Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss

Objective: Self-reports of ‘hearing handicap’ are available, but a comprehensive measure of health-related quality of life (HRQOL) for individuals with adult-onset hearing loss (AOHL) does not exist. Our objective was to develop and evaluate a multidimensional HRQOL instrument for individuals with AOHL. Design: The Impact of Hearing Loss Inventory Tool (IHEAR-IT) was developed using results of focus groups, a literature review, advisory expert panel input, and cognitive interviews. Study sample: The 73-item field-test instrument was completed by 409 adults (22–91 years old) with varying degrees of AOHL and from different areas of the USA. Results: Multitrait scaling analysis supported four multi-item scales and five individual items. Internal consistency reliabilities ranged from 0.93 to 0.96 for the scales. Construct validity was supported by correlations between the IHEAR-IT scales and scores on the 36-item Short Form Health Survey, version 2.0 (SF-36v2) mental composite summary (r?=?0.32–0.64) and the Hearing Handicap Inventory for the Elderly/Adults (HHIE/HHIA) (r?≥??0.70). Conclusions: The field test provides initial support for the reliability and construct validity of the IHEAR-IT for evaluating HRQOL of individuals with AOHL. Further research is needed to evaluate the responsiveness to change of the IHEAR-IT scales and identify items for a short-form.     

The bone-anchored hearing aid: quality-of-life assessment

OBJECTIVES: To assess the impact of a bone-anchored hearing aid (BAHA) on the quality of life (QOL) of adults and to test the hypothesis that a BAHA improves QOL because otorrhea and/or skin irritations decrease. DESIGN: Prospective postal-based questionnaire study using validated health-related QOL instruments, combined with hearing-aid-related questions. PATIENTS AND METHODS: The study included 56 consecutive adult patients with acquired conductive or mixed hearing loss who were scheduled for BAHA implantation at the University Medical Centre Nijmegen, Nijmegen, the Netherlands. All 56 patients completed the 36-Item Short-Form Health Survey (SF-36), the EuroQol-5D (EQ-5D), and the Hearing Handicap and Disability Inventory (HHDI); 36 patients had been using an air-conduction hearing aid (ACHA) and 20 patients a conventional bone-conduction hearing aid (CBHA). Questionnaires were filled out before surgery and after 6 months of experience with the BAHA. RESULTS: In the SF-36 group, there was significant improvement in the scores of the mental health domain (P =.02). When the SF-36 patients were classified according to previous hearing aid, there was no statistically significant change in the scores in any of the domains. In the EQ-5D group and in its ACHA and CBHA subgroups, there were no important differences in the results before and after the patients received their BAHAs. In the HHDI group, the handicap and disability scales showed significant improvement (P<.01) irrespective of the type of previously worn hearing aid. CONCLUSIONS: Overall, generic health-related QOL was not influenced significantly by the use of a BAHA according to the SF-36 and the EQ-5D. The more disease-specific scales (HHDI) did show improved QOL with a BAHA.     

Validation of a French translation of the speech,spatial, and qualities of hearing scale (SSQ) and comparison with other language versions

Objective: To validate a French version of the speech, spatial, and qualities of hearing scale (SSQ), a subjective evaluation of patients’ hearing disability, and to assess SSQ reproducibility across different language versions. Design: The SSQ was translated in accordance with the principles of the ‘Universalist approach’ of cross-cultural adaptation of patient-reported outcome instruments. Scores from a normal-hearing and a hearing-impaired population were compiled and compared, whenever possible, with data from the literature, collected using other language versions. Study sample: One hundred normal-hearing subjects and 230 hearing-impaired subjects. Results: Good reproducibility of scores and inter-subject variability were obtained between several language versions, even if scores found using the French version were slightly lower than those obtained using Dutch or English versions. A comparison of factor analysis outcomes between the English and French versions confirmed good conceptual equivalence across languages and robustness of the SSQ for use in international settings. The three main subscales (speech, spatial, and qualities) confirmed their usefulness in assessing different aspects of hearing disability. Conclusion: This study validated a French-language version of the SSQ, and assessed the reproducibility of the SSQ across subject groups, administration modes, and different countries/languages, confirming its potential as an international standard for hearing disability evaluation.     

