Measurement Properties of Available Quality-of-life Instruments in Oral Lichen Planus

Objectives: To critically appraise and compare the evidence on measurement properties of available quality-of-life (QoL) measurement instruments used for oral lichen planus (OLP).
Methods: Electronic databases (MEDLINE via PubMed and EMBASE) were searched for original articles evaluating measurement properties of QoL instruments used for OLP. The methodological quality of selected articles were appraised using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. To determine the quality of the instruments, measurement properties were assessed against predefined quality criteria and overall evidence for each instrument was synthesized.
Results: Of 991 retrieved titles/abstracts, 7 original articles providing information on four QoL instruments were eligible for inclusion. Of the 7 included instruments, the Chronic Oral Mucosal Disease Questionnaire (COMDQ) demonstrated the strongest evidence supporting structural validity, internal consistency, reliability and hypothesis testing for use in the OLP population, followed by the Oral Potentially Malignant Disorder Quality of Life Questionnaire (OPMDQoL). Psychometric robustness of the Oral Health Impact Profile-14 (OHIP-14) and the Oral Health-related Quality of Life-UK (OHQOL-UK) in the OLP population remains uncertain due to poor methodological quality of validation studies. None of included QoL instruments had documentation on all measurement properties as recommended by the COSMIN guidelines with data from OLP population.

Conclusions: At least one QoL instrument with moderate-to-strong level of evidence for some aspects of validity and reliability was available for use in OLP population. Despite their increasing use in clinical practice and trials of OLP, all identified QoL instruments still lack robust evidence supporting some aspects of measurement properties, particularly on measurement error and responsiveness. Additional good quality research is thus warranted. Dental practitioners and researchers need to be aware of the deficiencies of existing QoL instruments to support high quality information of QoL in patients with OLP.