PhD Defence Maarten Johannes Ottenhof

Keywords: PROMs (Patient-Reported Outcome Measures) / Psychometrics, Quality of Life, Facial Skin Cancer Reconstruction, Plastic Surgery 
 

"Face values: Psychometric validation of patient-reported outcomes in facial skin surgery"

This PhD thesis presents comprehensive research on the FACE-Q Skin Cancer Module, a patient-reported outcome measure (PROM) in plastic surgery, specifically in skin cancer reconstruction. 

In the initial part of the research, the FACE-Q Skin Cancer Module was translated and adapted into Dutch. The translation process was rigorous, involving multiple steps of forward and back translation, independent review, and pre-testing, ensuring that the Dutch version was both linguistically accurate and culturally relevant. 

The next part of the research focused on anglicizing and validating the FACE-Q Skin Cancer Module within a UK cohort as part of the Patient-Reported Outcome Measures in Skin Cancer Reconstruction (PROMISCR) study. This study demonstrated that the anglicized version of the FACE-Q Skin Cancer Module was a valid and reliable tool for evaluating skin cancer patients' health-related quality of life, satisfaction with appearance, and experience of care. The research then explored the calibration of the Dutch FACE-Q skin cancer module. Calibration, a critical aspect of scale development, ensures that the measurement tool functions as expected across different groups of people. 

Subsequently, the research delved into a specific application of the FACE-Q Skin CancerModule: assessing satisfaction with the Rintala flap for nasal tip defect reconstruction. The study found that most patients were satisfied with their appearance and the information provided about the procedure, demonstrating the utility of the module in evaluating specific surgical procedures. A narrative review of the use of the FACE-Q Aesthetic was then conducted. This reviewhighlighted the module's versatility and applicability in a range of contexts, from clinical practice to research settings. 

The final part of the thesis examined the potential of improving the efficiency of the FACE-Q Skin Cancer Module through computerized adaptive testing (CAT). Using a simulation study, it was shown that CAT could significantly reduce the number of items administered without sacrificing the precision of the test. This approach could potentially redefine the field, as it enables patients to answer only those items that are most relevant to them. In conclusion, the research presented in this thesis supports the validity and utility of the FACE-Q Skin Cancer Module as a PROM in skin cancer reconstruction. It demonstrates the potential for further improving its efficiency through computerized adaptive testing and highlights its applicability in various contexts, from specific surgical procedures to different cultural settings. 

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