Hearing impairment and health-related quality of life: the Blue Mountains Hearing Study

OBJECTIVES: To assess the association between hearing impairment and health-related quality of life (HRQOL) in an older population, using the self-administered 36-item Short-Form Health Survey (SF-36). DESIGN: Participants of the Blue Mountains Hearing Study (BMHS, N = 2956) attended a comprehensive interview and hearing examination in which both self-reported and measured hearing impairments were assessed. Hearing impairment was defined as the pure-tone average of air-conduction hearing thresholds >25 decibels hearing level (dB HL) for the four frequencies (0.5 to 4.0 kHz) in the better ear. RESULTS: Of the 2431 participants with complete data (mean age, 67.0 yr), 1347 (55.4%) did not have measured hearing loss, whereas 324 (13.3%) had unilateral (285 mild, 22 moderate, 17 severe) and 760 (31.3%) had bilateral hearing impairment (478 mild, 207 moderate, 75 severe). After adjusting for demographic and medical confounders, bilateral hearing impairment was associated with poorer SF-36 scores in both physical and mental domains (fall in physical component score, PCS of 1.4 points, p = 0.025; fall in mental component score, MCS of 1.0 point, p = 0.13), with poorer scores associated with more severe levels of impairment (PCS p(trend) = 0.04, MCS p(trend) = 0.003). Participants with bilateral hearing impairment who habitually used hearing aids had a slightly better PCS (mean, 43.1; standard error [SE], 0.9) than those with the same impairment who did not have hearing aids or who only used them occasionally (mean, 41.2; SE 0.5), although this finding was not statistically significant (p = 0.055). Persons with self-reported hearing loss had significantly poorer HRQOL than corresponding persons without, but persons with unilateral or high-frequency hearing loss did not have significantly different HRQOL scores than their corresponding counterparts. CONCLUSIONS: This study quantifies the associated disease burden of age-related hearing impairment on health-related quality of life in a population-based cohort of older persons.     

ORIGINAL ARTICLE: The relationship between patients’ perception of the effects of neurofibromatosis type 2 and the domains of the Short Form-36

Clin. Otolaryngol. 2010, 35 , 291–299 Objectives: To investigate the relationship between those issues concerning quality of life in patients with neurofibromatosis type 2 (NF2) as identified by the closed set NF2 questionnaire and the eight norm-based measures and the physical component summary (PCS) and mental component summary (MCS) scores of the Short Form-36 (SF-36) Questionnaire. Design: Postal questionnaire study. Setting: Questionnaires sent to subjects’ home addresses. Participants: Eighty-seven adult subjects under the care of the Manchester Multidisciplinary NF2 Clinic were invited to participate. Main outcome measures: Sixty-two (71%) completed sets of closed set NF2 questionnaires and SF-36 questionnaires were returned. Results: Subjects with NF2 scored less than the norm of 50 on both the physical component summary and mental component summary scores and the eight individual norm-based measures of the Short Form-36 questionnaire. Correlations (using Kendall’s tau) were examined between patients’ perceptions of their severity of difficulty with the following activities and the eight norm-based measures and the physical component summary and mental component summary scores of the Short Form-36 questionnaire: Communicating with spouse/significant other (N = 61). The correlation coefficients were significant at the 0.01 level for the mental component summary score, together with three of the norm-based scores [vitality (VT), social functioning and role emotional]. Social communication (N = 62). All 10 correlations were significant at the 0.01 or 0.001 level. Balance (N = 59). All 10 correlations were highly significant at the P < 0.001 level. Hearing difficulties (N = 61). All correlations were significant at either the 0.01 level or less apart from the mental component summary score and three of the norm-based scores (role physical, VT and mental health). Mood change (N = 61). All correlations were significant at the 0.01 level or less, apart from one norm-based score (role physical). Conclusions: The Short Form-36 questionnaire has allowed us to relate patients’ perceptions of their difficulties, as identified by the closed set NF2 questionnaire, to the physical and mental domains measured by this validated and widely used scale, and has provided further insight into areas of functioning affected by NF2.     

Improved quality of life in adults undergoing tonsillectomy for recurrent tonsillitis. Is adult tonsillectomy really a low priority treatment?

