Determining the minimal important difference of the Oral Health Impact Profile for Chronic Periodontitis
Corresponding Author
Song-lin He
College of Stomatology, Chongqing Medical University, Chongqing, China
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
Correspondence
Song-lin He, Stomatological Hospital of Chongqing Medical University, No. 7, Shang Qing Si Road, Chongqing 400015, China.
Email: [email protected]
Search for more papers by this authorHai-juan Hou
College of Stomatology, Chongqing Medical University, Chongqing, China
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
Search for more papers by this authorJin-hua Wang
College of Stomatology, Chongqing Medical University, Chongqing, China
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
Search for more papers by this authorCorresponding Author
Song-lin He
College of Stomatology, Chongqing Medical University, Chongqing, China
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
Correspondence
Song-lin He, Stomatological Hospital of Chongqing Medical University, No. 7, Shang Qing Si Road, Chongqing 400015, China.
Email: [email protected]
Search for more papers by this authorHai-juan Hou
College of Stomatology, Chongqing Medical University, Chongqing, China
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
Search for more papers by this authorJin-hua Wang
College of Stomatology, Chongqing Medical University, Chongqing, China
Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
Search for more papers by this authorFunding information
This research is funded by the Program for Innovation Team Building at Institutions of Higher Education in Chongqing in 2016 and the Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education.
Abstract
Aim
Building on previous psychometric work, we aimed to further assess the minimally important difference (MID) of the Oral Health Impact Profile for Chronic Periodontitis (OHIP-CP).
Methods
In total, 240 consecutive patients with chronic periodontitis were recruited in the study. The OHIP-CP was completed at baseline and after six weeks. Methodology testing included the confirmatory factor analysis (CFA) and MID. Confirmatory factor analysis (CFA) was performed to assess the fit of the previously proposed three-factor model. The MID of this questionnaire was determined by applying anchor-based and distribution-based approaches.
Results
The CFA supported a three-factor model for the OHIP-CP with acceptable fit to the data. The fit indices were χ2/df = 2.231, GFI = 0.935, TLI = 0.969 and CFI = 0.976, RMSEA = 0.076. The OHIP-CP scores showed significant improvements after treatment (p < .001). The anchor-based MIDs of OHIP-CP for “oral function restriction,” “oral pain” and “psychological and social impact,” and total score were 2, 1, 4 and 7 points, respectively. The effect sizes (ES) and standardized response mean (SRM) for the OHIP-CP were moderate to large.
Conclusions
The MID of the OHIP-CP is recommended for interpreting clinically meaningful change in oral health-related quality of life (OHRQoL) over time.
CONFLICT OF INTEREST
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
REFERENCES
- Abanto, J., Paiva, S. M., Sheiham, A., Tsakos, G., Mendes, F. M., Cordeschi, T., … Bonecker, M. (2016). Changes in preschool children's OHRQoL after treatment of dental caries: Responsiveness of the B-ECOHIS. International Journal of Paediatric Dentistry, 26, 259–265. https://doi.org/10.1111/ipd.12192
- Allen, P. F., O'Sullivan, M., & Locker, D. (2009). Determining the minimally important difference for the Oral Health Impact Profile-20. European Journal of Oral Sciences, 117, 129–134. https://doi.org/10.1111/j.1600-0722.2009.00610.x
- Angst, F., Aeschlimann, A., & Angst, J. (2017). The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies. Journal of Clinical Epidemiology, 82, 128–136. https://doi.org/10.1016/j.jclinepi.2016.11.016
- Bentler, P. M., & Bonett, D. G.(1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88, 588–606. https://doi.org/10.1037/0033-2909.88.3.588
- Botelho, J., Machado, V., Proenca, L., Bellini, D. H., Chambrone, L., Alcoforado, G., & Mendes, J. J. (2020). The impact of nonsurgical periodontal treatment on oral health-related quality of life: A systematic review and meta-analysis. Clinical Oral Investigations, 24, 585–596. https://doi.org/10.1007/s00784-019-03188-1
- Brauchle, F., Noack, M., & Reich, E. (2013). Impact of periodontal disease and periodontal therapy on oral health-related quality of life. International Dental Journal, 63, 306–311. https://doi.org/10.1111/idj.12042
- Buset, S. L., Walter, C., Friedmann, A., Weiger, R., Borgnakke, W. S., & Zitzmann, N. U. (2016). Are periodontal diseases really silent? A systematic review of their effect on quality of life. Journal of Clinical Periodontology, 43, 333–344. https://doi.org/10.1111/jcpe.12517
- Daire Hooper, J. C., & Mullen, M. R. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6, 53–60.
