Development of a holistic communication score (HoCoS) in patients treated for oral or oropharyngeal cancer: preliminary validation
Résumé
Background In head and neck cancer, few tools are validated to evaluate the impact of speech disorders on daily communication abilities. The aim is to develop a holistic score measuring the functional impact of speech disorders on communication in patients treated for oral/oropharyngeal cancer. Methods Patients treated for oral/oropharyngeal cancer filled two self-questionnaires about communicative dynamics (ECVB, DIP), two assessing speech function (PHI, CHI), and two relating to quality of life (EORTC QLQ-C30, QLQ-H&N35). From 174 items initially collected, a dimensionality reduction methodology was applied. Face validity analysis led to eliminate non-relevant items by surveying nine experts from communication-related disciplines. Construct validity analysis led to eliminate redundant items. The holistic communication score (HoCoS) was elaborated by principal-component factor analysis and validated using cross-validation and latent profile analysis (LPA).
Results Twenty-five patients were included (median 67 years, IQR 12; 15 men, 10 women; oral cavity 14, oropharynx 10, both 1). The experts’ survey let to retain 44 items (Kappa>0.80). Four items were excluded for redundancy (r>0.90 with others presenting a better dispersion). Forty items were included in the factor analysis. A post-analysis score prediction was performed (mean=100; sd=10). Twenty-four items are finally used in the HoCoS (ECVB: 13, DIP: 6, PHI: 4, EORTC QLQ H&N35: 1). Reliability (five-fold cross-validation: rs=0.91) and validity (correct clusterization of subjects by LPA) are good. Conclusions A score measuring the daily impact of speech disorders on communication was developed. It allows to better understand the functional and psychosocial consequences of the pathology in follow-up.
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