Psychometric Properties of General Oral Health Assessment Index Across Ages: COSMIN Systematic Review

Objectives: To systematically review the psychometric properties of the Geriatric Oral Health Assessment Index (GOHAI) across age groups using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Methods: Data: English peer-reviewed articles reporting studies of the development, translation, or validation of GOHAI. Sources: PubMed, Web of Science, and EMBASE from Jan 1990 until December 31, 2023. Methodological evaluation: based on COSMIN methodology. The results are presented overall and for 4 age groups (>= 60 years, all ages, <60 years, <= 45 years). Structural validity was summarized qualitatively. Internal consistency and reliability were synthesized via randomeffects meta-analysis of T-transformed Cronbach a values, and Fisher 's Z transformed correlation coef ficients. Construct validity and responsiveness were assessed using effect sizes. Results: Four hundred ninety-seven records were identi fied, 72 underwent full-text assessment, resulting in 60 included reports. Structural validity was inconsistent across all age groups and overall. Internal consistency was suf ficient with overall a = 0.81, and high evidence quality. Testretest reliability was consistently suf ficient across age groups with overall r = 0.84. For construct validity 361 hypotheses were assessed (37.4% for convergent-, 62.6% for known-groups validity). The percentage of con firmed hypotheses in >= 60-years, all ages, <60-years and <= 45-years were 75.5%, 66.7%, 78.9%, and 88.9%, respectively. Responsiveness was not assessed in the <60-years and <= 45-years age groups, leading to indeterminate overall rating with very low evidence quality. Conclusions: This review af firms that GOHAI has suf ficient psychometric properties as an oral health-related quality of life instrument in various age groups, but its responsiveness is scarcely researched and its utility for individual-level follow-up is limited. The measurement properties of oral health-related quality of life tools must be scrutinized in the changing demands of personalized and value-based dental care.