Slovenian Cross-Cultural Adaptation and Validation of Health-Related Quality of Life Measures for Chronic Otitis Media (COMQ-12), Vertigo (DHI, NVI) and TINNITUS (THI)

Domen Vozel, Nejc Steiner, Nina Božanić Urbančič, Dejan Mladenov, Saba Battelino, Domen Vozel, Nejc Steiner, Nina Božanić Urbančič, Dejan Mladenov, Saba Battelino

Abstract

Purpose: To provide physicians and patients with the tools needed to evaluate patients' problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI).

Materials and methods: COMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire.

Results: Test-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p>0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden's index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively.

Conclusion: Slovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.

Keywords: dizziness; otitis media; quality of life; surveys and questionnaires; tinnitus; vertigo.

Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that no conflicts of interest exist.

© 2020 Domen Vozel et al., published by Sciendo.

Figures

Figure 1
Figure 1
COMQ-12 ROC curve. Commentary: The area under the ROC curve (0.987) signifies outstanding diagnostic accuracy. A threshold score of 7 was determined to distinguish between chronic otitis media and a healthy ear. The ROC curve was created by plotting PCOMQ-12 and CTCOMQ-12.
Figure 2
Figure 2
DHI ROC curve. Commentary: The area under the ROC curve (0.999) signifies outstanding diagnostic accuracy. A threshold score of 9 was determined for the recognition of vertigo. The ROC curve was created by plotting PTDHI and CDHI.
Figure 3
Figure 3
NVI ROC curve. Commentary: The area under the ROC curve (0.781) signifies acceptable diagnostic accuracy. A threshold score of 56 was determined for the recognition of vertigo. The ROC curve was created by plotting PTNVI and CNVI.
Figure 4
Figure 4
THI ROC curve. Commentary: The area under the ROC curve (1.000) signifies perfect diagnostic accuracy. A threshold score of 7 was determined for the recognition of tinnitus. The ROC curve was created by plotting PTHI and CTTHI.

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