McCarty J, Herrera-Escobar J, Gadkaree S, El Moheb M, Kaafarani H, Velmahos G . Long-Term Functional Outcomes of Trauma Patients With Facial Injuries. J Craniofac Surg. 2021; 32(8):2584-2587. DOI: 10.1097/SCS.0000000000007818. View

12.

Anwar Z, McLeod N, Van den Bosch P, Cairns M . A review of the use of patient reported outcome measures (PROMS) in temporomandibular joint (TMJ) surgery. J Craniomaxillofac Surg. 2023; 52(2):181-187. DOI: 10.1016/j.jcms.2023.11.005. View

13.

Williams A, Bearn D, Mildinhall S, Murphy T, Sell D, Shaw W . Cleft lip and palate care in the United Kingdom--the Clinical Standards Advisory Group (CSAG) Study. Part 2: dentofacial outcomes and patient satisfaction. Cleft Palate Craniofac J. 2001; 38(1):24-9. DOI: 10.1597/1545-1569_2001_038_0024_clapci_2.0.co_2. View

14.

Astrom A, Okullo I . Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda. BMC Oral Health. 2003; 3(1):5. PMC: 212323. DOI: 10.1186/1472-6831-3-5. View

15.

Choudhury-Peters D, Dain V . Developing psychological services following facial trauma. BMJ Qual Improv Rep. 2016; 5(1). PMC: 4964208. DOI: 10.1136/bmjquality.u210402.w4210. View

16.

Omeje K, Rana M, Adebola A, Efunkoya A, Olasoji H, Purcz N . Quality of life in treatment of mandibular fractures using closed reduction and maxillomandibular fixation in comparison with open reduction and internal fixation--a randomized prospective study. J Craniomaxillofac Surg. 2014; 42(8):1821-6. DOI: 10.1016/j.jcms.2014.06.021. View

17.

List M, DAntonio L, Cella D, Siston A, Mumby P, Haraf D . The Performance Status Scale for Head and Neck Cancer Patients and the Functional Assessment of Cancer Therapy-Head and Neck Scale. A study of utility and validity. Cancer. 1996; 77(11):2294-301. DOI: 10.1002/(SICI)1097-0142(19960601)77:11<2294::AID-CNCR17>3.0.CO;2-S. View