Validation of the Edmonton-33: A Patient-Reported Outcome Instrument in Head and Neck Oncology at Baseline and Subacute Phases Post-Treatment

Abstract

Background: Patient-reported outcomes (PRO), which prioritize patient perspectives, are highly valuable for patient-centered care in Head and Neck Oncology. The objective of this study was to explore the longitudinal validity of the Edmonton-33 (E-33), a PRO instrument for assessing head and neck functions in swallowing, chewing, dry mouth, and speech.

Methods: This study involved 59 adult patients (18 female, 41 male) with squamous cell carcinoma (SCC) of the oral cavity. Participants provided consent and completed the E-33 and other PRO instruments before and after surgical and radiation treatment at months 3 (n = 18), 6 (n = 18), and 9 (n = 16). Data were collected (from June 2021 to August 2024) and analyzed for correlation between domains of the E-33 and their domain-specific, previously validated counterparts before treatment (baseline) and after treatment (Months 3, 6, and 9).

Results: There were statistically significant correlations (p < 0.05) between all E-33 domains and their domain-specific counterparts at baseline and at post-treatment month 6. At Months 3 and 9 post-treatment, there were partial correlations between E-33 domains and some domain-specific counterparts.

Conclusion: The E-33 demonstrates validity pre-treatment and post-treatment at subacute timepoint (Months 6) for capturing data on swallowing, chewing, dry mouth, and speech, similar to other previously validated instruments. This validity is limited at the more acute timepoint of 3 months post-treatment and the later timepoint of 9 months post-treatment. Additional data are needed to further explore the long-term validity at further longitudinal timepoints at 1 and 2 years post-treatment.

Keywords: head and neck oncology; head and neck reconstruction; head and neck surgery; patient reported outcomes; quality of life.