There is a paucity of studies on patient-reported outcome measures in adult tonsillectomy. Our aim was to add to the body of health-related quality of life (HRQOL) evidence on adult tonsillectomy at a time when this intervention is being branded a low priority treatment in the United Kingdom (UK). We designed a prospective questionnaire study that was carried out in two UK district general hospitals. 41 patients were recruited into the study and completed a pre-operative short form 36 questionnaire. All 41 were contacted at least 1?year after tonsillectomy and were asked to complete the same SF-36 questionnaire and three additional HRQOL questions. There was a significant improvement in quality of life shown by both the mean SF-36 scores and the HRQOL questions. The SF-36 summary measures and the total SF-36 scores improved significantly (p?<?0.01). The study emphasises the importance of tonsillectomy being available on the National Health Service to adults with recurrent tonsillitis. This proven quality of life improvement is also highly likely to confer a secondary health economic benefit from less GP attendances and fewer missed work days.     

Quality of life in elderly patients with dizziness: analysis of the short-form health survey in 197 patients

Conclusion Elderly patients with chronic dizziness had a poor HRQoL, which could be successfully assessed using the SF-36, a generic health-status instrument. The frequency of dizziness and comorbid psychological distress were predictive of impairment in QoL.

Objectives To evaluate health-related quality of life (HRQoL) and its relationship to characteristics of dizziness in elderly persons with chronic dizziness.

Material and methods A standardized dizziness questionnaire was used to evaluate characteristics of dizziness as well as medical, functional and demographic data in 197 consecutive patients with chronic dizziness aged≥60 years. HRQoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS).

Results Compared with normative data, results from patients with dizziness indicated a pervasive multidimensional decline in SF-36 scores. This decline was most notable in terms of role limitations in the physical and emotional dimensions. The frequency of attacks of dizziness correlated with perceived disability. Patients with chronic dizziness also had great psychological distress, as measured by the HADS score, which had a detrimental influence on their QoL.     

Quality of life after unilateral acoustic neuroma surgery via middle cranial fossa approach

Conclusions

Patients with acoustic neuroma experienced reduced quality of life (QOL) after surgery. Individual factors did not have a significant effect on QOL. In the future, QOL should be a basic factor in the outcome evaluation of different therapeutic regimens in the treatment of acoustic neuroma.

Objective

To measure the QOL of patients who underwent unilateral acoustic neuroma surgery via the middle cranial fossa approach.

Material and methods

The Short Form-36 (SF-36) Health Survey and a self-designed disease-specific questionnaire were used during follow-up examinations to assess health-related QOL. The pure-tone average was used to specify hearing ability. Facial nerve function was described using the House–Brackmann grading system. A total of 28 male and 14 female patients who underwent surgery between 1997 and 2001 were included in the study.

Results

Patients’ QOL scores revealed significant reductions in QOL in comparison to normative German QOL data. Gender, age, tumor size or location and clinical symptoms such as hearing loss and restricted facial nerve function did not have an effect on QOL. The SF-36 scales physical functioning, role functioning—physical, bodily pain, general health, social functioning and role functioning—emotional demonstrated significant QOL reductions.     

Sources of variability of speech,spatial, and qualities of hearing scale (SSQ) scores in normal-hearing and hearing-impaired populations

Objective: To identify and quantify sources of variability in scores on the speech, spatial, and qualities of hearing scale (SSQ) and its short forms among normal-hearing and hearing-impaired subjects using a French-language version of the SSQ. Design: Multi-regression analyses of SSQ scores were performed using age, gender, years of education, hearing loss, and hearing-loss asymmetry as predictors. Similar analyses were performed for each subscale (Speech, Spatial, and Qualities), for several SSQ short forms, and for differences in subscale scores. Study sample: One hundred normal-hearing subjects (NHS) and 230 hearing-impaired subjects (HIS). Results: Hearing loss in the better ear and hearing-loss asymmetry were the two main predictors of scores on the overall SSQ, the three main subscales, and the SSQ short forms. The greatest difference between the NHS and HIS was observed for the Speech subscale, and the NHS showed scores well below the maximum of 10. An age effect was observed mostly on the Speech subscale items, and the number of years of education had a significant influence on several Spatial and Qualities subscale items. Conclusion: Strong similarities between SSQ scores obtained across different populations and languages, and between SSQ and short forms, underline their potential international use.     

