Content Validation of the International Classification of Functioning, Disability and Health Core Sets for Head and Neck Cancer: A Multicentre Study

OBJECTIVE: the International Classification of Functioning, Disability and Health (ICF) Core Sets for head and neck cancer (HNC) structure the assessment of functioning and guide rehabilitation. They are an application of the ICF that was adopted by the World Health Organization. They exist in a first version as a Comprehensive Core Set (CCS) with 112 categories for multidisciplinary assessment and clinical studies and as a Brief Core Set (BCS) with 19 categories for data collection in clinical routine. The BCS is a selection of the most important categories from the CCS. The objective of this study was to test whether the CCS and BCS are relevant in patients with HNC treated in different departments and countries across the world. DESIGN: a multicentre, cross-sectional study was conducted with 276 patients at 14 international study-centres. Data collection included departments of otolaryngology, maxillofacial surgery, hemato-oncology, psychiatry, speech therapy, and physiotherapy. METHODS: questionnaires on the CCS, the University of Washington Quality of Life questionnaire (UW-QOL version 4), and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ) modules c30 and hn35 were completed by patients and health professionals. Frequency analyses and Spearman correlations were applied. RESULTS: for the CCS, 105 of 112 categories (94%) were confirmed. New categories were not identified. For the BCS, 14 of 19 categories (74%) were confirmed, whereas several additional categories of the CCS have qualified for upgrading and inclusion in the BCS. Correlations between the UW-QOL and EORTC-QLQ (modules c30 and hn35) to the ICF-based data collection were satisfactory (mostly p < .01). CONCLUSION: the CCS proved to be exhaustive and covers a broader range of aspects than any of the tested questionnaires. Final selection of categories out of the CCS into the BCS requires further studies.