REVIEW ARTICLE Psychometric Characteristics of Health-Related Quality-of-Life Questionnaires in Oropharyngeal Dysphagia Angelique A. Timmerman • Rene ´e Speyer • Bas J. Heijnen • Iris R. Klijn-Zwijnenberg Received: 16 July 2013 / Accepted: 14 December 2013 / Published online: 5 March 2014 Ó Springer Science+Business Media New York 2014 Abstract Dysphagia can have severe consequences for the patient’s health, influencing health-related quality of life (HRQoL). Sound psychometric properties of HRQoL questionnaires are a precondition for assessing the impact of dysphagia, the focus of this study, resulting in recom- mendations for the appropriate use of these questionnaires in both clinical practice and research contexts. We per- formed a systematic review starting with a search for and retrieval of all full-text articles on the development of HRQoL questionnaires related to oropharyngeal dysphagia and/or their psychometric validation from the electronic databases PubMed and Embase published up to June 2011. Psychometric properties were judged according to quality criteria proposed for health status questionnaires. Eight questionnaires were included in this study. Four are aimed solely at HRQoL in oropharyngeal dysphagia: the deglu- tition handicap index (DHI), dysphagia handicap index (DHI 0 ), M.D. Anderson Dysphagia Inventory (MDADI), and SWAL-QOL, while the EDGQ, EORTC QLQ-STO 22, EORTC QLQ-OG 25 and EORTC QLQ-H&N35 focus on other primary diseases resulting in dysphagia. The psy- chometric properties of the DHI, DHI 0 , MDADI, and SWAL-QOL were evaluated. For appropriate applicability of HRQoL questionnaires, strong scores on the psycho- metric criteria face validity, criterion validity, and inter- pretability are prerequisites. The SWAL-QOL has the strongest ratings for these criteria, while the DHI 0 is the most easy to apply given its 25 items and the use of a uniform scoring format. For optimal use of HRQoL ques- tionnaires in diverse settings, it is necessary to combine psychometric and utility approaches. Keywords Oropharyngeal dysphagia Á Health-related quality of life Á Questionnaires Á Psychometric characteristics Á Deglutition Á Deglutition disorders Introduction In clinical care there is a growing prevalence of chronic over infectious diseases given the rise in life expectancy since the 19th century due to better life conditions and quality of care, resulting in a shift from cure to care when measuring the effectiveness of treatment, i.e., from ‘‘life- saving’’ to ‘‘life quality’’ [1, 2]. Quality of life (QoL) as a concept has increasingly been recognized and used as an outcome measure of the effect of (chronic) medical conditions (and their treatment) on daily functioning, in agreement with the World Health Organi- zation’s definition of health as ‘‘a state of complete phys- ical, mental and social well-being, not merely the absence of disease or infirmity’’ [3–5]. QoL has been broadly op- erationalized as health-related quality of life (HRQoL) in conceptual models and resulting instruments, and also A. A. Timmerman (&) Department of Family Medicine, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands e-mail: a.timmerman@maastrichtuniversity.nl R. Speyer School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, 43, James Cook Drive, Townsville, QLD 4811, Australia R. Speyer Á B. J. Heijnen Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands I. R. Klijn-Zwijnenberg Emergency Medicine, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ Den Bosch, The Netherlands 123 Dysphagia (2014) 29:183–198 DOI 10.1007/s00455-013-9511-8