Quality of life,effort and disturbance perceived in noise: A comparison between employees with aided hearing impairment and normal hearing

Abstract

Objectives: The aims were to compare health-related quality of life (HRQOL) and hearing handicap between two groups of employees with normal hearing and aided hearing impairment (HI). HRQOL was also compared to a normative population. The second aim was to compare perceived effort (PE) and disturbance after completing a task in office noise between the two study groups. Design: A Swedish version of the short form-36 (SF-36) and the hearing handicap inventory for adults (HHIA) was used to determine HRQOL and hearing handicap. The Borg-CR 10 scale was used to measure PE and disturbance. Study sample: Hearing impaired (n = 20) and normally hearing (n = 20) participants. The normative sample comprised of 597 matched respondents. Results: Hearing-impaired employees report relatively good HRQOL in relation to the normative population, but significantly lower physical functioning and higher PE than their normally-hearing peers in noise. Results from the HHIA showed mild self-perceived hearing handicap. Conclusions: The current results demonstrate that physical health status can be negatively affected even at a mild-moderate severity of HI, and that a higher PE is reported from this group when performing a task in noise, despite the regular use of hearing aids.     

Hearing-aid use and long-term health outcomes: Hearing handicap,mental health,social engagement,cognitive function,physical health,and mortality

Objective: To clarify the impact of hearing aids on mental health, social engagement, cognitive function, and physical health outcomes in older adults with hearing impairment. Design: We assessed hearing handicap (hearing handicap inventory for the elderly; HHIE-S), cognition (mini mental state exam, trail making, auditory verbal learning, digit-symbol substitution, verbal fluency, incidence of cognitive impairment), physical health (SF-12 physical component, basic and instrumental activities of daily living, mortality), social engagement (hours per week spent in solitary activities), and mental health (SF-12 mental component) at baseline, five years prior to baseline, and five and 11 years after baseline. Study sample: Community-dwelling older adults with hearing impairment (N = 666) from the epidemiology of hearing loss study cohort. Results: There were no significant differences between hearing-aid users and non-users in cognitive, social engagement, or mental health outcomes at any time point. Aided HHIE-S was significantly better than unaided HHIE-S. At 11 years hearing-aid users had significantly better SF-12 physical health scores (46.2 versus 41.2; p = 0.03). There was no difference in incidence of cognitive impairment or mortality. Conclusion: There was no evidence that hearing aids promote cognitive function, mental health, or social engagement. Hearing aids may reduce hearing handicap and promote better physical health.     

European multi-centre study of the Nucleus Hybrid L24 cochlear implant

Abstract

Objectives: To investigate the preservation of residual hearing in subjects who received the Nucleus Hybrid L24 cochlear implant. To investigate the performance benefits up to one year post-implantation in terms of speech recognition, sound quality, and quality of life. Design: Prospective, with sequential enrolment and within-subject comparisons. Post-operative performance using a Freedom Hybrid sound processor was compared with that of pre-operative hearing aids. Study sample: Sixty-six adult hearing-impaired subjects with bilateral severe-to-profound high frequency hearing loss. Results: Group median increase in air-conduction thresholds in the implanted ear for test frequencies 125–1000 Hz was < 15 dB across the population; both immediately and one year post-operatively. Eighty-eight percent of subjects used the Hybrid processor at one year post-op. Sixty-five percent of subjects had significant gain in speech recognition in quiet, and 73% in noise (≥ 20 percentage points/2 dB SNR). Mean SSQ subscale scores were significantly improved (+ 1.2, + 1.3, + 1.8 points, p < 0.001), as was mean HUI3 score (+ 0.117, p < 0.01). Combining residual hearing with CI gave 22?26 %age points mean benefit in speech recognition scores over CI alone (p < 0.01). Conclusions: Useful residual hearing was conserved in 88% of subjects. Speech perception was significantly improved over preoperative hearing aids, as was sound quality and quality of life.     

Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids: comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings

Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative procedure based on optimizing speech intelligibility scores and a strictly implemented fitting formula. Hearing disability and handicap were assessed with the hearing handicap and disability inventory and benefit of hearing aids with the abbreviated profile of hearing aid benefit. Effects on health-related quality of life and depression were assessed with the EuroQol-5D questionnaire and the geriatric depression scale. We found that hearing-aid fitting according to either procedure had a significantly positive effect on disability and handicap associated with hearing loss. This effect lasted for several months. Only the effect on disability persisted after 1-year of follow-up. Self-reported benefit from hearing aids was comparable for both fitting procedures. Unaided hearing disability was more pronounced in groups of participants with greater hearing loss, while the benefit of hearing aids was independent from the degree of hearing impairment. First-time hearing aid users reported greater benefit from their hearing aids. The added value from a bilateral hearing-aid fitting was not significant. Overall health-related quality of life and incidence of depression did not alter after hearing-aid fitting.     

