Diagnostic accuracy of patient-reported dry mouth as a predictor for oral dryness in terminally ill cancer patients
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ORIGINAL ARTICLE
Diagnostic accuracy of patient-reported dry mouth as a predictor for oral dryness in terminally ill cancer patients Maiko Shimosato 1
&
Keita Asai 2 & Naosuke Yokomichi 3 & Keiji Nagano 4
&
Naoki Sakane 5
Received: 9 May 2020 / Accepted: 22 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of the study was to determine the diagnostic accuracy of patient-reported dry mouth using an oral moisturechecking device in terminally ill cancer patients. Methods The study was conducted following the STARD guidelines, and the participants were recruited prospectively from the Palliative Care Unit, Kyoto Medical Center, Japan, between 1 January 2017 and 30 November 2018. Patients reporting dry mouth were asked to rate oral dryness on a 5-point rating scale. The outcome was oral dryness at the lingual mucosa, measured using an oral moisture-checking device. Receiver operating characteristic (ROC) curves were plotted, and the sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (LR), and overall diagnostic accuracy were calculated. Results Of 103 participants, the prevalence of oral dryness was 65.0%. ROC analysis indicated that patient-reported dry mouth was a poor predictor of oral dryness, with an area under the curve of 0.616 (95% confidence interval: 0.508–0.723), a sensitivity of 46.3%, a specificity of 75.8%, a PPV of 55.9%, an NPV of 68.1, a positive LR of 1.9, a negative LR of 0.7, and an overall diagnostic accuracy of 64.1%, with a cut-off value of 3 points. Conclusion In conclusion, patient-reported dry mouth is not a useful parameter for the assessment of oral dryness in terminally ill cancer patients. Keywords Palliative care . Oral care . Dry mouth . Patient-reported dry mouth . Thirst . Assessment
Introduction Various adverse oral symptoms appear in terminally ill cancer patients due to deterioration in systemic conditions and the
* Maiko Shimosato [email protected] 1
Department of Oral and Maxillofacial Surgery, National Hospital Organization Kyoto Medical Center, 1-1, Fukakusa-Mukaihata, Fushimi-Ku, Kyoto 612-8555, Japan
2
Department of Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
3
Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
4
Division of Oral Biology, Health Sciences University of Hokkaido, Hokkaido, Japan
5
Division of Preventive Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
side effects of chemo- and radiotherapy. Oral care contributes to the reduction of oral symptoms; therefore, oral care is necessary because it can increase the quality of life and death of the patient [1–5]. Dry mouth is reported to occur in 30 to 88% of advanced cancer patients [6–9]. Complications of dry mouth include oral candidiasis, difficulty in the use of dentures, having a bad taste in the mouth, speech and swallowing disorders, poor ir
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