- Durham, J., Fraser, H. M., McCracken, G. I., Stone, K. M., John, M. T., & Preshaw, P. M. (2013). Impact of periodontitis on oral health-related quality of life. Journal of Dentistry, 41, 370–376. https://doi.org/10.1016/j.jdent.2013.01.008
- Eke, P. I., Page, R. C., Wei, L., Thornton-Evans, G., & Genco, R. J. (2012). Update of the case definitions for population-based surveillance of periodontitis. Journal of Periodontology, 83, 1449–1454. https://doi.org/10.1902/jop.2012.110664
- El Sayed, N., Baeumer, A., El Sayed, S., Wieland, L., Weber, D., Eickholz, P., & Pretzl, B. (2019). Twenty years later: Oral health-related quality of life and standard of treatment in patients with chronic periodontitis. Journal of Periodontology, 90, 323–330. https://doi.org/10.1002/JPER.18-0417
- Graziani, F., Music, L., Bozic, D., & Tsakos, G. (2019). Is periodontitis and its treatment capable of changing the quality of life of a patient? British Dental Journal, 227, 621–625. https://doi.org/10.1038/s41415-019-0735-3
- He, S., Wang, J., Wei, S., & Ji, P. (2017). Development and validation of a condition-specific measure for chronic periodontitis: Oral health impact profile for chronic periodontitis. Journal of Clinical Periodontology, 44, 591–600. https://doi.org/10.1111/jcpe.12716
- He, S., Wei, S., Wang, J., & Ji, P. (2018). Chronic periodontitis and oral health-related quality of life in Chinese adults: A population-based, cross-sectional study. Journal of Periodontology, 89, 275–284. https://doi.org/10.1002/JPER.16-0752
- Iacobucci, D. (2010). Structural equations modeling: Fit indices, sample size, and advanced topics. Journal of Consumer Psychology, 20, 90–98. https://doi.org/10.1016/j.jcps.2009.09.003
- Irani, F. C., Wassall, R. R., & Preshaw, P. M. (2015). Impact of periodontal status on oral health-related quality of life in patients with and without type 2 diabetes. Journal of Dentistry, 43, 506–511. https://doi.org/10.1016/j.jdent.2015.03.001
- Jaeschke, R., Singer, J., & Guyatt, G. H. (1989). Measurement of health status. Ascertaining the minimal clinically important difference. Controlled Clinical Trials, 10, 407–415. https://doi.org/10.1016/0197-2456(89)90005-6
- Johnston, B. C., Thorlund, K., Schunemann, H. J., Xie, F., Murad, M. H., Montori, V. M., & Guyatt, G. H. (2010). Improving the interpretation of quality of life evidence in meta-analyses: The application of minimal important difference units. Health and Quality of Life Outcomes, 8, 116. https://doi.org/10.1186/1477-7525-8-116
- Jonsson, B., & Ohrn, K. (2014). Evaluation of the effect of non-surgical periodontal treatment on oral health-related quality of life: Estimation of minimal important differences 1 year after treatment. Journal of Clinical Periodontology, 41, 275–282. https://doi.org/10.1111/jcpe.12202
- Kassebaum, N. J., Bernabe, E., Dahiya, M., Bhandari, B., Murray, C. J., & Marcenes, W. (2014). Global burden of severe periodontitis in 1990–2010: A systematic review and meta-regression. Journal of Dental Research, 93, 1045–1053. https://doi.org/10.1177/0022034514552491
- Lang, N. P., & Bartold, P. M. (2018). Periodontal health. Journal of Periodontology, 89(Suppl 1), S9–S16. https://doi.org/10.1002/JPER.16-0517
- Linden, G. J., Herzberg, M. C. & working group 4 of the joint EFP/AAP workshop (2013). Periodontitis and systemic diseases: A record of discussions of working group 4 of the Joint EFP/AAP Workshop on periodontitis and systemic diseases. Journal of Periodontology, 84, S20–23. https://doi.org/10.1902/jop.2013.1340020
- Locker, D., & Allen, F. (2007). What do measures of 'oral health-related quality of life' measure? Community Dentistry and Oral Epidemiology, 35, 401–411. https://doi.org/10.1111/j.1600-0528.2007.00418.x
- Masood, M., Masood, Y., Saub, R., & Newton, J. T. (2014). Need of minimal important difference for oral health-related quality of life measures. Journal of Public Health Dentistry, 74, 13–20. https://doi.org/10.1111/j.1752-7325.2012.00374.x
