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

doi:10.2478/sjph-2020-0016

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)

Zdr Varst. 2020 Jun 25;59(3):120-127. doi: 10.2478/sjph-2020-0016. eCollection 2020 Sep.

Authors

Domen Vozel^{1

2}, Nejc Steiner¹, Nina Božanić Urbančič^{1

2}, Dejan Mladenov³, Saba Battelino^{1

2}

Affiliations

¹ University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000 Ljubljana, Slovenia.
² University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000 Ljubljana, Slovenia.
³ Železniški zdravstveni dom Ljubljana, Celovška cesta 4, 1000 Ljubljana, Slovenia.

Abstract
in English, Slovenian

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.

Namen: Orodja za oceno težav bolnikov s kroničnimi vnetji srednjega ušesa, težav z ravnotežjem in tinitusom ter vpliv slednjih na kakovost življenja v slovenščini ne obstajajo. S projektom smo jih želeli zagotoviti zdravnikom in bolnikom s temi težavami. Vrzel bi zapolnili z medkulturno prilagoditvijo in potrditvijo vprašalnika o kroničnem vnetju srednjega ušesa (COMQ-12), vrtoglavici (DHI), nevropsiholoških vplivih vrtoglavice (NVI) in o obremenjenosti zaradi tinitusa (THI).

Metode: Vprašalniki so bili prevedeni iz angleščine v slovenščino skladno s priporočili. COMQ-12 so izpolnili bolniki s kroničnim vnetjem srednjega ušesa, DHI in NVI z vrtoglavico in THI s tinitusom. Kontrolno skupino za vsak vprašalnik so sestavljali zdravi prostovoljci. Vsakemu vprašalniku je bila določena stopnja notranje skladnosti, zanesljivost pri ponovnem testiranju, diskriminantna validnost, diagnostična natančnost in mejna vrednost.

Rezultati: Zanesljivost pri ponovnem testiranju je bila odlična za DHI (ICCA = 0,946) in NVI (p = 0,315, ICCA = 0,975), dobra do odlična za COMQ-12 (p = 0,680, ICCA = 0,858) in zadovoljiva za THI (p = 0,120). Diskriminantna validnost je bila potrjena (p > 0,05) za vsak vprašalnik bodisi z uporabo testa Mann-Whitney U (COMQ-12, DHI, THI) bodisi z Welchovim t-testom (NVI). COMQ-12 je imel sprejemljivo (α = 796), DHI (α = 0,910), NVI (α = 0,950) in THI (α = 0,924) pa popolno notranjo skladnost. COMQ-12 in DHI sta imela odlično (0,987 in 0,999), NVI sprejemljivo (0,781) in THI popolno (1,000) diagnostično natančnost glede na vrednost površine pod krivuljo ROC. Mejne vrednosti so bile določene objektivno z Youdonovim indeksom (J) in so znašale 7 za COMQ-12 (J = 0,90) in THI (J = 1,00), 9 za DHI (J = 0,95) in 56 za NVI (J = 0,43).

Zaključek: Slovenske različice vprašalnikov COMQ-12, DHI, NVI in THI so medkulturno prilagojene, potrjene in uporabne kot pomembna merila za oceno z zdravjem povezane kakovosti življenja. Hkrati so tudi natančen diagnostični pripomoček pri bolnikih s kroničnim vnetjem srednjega ušesa, vrtoglavico ali tinitusom, ki bo v pomoč zdravnikom specialistom družinske medicine, specialistom medicine dela, prometa in športa, nevrologom ter otorinolaringologom.

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

Abstract in English, Slovenian

Abstract
in English, Slovenian