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Development of a holistic communication score (HoCoS) in patients treated for oral or oropharyngeal cancer: Preliminary validation

Abstract : Background In head and neck cancer, many tools exist to measure speech impairment, but few evaluate the impact on communication abilities. Some self-administered questionnaires are available to assess general activity limitations including communication. Others are not validated in oncology. These different tools result in scores that does not provide an accurate measure of the communication limitations perceived by the patients. Aim To develop a holistic score measuring the functional impact of speech disorders on communication in patients treated for oral or oropharyngeal cancer, in two steps: its construction and its validation. Methods & Procedures Patients treated for oral/oropharyngeal cancer filled six self-questionnaires: two about communicative dynamics (ECVB and DIP), two assessing speech function (PHI and CHI), and two relating to quality of life (EORTC QLQ-C30 and EORTC QLQ-H&N35). One hundred and seventy-four items were initially collected. A dimensionality reduction methodology was then applied. Face validity analysis led to eliminate non-relevant items by surveying a panel of nine experts from communication-related disciplines (linguistics, medicine, speech pathology, computer science). Construct validity analysis led to eliminate redundant and insufficiently variable items. Finally, the holistic communication score was elaborated by PCF (principal-component factor) and validated using cross-validation and latent profile analysis. Outcomes & Results Twenty-five patients filled the questionnaires (median age 67 years, EIQ 12; 15 men, 10 women; oral cavity 14, oropharynx 10, two locations 1). After face validity analysis, 44 items were retained (Kappa>0.80). Four additional items were excluded because of a very high correlation (r>0.90) with other items presenting a better dispersion. Forty items were finally included in the factor analysis. A post-analysis score prediction was performed (mean=100; standard deviation=10). Twenty-four items are finally retained for the construction of the holistic communication score (HoCoS): 19 items from questionnaires assessing communicative dynamics (13 from the ECVB and six from the DIP), four items from a perceived speech impairment questionnaire (PHI) and one from a quality-of-life questionnaire (EORTC QLQ-H&N35). The reliability is good (five-fold cross-validation: rs=0.91) and the complementary latent profile analysis shows a good validity of the HoCoS, clustering subjects by level of communication performance. Conclusions & Implications A global score allowing a measure of the impact of the speech disorder on communication was developed. It fills the lack of this type of score in head and neck oncology and allows to better understand the functional and psychosocial consequences of the pathology in the patients’ follow-up.
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Contributor : Mathieu Balaguer Connect in order to contact the contributor
Submitted on : Wednesday, August 31, 2022 - 1:28:50 PM
Last modification on : Monday, September 5, 2022 - 9:38:00 AM
Long-term archiving on: : Thursday, December 1, 2022 - 7:12:40 PM


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Mathieu Balaguer, Julien Pinquier, Jérôme Farinas, Virginie Woisard. Development of a holistic communication score (HoCoS) in patients treated for oral or oropharyngeal cancer: Preliminary validation. International Journal of Language and Communication Disorders, 2022, pp.1-13. ⟨10.1111/1460-6984.12766⟩. ⟨hal-03765649⟩



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