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Bias in retrospective assessment of perceived dental treatment effects when using the Oral Health Impact Profile

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Abstract

Purpose

Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance.

Methods

In this prospective clinical study, a sample of 126 adult patients (age 17–83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients’ ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments.

Results

Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment.

Conclusion

Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.

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Acknowledgements

The authors are grateful to Ms. Annett Schrock (University of Leipzig) for her help with data management.

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Author notes

    Authors and Affiliations

    1. Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

      Daniel R. Reissmann

    2. Department of Prosthodontics and Materials Science, School of Dentistry, University of Leipzig, Leipzig, Germany

      Antje Erler & Oliver Schierz

    3. Department of Pediatric Dentistry, School of Dentistry, University of Leipzig, Leipzig, Germany

      Christian Hirsch

    4. Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Center for Dental and Craniofacial Sciences, Charité – Universitätsmedizin Berlin, Berlin, Germany

      Ira Sierwald

    5. Academic Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK

      Carolina Machuca

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    1. Daniel R. Reissmann
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    Correspondence to Daniel R. Reissmann.

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    The authors declare that they have no conflict of interest.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Research involving human participants

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    Daniel R. Reissmann and Antje Erler have contributed equally to this work and are considered as joint first authors.

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    Reissmann, D.R., Erler, A., Hirsch, C. et al. Bias in retrospective assessment of perceived dental treatment effects when using the Oral Health Impact Profile. Qual Life Res 27, 775–782 (2018). https://doi.org/10.1007/s11136-017-1725-z

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