Nakshatra Shetty, Arun Ghoshal, Adarsh Kudva, Ananth Pai, Ravindranathan Vineetha, Sudeendra Prabhu, Anuja Damani, Krithika S Rao, Abhinav Mishra, S Gayatri, Kunal Das, Naveen Salins
The manual was considered relevant, practical and appropriate. Clinical piloting remains a necessary next step before formal implementation recommendations can be made.
INTRODUCTION: Chemotherapy-related oral complications (CROC), such as oral mucositis (OM), xerostomia and candidiasis, affect 40%-80% of patients with cancer in India, compromising quality of life (QOL) and treatment outcomes. Standardised, evidence-based, supportive dentistry intervention manuals (SDIM) tailored to local contexts remain limited. This study aims to develop and evaluate the content validity, clinical relevance, clarity and usability of a SDIM for managing CROC in patients with cancer receiving chemotherapy (CT), as assessed by expert dental clinicians.
METHODS: The manual was developed through a comprehensive review of literature, clinical guidelines and oncology oral care resources, followed by contextual adaptation. It was structured into four domains: (1) basic oral care, (2) soft tissue-related complications, (3) oral infections and (4) hard tissue complications. Content validation was conducted using a content validity index (CVI)-based approach informed by Lawshe's framework, complemented by qualitative expert feedback to refine and validate the structured SDIM. Ten purposively selected senior dental experts (at least 5 years of experience) from the Department of Oral Medicine and Radiology evaluated the manual using a 4-point Likert scale for relevance, clarity, simplicity and necessity.
RESULT: Experts found the manual clinically useful and relevant for managing common CROC, particularly xerostomia, OM and candidiasis. Feedback highlighted the need to simplify for multidisciplinary use, improve structuring for quick reference, and include context-specific, feasible interventions. Suggestions also included reducing dense text and standardising tables and flowcharts for better usability.
CONCLUSION: The manual was considered relevant, practical and appropriate. Clinical piloting remains a necessary next step before formal implementation recommendations can be made.