Baumann I, Kurpiers B, Plinkert P K, Praetorius M
Universitäts-HNO-Klinik, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
HNO. 2009 Sep;57(9):889-95. doi: 10.1007/s00106-008-1870-3.
Clinical experience has shown that chronic otitis media (COM) affects health-related quality of life (HR-QOL) of the patients. Nevertheless, up to now no validated measurement instrument encompassing all the relevant dimensions of HR-QOL is available.
In phase 1 the development of the Chonic Otitis Media Outcome Test (COMOT) was conducted. A group of experts identified 31 HR-QOL concepts as being relative for COM which was reduced to 15 items (COMOT-15) by sequential statistical analysis on the basis of data from 50 consecutive COM patients. In addition to the overall score (GS), three sub-scores (ear symptoms, OS; hearing function, HF; and mental being, PB) were introduced. In phase 2 validation was performed by calculating reliability, validity, and responsiveness with the data of 121 prospectively evaluated patients.
COMOT-15 showed an excellent reliability with high internal consistency (Cronbach's alpha from 0.89 to 0.91) and high retest reliability coefficients (all r>0.8). Content validity was determined by a study of the literature. COMOT-15 can distinguish COM patients from healthy subjects. Global assessment of impairment of HR-QOL by COM correlated very well with the scores of COMOT-15. However, the responsiveness of the COMOT-15 questionnaire was low.
COMOT-15 is a reliable, valid and sensitive instrument for measurement of HR-QOL of COM patients. The results obtained with the questionnaire can be interpreted very well by the investigator. COMOT-15 should be used in otological outcomes research.
临床经验表明,慢性中耳炎(COM)会影响患者的健康相关生活质量(HR-QOL)。然而,到目前为止,尚无一种经过验证的测量工具能够涵盖HR-QOL的所有相关维度。
在第1阶段,开展了慢性中耳炎结果测试(COMOT)的开发工作。一组专家确定了31个与COM相关的HR-QOL概念,基于50例连续COM患者的数据,通过序贯统计分析将其缩减为15项(COMOT-15)。除总分(GS)外,还引入了三个子分数(耳部症状,OS;听力功能,HF;以及心理状态,PB)。在第2阶段,通过对121例前瞻性评估患者的数据计算信度、效度和反应度来进行验证。
COMOT-15显示出极佳的信度,具有高内部一致性(Cronbach's α系数从0.89至0.91)和高重测信度系数(所有r>0.8)。内容效度通过文献研究确定。COMOT-15能够区分COM患者与健康受试者。COM对HR-QOL损害的整体评估与COMOT-15的分数高度相关。然而,COMOT-15问卷的反应度较低。
COMOT-15是一种可靠、有效且敏感的测量COM患者HR-QOL的工具。研究者能够很好地解释通过该问卷获得的结果。COMOT-15应用于耳科结局研究。