Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):703-711. doi: 10.1007/s00405-021-06702-y. Epub 2021 Mar 31.
Evaluating the current health state in chronic otitis media (COM), audiologic results are complemented by subjective outcomes, such as health-related quality of life (HRQoL). Two disease-specific instruments assessing HRQoL in COM in German-speaking patients exist, i.e., the chronic otitis media outcome test (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). Since the psychometric properties of these questionnaires in a concurrent application are unknown, the aim of this study was to compare the COMOT-15 and the ZCMEI-21.
HRQoL was assessed in adult COM patients using the COMOT-15 and the ZCMEI-21. Psychometric properties were determined, including response distribution, concurrent validity, internal consistency, correlation to hearing and gender differences.
In 173 patients (mean age 51.5 years), both questionnaires showed normally distributed scores without strong floor and ceiling effects. The total scores and subscores of both questionnaires exhibited satisfactory internal consistency (Cronbach's α 0.7-0.9) with the exception of the COMOT-15 hearing subscore (α = 0.94) and the ZCMEI-21 medical resource subscore (α = 0.66). Fair correlations between the air conduction pure-tone average and the total scores were found (COMOT-15: r = 0.36, p < 0.0001; ZCMEI-21: r = 0.34, p < 0.0001).
In the first study comparing the COMOT-15 and the ZCMEI-21, both questionnaires exhibited satisfactory psychometric properties with several subtle differences. The COMOT-15 has a strong focus on hearing with a probably redundant content of the hearing subscore and may be suited for hearing-focused research questions. The ZCMEI-21 provides a comprehensive assessment of the COM symptom complex and may therefore also be used in research settings, where ear discharge, vertigo or pain should be covered.
评估慢性中耳炎（COM）的当前健康状况，听力结果由健康相关生活质量（HRQoL）等主观结果补充。在德语患者中，有两种用于评估 COM 中 HRQoL 的疾病特异性工具，即慢性中耳炎结局测试（COMOT-15）和苏黎世慢性中耳量表（ZCMEI-21）。由于这些问卷在同时应用中的心理测量特性尚不清楚，因此本研究旨在比较 COMOT-15 和 ZCMEI-21。
使用 COMOT-15 和 ZCMEI-21 评估成人 COM 患者的 HRQoL。确定心理测量特性，包括反应分布、并行效度、内部一致性、与听力的相关性和性别差异。
在 173 名患者（平均年龄 51.5 岁）中，两个问卷的得分均呈正态分布，无明显地板效应和天花板效应。除 COMOT-15 听力分量表（α=0.94）和 ZCMEI-21 医疗资源分量表（α=0.66）外，两个问卷的总分和分量表均具有令人满意的内部一致性（Cronbach's α 0.7-0.9）。气导纯音平均听阈与总分之间存在良好的相关性（COMOT-15：r=0.36，p<0.0001；ZCMEI-21：r=0.34，p<0.0001）。
在首次比较 COMOT-15 和 ZCMEI-21 的研究中，两个问卷均具有令人满意的心理测量特性，但存在一些细微差异。COMOT-15 对听力有强烈的关注，其听力分量表的内容可能有些冗余，因此可能更适合关注听力的研究问题。ZCMEI-21 全面评估了 COM 症状的复杂性，因此也可用于需要涵盖耳溢液、眩晕或疼痛等问题的研究环境。
