Screening for dysfunction to promote multidisciplinary intervention by using the University of Washington Quality of Life Questionnaire

Objective To investigate the potential of the University of Washington Quality of Life Questionnaire (UW-QOL) in routine clinics as a quick screening tool for possible dysfunction in patients after treatment of head and neck cancer. Design Retrospective analysis. Setting Regional Maxillofacial Unit, Aintree University Hospitals National Health Service Foundation Trust Liverpool, a National Health Service teaching hospital. Patients Consecutive disease-free patients with oral or oropharyngeal squamous cell carcinoma, who had undergone primary surgery with or without adjuvant radiotherapy, for whom UW-QOL version 4 data from 2000 to May 2006 were available in our research database; and consecutive patients from previous studies (4 postal surveys of disease-free patients with oral or oropharyngeal squamous cell carcinoma, 1 clinic-based study that targeted speech and swallowing in patients with oropharyngeal disease, 1 that evaluated shoulder function in patients with various diagnoses, and 1 that recruited patients without cancer attending a general dental practice). Main Outcome Measures Cutoff strategies for further evaluation/intervention derived from studies using the UW-QOL in parallel with 13 other established questionnaires. Effects of preferred cutoffs on trigger variation were assessed with the use of all available UW-QOL version 4 data (615 patients). Results Trigger rates for further intervention fell between 9% (recreation and speech) and 16% (swallowing). Eighty-one percent of patients with free-flap surgery and adjuvant therapy for T3 or T4 tumors met the trigger criteria at around 2 years, with 42% meeting the trigger on 3 or more domains. Conclusion The fourth version of the UW-QOL is suitable for routine screening in clinical practice.