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The Carcinologic Handicap Index: validation of the upgraded version and ability to highlight head and neck cancer patients' needs

Balaguer, Mathieu and Champenois, Maëlle and Woisard, Virginie The Carcinologic Handicap Index: validation of the upgraded version and ability to highlight head and neck cancer patients' needs. (2019) In: 31th World Congress of the International Association of Logopedics and Phoniatrics (IALP 2019), 18 August 2019 - 22 August 2019 (Taipei, Taiwan, Province Of China). (Unpublished)

(Document in English)

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The first version of the Carcinologic Handicap Index (CHI) assessed the symptoms presented by ENT patients and the impact on their quality of life (Balaguer, 2017). But this version got two issues : missing domains, and lack of emerging priorities for the patients in terms of care. The objective of this study is to validate the complete version of the CHI, and to evaluate the link between the scores of the CHI and the patients' needs. Methods: We added two new dimensions to the 9 of the first version of the CHI : neck and shoulders limitation, and psychosocial impact due to physical modifications. We included 71 patients with head and neck cancer consulting for a follow-up consultation in ENT between november 2017 and march 2018, with no restriction about location, tumor size or treatment received. Our controls were 36 healthy subjects. The cases and controls had to fill the completed version to assess the convergent validity, and also a Visual Analog Scale for each dimension (criterion validity). The comparison between cases and controls allowed us to assess the structural validity. They had to fill once again the CHI after 7 days to evaluate the temporal validity. Finally, to study the link between the scores of the different dimension of the CHI and the patients's needs, the subjects had to rank the 11 dimensions of the CHI from the most troublesome to the least. Results: our new dimensions shows good convergent validity (Spearman's coefficient of correlation between 0.35 and 0.73) and discriminant validity (r<0.30). A factorial analyzis confirms the structure in 11 domains. The structural validity shows a difference between cases and control (p<0.001). Strong correlations between CHI score and VAS are found with a coefficient r=0.74 for « physical modification » and r=0.68 for « neck and shoulders limitations ». The reliability is high, with a Cronbach's alpha higher than 0.72 for the new dimensions. Finally, the temporal validity is correct with correlations higher than 0.67 between the 2 completions of the CHI. The ranking of dimensions differs the scores for 54 % of the subjects (confidence intervals of intraclass correlations). But, if we only consider the 5 top-scored domains in the CHI, a match exists with 3 or 4 top-ranked domains for 77% of the subjects. Discussion: the two new dimensions presents good psychometric qualities and assess dimensions frequently impacted by the pathology in this population. By considering the 5 top-scored dimensions of the CHI, care-team members can enlight which domains are the more important for the patients in terms of care strategy, to reduice the impact in their everyday life. This completed versions needs to be translated, and compared to a Patients Concerns Inventory.

Item Type:Conference or Workshop Item (Other)
Audience (conference):International conference proceedings
Uncontrolled Keywords:
Institution:French research institutions > Centre National de la Recherche Scientifique - CNRS (FRANCE)
Université de Toulouse > Institut National Polytechnique de Toulouse - Toulouse INP (FRANCE)
Université de Toulouse > Université Toulouse III - Paul Sabatier - UT3 (FRANCE)
Université de Toulouse > Université Toulouse - Jean Jaurès - UT2J (FRANCE)
Université de Toulouse > Université Toulouse 1 Capitole - UT1 (FRANCE)
Other partners > Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE)
Laboratory name:
Deposited On:21 Jan 2020 12:40

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