Homozygous M34T mutation of the GJB2 gene associates with an autosomal recessive nonsyndromic sensorineural hearing impairment in Finnish families

Conclusions. Patients with hereditary hemorrhagic telangiectasia genotype ALK-1 (HHT2-ALK-1) with nonsense mutation demonstrated tendentially higher health-related quality of life (HR-QOL) scores than patients with HHT with genotype ENG (HHT1-ENG) with missense mutation. Objective. HHT, also known as Osler-Weber-Rendu syndrome, comprises different expressions depending on genetic type and mutation type. The influence of HHT type on HR-QOL has not been established and is addressed in this paper. Patients and methods. A total of 94patients with confirmed diagnoses of HHT (Curaçao criteria) participated in this study. EDTA (ethylene diamine tetraacetic acid) blood samples of 24patients were sequenced genetically into genotype HHT1 (ENG) vs HHT2 (ALK-1) and mutation type missense vs nonsense. HR-QOL was assessed with the German Short Form 36Health Survey (SF-36). Results. HHT2 patients (genotype ALK-1) demonstrated significantly higher physical component scores than HHT1 patients (effect size d=0.62). Patients with genotype ENG (HHT1) with nonsense mutations showed significantly higher mental component scores than patients with missense mutations (effect size=0.79).     

The impact of laryngopharyngeal reflux on patient-reported quality of life

OBJECTIVES/HYPOTHESIS: The objectives were to assess patient-reported outcomes, specifically, the health-related quality of life of patients with laryngopharyngeal reflux, and to compare those reported levels with the health-related quality of life of patients with gastroesophageal reflux disease and a general population. STUDY DESIGN: Prospective study. METHODS: As part of a prospective study to validate a health-related quality of life instrument for laryngopharyngeal reflux, patient-reported data were collected before the initiation of therapy. Use of the Short Form-36 (SF-36), a generic instrument, allowed the health-related quality of life of the patients with laryngopharyngeal reflux to be compared with benchmarks existing for patients with gastroesophageal reflux disease and a general U.S. population. RESULTS: The 117 patients with laryngopharyngeal reflux often reported multiple symptoms, most frequently, chronic throat-clearing (85.5%), globus (82.1%), and hoarseness (80.3%). Their mean health-related quality of life was statistically significantly worse than that of a general U.S. population in seven of the eight SF-36 domains. The most dramatic differences between patients with laryngopharyngeal reflux and the general population were in social functioning and bodily pain (P <.001). Mean scores for patients with laryngopharyngeal reflux were significantly lower than those for patients with gastroesophageal reflux disease in social functioning (P <.001) and vitality (P =.0017). In five of the six remaining domains, patients with laryngopharyngeal reflux reported lower mean scores than did patients with gastroesophageal reflux disease, but those differences were not statistically significant. CONCLUSION: The study's assessment of health-related quality of life suggests that laryngopharyngeal reflux has a significant negative impact on the lives of patients. Although its impact is similar in some respects to that of gastroesophageal reflux disease, laryngopharyngeal reflux has a more significant impact on patients' social functioning and vitality.     

Sound localization ability of young children with bilateral cochlear implants.

OBJECTIVE: To evaluate the benefit of bilateral cochlear implantation in young children. STUDY DESIGN: Clinical trial comparing a group of bilaterally implanted children with a group of unilaterally implanted children. SETTING: Tertiary referral center. PATIENTS: Five bilaterally implanted children (mean age at testing, 3 yr 7 mo) were compared with 5 unilaterally implanted children (mean age at testing, 5 yr 3 mo). Meningitis was the cause of deafness in all of the children. METHODS: Children were asked to localize a prerecorded melody band limited from 500 to 4,000 Hz presented from loudspeakers placed at either -90 or 90 degrees or -30 or 30 degrees azimuth. Their parents filled in the Speech, Spatial and Qualities of Hearing Scale (SSQ) and PedsQL questionnaires on hearing and health-related quality of life of their children. RESULTS: The bilaterally implanted children had significantly better scores on the localization test than the children with unilateral cochlear implants. The scores of the children with bilateral cochlear implants were also significantly higher on the spatial domain of the SSQ, which concerns localization. No significant differences were found in the speech and quality of hearing domains and the total scores on the SSQ or the PedsQL between the two groups. CONCLUSION: Children with bilateral cochlear implantation already demonstrate an advantage over unilaterally implanted children at a young age.     

