Knoke Michael, Neudert Marcus, Zahnert Thomas, Lailach Susen
Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland.
HNO. 2023 Sep;71(9):572-582. doi: 10.1007/s00106-023-01334-6. Epub 2023 Aug 4.
With the Chronic Ear Survey (CES), a validated measurement instrument for the assessment of disease-specific health-related quality of life (HRQoL) has been available internationally since 2000. The aim of this study was to provide a validated German version of this international instrument and to compare it with the German Chronic Otitis Media Outcome Test 15 (COMOT-15).
The CES was translated into German via a forward-backward translation process. For validation, 79 patients with COM undergoing middle ear surgery were prospectively included. HRQoL was determined preoperatively and 6 months postoperatively using the CES and the COMOT-15. Pure tone audiometry was also performed at both measurement time points. In the control examination, an additional retrospective assessment of the preoperative situation was additionally performed using the CES and the COMOT-15 to assess the response shift. The determined psychometric characteristics were internal consistency, test-retest reliability, discrimination validity, agreement validity, responsiveness, and response shift for both measurement instruments. Convergent validity of both measurement instruments was assessed using linear regression.
On the basis of the CES, patients with COM could be reliably distinguished from patients with healthy ears. The CES showed satisfactory reliability with high internal consistency (Cronbach α 0.65-0.85) and high retest reliability (r > 0.8). The global assessment of HRQoL impairment correlated very well with the scores of the CES (r = 0.51). In addition, it showed a high sensitivity to change (standardized response mean -0.86). Compared to the COMOT-15, it showed a lower response shift (effect size -0.17 vs. 0.44). Both measurement instruments correlated only slightly with air conduction hearing threshold (r = 0.29 and r = 0.24, respectively). The concordant validity of both measurement instruments was high (r = 0.68).
The German version of the CES shows satisfactory psychometric characteristics, so that its use can be recommended. The CES focuses on the influence of ear symptoms on HRQoL, whereas the COMOT-15 also includes functional and psychological aspects. Due to only minor response shift effects, the CES is particularly suitable for studies with multiple repeat measurements.
自2000年以来，慢性耳病调查（CES）作为一种经过验证的测量工具，可在国际上用于评估特定疾病的健康相关生活质量（HRQoL）。本研究的目的是提供该国际工具的德语验证版本，并将其与德国慢性中耳炎结果测试15（COMOT - 15）进行比较。
通过正向 - 反向翻译过程将CES翻译成德语。为进行验证，前瞻性纳入了79例接受中耳手术的慢性中耳炎（COM）患者。在术前和术后6个月使用CES和COMOT - 15测定HRQoL。在两个测量时间点均进行纯音听力测定。在对照检查中，还使用CES和COMOT - 15对术前情况进行了额外的回顾性评估，以评估反应转移。所确定的心理测量学特征包括两种测量工具的内部一致性、重测信度、区分效度、一致性效度、反应性和反应转移。使用线性回归评估两种测量工具的收敛效度。
基于CES，可可靠地区分COM患者和健康耳朵患者。CES显示出令人满意的信度，具有高内部一致性（Cronbach α 0.65 - 0.85）和高重测信度（r＞0.8）。HRQoL损害的总体评估与CES得分高度相关（r = 0.51）。此外，它对变化具有高敏感性（标准化反应均值 - 0.86）。与COMOT - 15相比，它显示出较低的反应转移（效应大小 - 0.17对0.44）。两种测量工具与气导听力阈值的相关性均较弱（分别为r = 0.29和r = 0.24）。两种测量工具的一致性效度较高（r = 0.68）。
CES的德语版本显示出令人满意的心理测量学特征，因此推荐使用。CES侧重于耳部症状对HRQoL的影响，而COMOT - 15还包括功能和心理方面。由于反应转移效应较小，CES特别适用于多次重复测量的研究。
