What is the quality of patient-reported outcomes of salivary function?
Reviewed by Gemma Clunie

Salivary gland dysfunction has multiple causes and can have significant impact on quality of life, particularly when symptoms are severe. There are several patient-reported outcomes (PROMS) that assess these issues; however, these are variable in what they measure. This systematic review aimed to identify PROMS available and compare the quality of each of these. The team identified 16 measures that assessed different causes of salivary gland dysfunction (xerostomia, sialadenitis, Sjogren’s syndrome, Parkinson’s-associated sialorrhea, oral systemic sclerosis). The PROMS were assessed against the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. Fifteen of the PROMS were newly developed, with one (the Oral Health Impact-14) being adapted from an existing questionnaire. Internal consistency, the extent to which individual items of a PROM measure various aspects of the same construct, was ‘very good’ based on eleven of the PROMs, and test-retest information was provided for 10. However, patients and healthcare professionals had only been involved in the development of four of the PROMS and none of these four were judged ‘adequate’. Based on COSMIN, the most rigorously designed PROM was the Xerostomia Inventory which was adequate in six out of seven domains. This systematic review shows that the quality of available PROMs to measure salivary gland dysfunction varies a great deal, particularly in relation to limited-to-no content validity. Clinicians should be aware of their limitations when using these PROMS. The authors recommend that future work in this area includes patient and healthcare professional input into the development of PROMs.

Patient-reported outcomes of salivary function: A systematic review.
Gulati A, Kidane J, Chang, JL.
LARYNGOSCOPE
2023:133(8):1796-1805.