- McGlothlin, A. E., & Lewis, R. J. (2014). Minimal clinically important difference: Defining what really matters to patients. JAMA, 312, 1342–1343. https://doi.org/10.1001/jama.2014.13128
- Mokkink, L. B., Terwee, C. B., Patrick, D. L., Alonso, J., Stratford, P. W., Knol, D. L., … de Vet, H. C. (2010). The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: An international Delphi study. Quality of Life Research, 19, 539–549. https://doi.org/10.1007/s11136-010-9606-8
- Neelakantan, P., Liu, P., Dummer, P. M. H., & McGrath, C. (2020). Oral health-related quality of life (OHRQoL) before and after endodontic treatment: A systematic review. Clinical Oral Investigations, 24, 25–36. https://doi.org/10.1007/s00784-019-03076-8
- Ousmen, A., Conroy, T., Guillemin, F., Velten, M., Jolly, D., Mercier, M., … Anota, A. (2016). Impact of the occurrence of a response shift on the determination of the minimal important difference in a health-related quality of life score over time. Health and Quality of Life Outcomes, 14, 167. https://doi.org/10.1186/s12955-016-0569-5
- Ousmen, A., Touraine, C., Deliu, N., Cottone, F., Bonnetain, F., Efficace, F., … Anota, A. (2018). Distribution- and anchor-based methods to determine the minimally important difference on patient-reported outcome questionnaires in oncology: A structured review. Health and Quality of Life Outcomes, 16, 228. https://doi.org/10.1186/s12955-018-1055-z
- Peikert, S. A., Spurzem, W., Vach, K., Frisch, E., Ratka-Kruger, P., & Woelber, J. P. (2019). Association of non-surgical periodontal therapy on patients' oral health-related quality of life-A multi-centre cohort study. Journal of Clinical Periodontology, 46, 529–538. https://doi.org/10.1111/jcpe.13093
- Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. Journal of Clinical Epidemiology, 61, 102–109. https://doi.org/10.1016/j.jclinepi.2007.03.012
- Reynolds, I., & Duane, B. (2018). Periodontal disease has an impact on patients' quality of life. Evidence-Based Dentistry, 19, 14–15. https://doi.org/10.1038/sj.ebd.6401287
- Ruff, R. R., Sischo, L., & Broder, H. L. (2016). Minimally important difference of the child oral health impact profile for children with orofacial anomalies. Health and Quality of Life Outcomes, 14, 140. https://doi.org/10.1186/s12955-016-0544-1
- Shanbhag, S., Dahiya, M., & Croucher, R. (2012). The impact of periodontal therapy on oral health-related quality of life in adults: A systematic review. Journal of Clinical Periodontology, 39, 725–735. https://doi.org/10.1111/j.1600-051X.2012.01910.x
- Sischo, L., & Broder, H. L. (2011). Oral health-related quality of life: What, why, how, and future implications. Journal of Dental Research, 90, 1264–1270. https://doi.org/10.1177/0022034511399918
- Tsakos, G., Allen, P. F., Steele, J. G., & Locker, D. (2012). Interpreting oral health-related quality of life data. Community Dentistry and Oral Epidemiology, 40, 193–200. https://doi.org/10.1111/j.1600-0528.2011.00651.x
- Tsakos, G., Bernabe, E., D'Aiuto, F., Pikhart, H., Tonetti, M., Sheiham, A., & Donos, N. (2010). Assessing the minimally important difference in the oral impact on daily performances index in patients treated for periodontitis. Journal of Clinical Periodontology, 37, 903–909. https://doi.org/10.1111/j.1600-051X.2010.01583.x
- Wyrwich, K. W., Norquist, J. M., Lenderking, W. R., Acaster, S. & Industry Advisory Committee of International Society for Quality of Life Research (ISOQOL) (2013). Methods for interpreting change over time in patient-reported outcome measures. Quality of Life Research, 22, 475–483. https://doi.org/10.1007/s11136-012-0175-x
- Yen, P. Y., Sousa, K. H., & Bakken, S. (2014). Examining construct and predictive validity of the Health-IT Usability Evaluation Scale: Confirmatory factor analysis and structural equation modeling results. Journal of the American Medical Informatics Association, 21, e241–e248. https://doi.org/10.1136/amiajnl-2013-001811
Citing Literature
