Table I.

Measures of xerostomia

Type of measure	Name	Year	Performed by	Description	Scale	Ref.
Subjective	Vanderbilt Head and Neck Cancer Survey	2010–2012		28-Item questionnaire, with 5 symptom subscales: “Nutrition,” “Pain,” “Voice,” “Swallow,” and “Mucous/Dry Mouth”	Score from 0–10	12,13
Subjective	Groningen Radiotherapy-Induced Xerostomia questionnaire (GRIX)	2010	Patient	14-Item questionnaire, with 4 subscales: xerostomia during day and night and sticky saliva during day and night	Crohnbach’s α calculated for all subscales is converted to a 0–100 score, higher scores = worse xerostomia	14
Subjective	Visual Analog Scale (VAS)	2002	Patient	Mouth burning and/or pain intensity is evaluated on a 10-cm long VAS	0–10 cm scale, 10 cm being the highest toxicity	15,16
Subjective	Xerostomia-related QOL questionnaire (XQoLQ)	2001	Patient	Five questions relating xerostomia to QOL	Scale from 0–10	Several studies referenced in4
Subjective	Eisbruch’s Xerostomia Questionnaire (XQ), also called University of Michigan XQ (UMXQ)	2001	Patient	8-Item questionnaire evaluating dryness while eating or chewing and while not eating or chewing	0–100 score, higher scores = worse xerostomia	17
Subjective	Xerostomia Inventory (XI)	1999	Patient	11-Item survey	Below 14.5: normal 55: worse toxicity	18,19
Subjective	Patient Benefit Questionnaire (PBQ)	1999	Patient	8-Item questionnaire: difficulty speaking and eating, sleep problems, use of oral comfort aids or fluids, mouth and tongue soreness, and mouth dryness	1–10 Likert scale: 1 = severe negative impact; 10 = no negative impact	18,20
Subjective	Functional assessment of cancer therapy-head and neck (FACT-H&N) questionnaire	1997	Patient	38-Item survey on QOL, 11 of these questions are specific to H&N cancer	QOL score based on the sum of question scores, each rated 0–4 on a Likert scale	18,21
Subjective	Oral Impacts on Daily Performance (OIDP)	1997	Patient	8 Items (eating and enjoying food; speaking and pronouncing; cleaning teeth; sleeping and relaxing; smiling; laughing and showing teeth without embarrassment; maintaining one’s usual emotional state; carrying out one’s major work or social role and enjoying contact with people)	Likert scale for each question, that is summed to a score for each of the 8 categories	22,23
Subjective	Oral Health Impact Profile (OHIP): long form (OHIP49) and short form (OHIP14)	1994, 1997	Patient	49-Item or 14-item (short version) survey, in 7 domains (functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap)	Questions are scored on a 5-point Likert scale and then added to a normalized score	23–25
Subjective	University of Washington Quality of Life questionnaire (UWQoL)	1993–2010	Patient	The questionnaire covers 12 domainsdpain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function, taste, saliva, mood, and anxiety	Questions are scaled from 0 (worst) to 100 (best), and 3 global questions are on a Likert scale (0–5 or 0–6)	26,27
Subjective	Fox’s simple questionnaire (FOX)	1987	Patient	4 Simple questions concerning the patient’s perceptions of oral dryness, oral functions and comfort, and side effects		28
Subjective	Radiation Therapy Oncology Group (RTOG) scoring	1995	Clinician	Evaluating acute xerostomia, based on dryness of mouth and saliva thickness	From 0 (no xerostomia) to 4 (acute salivary gland necrosis)	29
Subjective	RTOG- European Organization for Research and Treatment of Cancer (EORTC) scoring	1995	Clinician	Evaluating late xerostomia, based on mouth dryness evaluation and response to stimulation	From 0 (no xerostomia) to 4 (fibrosis)	29
Subjective	Clinician rating of xerostomia	N/A	Clinician	Based on discussion with patient and/or above questionnaires	0 = no dryness to 3 = nonfunctional salivary	N/A
Objective	Quantitative salivary gland scintigraphy	2000	Clinician	Sequential imaging of the H&N region with a gamma camera after intravenous injection of the radioactive isotope 99mTc-pertechnetate and stimulation of the glands with citric acid	Two measures: maximum tracer uptake within the gland and excretion rate of tracer after stimulation	7,30
Objective	Sialometry: unstimulated whole salivary flow rate (uWSFR)	N/A	Clinician	For 5 min, patient is expectorating periodically into a measuring container	<0.1 mL/min = xerostomia	31
Objective	Sialometry: stimulated salivary flow rate (sSFR)	N/A	Clinician	Patient is chewing paraffin for 5 min, expectorating periodically into a measuring container	<0.7 mL/min = at risk; >1 mL/ min = normal	10
Objective	Clinician rating	N/A	Clinician	Based on uWSFR and sSFR	Grade I (mild), II (moderate), III (severe)	N/A
Objective	Common Terminology Criteria for Adverse Events (CTCAE) v.3.0. scoring	2003	Clinician	Based on a combination of symptomatic evaluation and uWSFR evaluation	Grade 0 (no xerostomia) to 3 (inability to aliment orally, uWSFR < 0.1 mL/min)	29

These various scales and questionnaires can be used to assess a patient’s xerostomia level and they have also been used to evaluate treatment effectiveness in several clinical trials. This list is not exhaustive.

N/A, not available.