Quality of life in elderly patients with dizziness: analysis of the Short-Form Health Survey in 197 patients

CONCLUSION: Elderly patients with chronic dizziness had a poor HRQoL, which could be successfully assessed using the SF-36, a generic health-status instrument. The frequency of dizziness and comorbid psychological distress were predictive of impairment in QoL. OBJECTIVES: To evaluate health-related quality of life (HRQoL) and its relationship to characteristics of dizziness in elderly persons with chronic dizziness. MATERIAL AND METHODS: A standardized dizziness questionnaire was used to evaluate characteristics of dizziness as well as medical, functional and demographic data in 197 consecutive patients with chronic dizziness aged > or =60 years. HRQoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Compared with normative data, results from patients with dizziness indicated a pervasive multidimensional decline in SF-36 scores. This decline was most notable in terms of role limitations in the physical and emotional dimensions. The frequency of attacks of dizziness correlated with perceived disability. Patients with chronic dizziness also had great psychological distress, as measured by the HADS score, which had a detrimental influence on their QoL.     

Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients

Objective: To determine the impact of translabyrinthine surgery on the quality of life in vestibular schwannoma patients with rotatory vertigo. Study design: Prospective study in 18 vestibular schwannoma patients. Setting: The study was conducted in a multispecialty tertiary care clinic. Participants: All 18 patients had a unilateral intracanalicular vestibular schwannoma, without serviceable hearing in the affected ear and severely handicapped by attacks of rotatory vertigo and constant dizziness. Despite an initial conservative treatment, extensive vestibular rehabilitation exercises, translabyrinthine surgery was performed because of the disabling character of the vertigo, which considerably continued to affect the patients’ quality of life. Main outcome measures: Preoperative and postoperative quality of life using the Short Form 36 Health Survey (Short Form‐36) scores and Dizziness Handicap Inventory (DHI) scores. Results: A total of 17 patients (94%) completed the questionnaire preoperatively and 3 and 12 months postoperatively. All Short Form‐36 scales of the studied patients scored significantly lower when compared with the healthy Dutch control sample (P < 0.05). There was a significant improvement of DHI total scores and Short Form‐36 scales on physical and social functioning, role‐physical functioning, role‐emotional functioning, mental health and general health at 12 months after surgery when compared with preoperative scores (P < 0.05). Conclusions: Vestibular schwannoma patients with disabling vertigo, experience significant reduced quality of life when compared with a healthy Dutch population. Translabyrinthine tumour removal significantly improved the patients’ quality of life. Surgical treatment should be considered in patients with small‐ or medium‐sized tumours and persisting disabling vertigo resulting in a poor quality of life.     

A short form of the Speech,Spatial and Qualities of Hearing scale suitable for clinical use: The SSQ12

Abstract

Objective: To develop and evaluate a 12-item version of the Speech, Spatial and Qualities of Hearing scale for use in clinical research and rehabilitation settings, and provide a formula for converting scores between the full (SSQ49) and abbreviated (SSQ12) versions. Design: Items were selected independently at the three centres (Eriksholm Research Centre, MRC Institute of Hearing Research, University of New England) to be representative of the complete scale. A consensus was achieved after discussion. Study sample: The data set (n = 1220) used for a factor analysis (, submitted) was re-analysed to compare original SSQ scores (SSQ49) with scores on the short version (SSQ12). Results: A scatter-plot of SSQ12 scores against SSQ49 scores showed that SSQ12 score was about 0.6 of a scale point lower than the SSQ49 (0–10 scale) in the re-analysis of the Akeroyd et al data. SSQ12 scores lay on a slightly steeper slope than scores on the SSQ49. Conclusions: The SSQ12 provides similar results to SSQ49 in a large clinical research sample. The slightly lower average SSQ12 score and the slightly steeper slope reflect the composition of this short form relative to the SSQ49.     

Impact of gender on general health-related quality of life in patients with chronic sinusitis

BACKGROUND: The aim of this study was to evaluate the impact of gender on health-related quality of life (HRQOL) in patients with chronic sinusitis METHODS: A prospectively administered survey was performed. For measuring HRQOL, we used the German versions of the Short Form 36 (SF-36; eight subscales) and the European Quality of Life-5 Dimensions (EQ-5D) (two subscales). For all SF-36 subscales we used norm-based scoring of the general German population. RESULTS: One hundred twenty-three patients (45 women and 78 men) underwent HRQOL evaluation at baseline (preoperatively) and 3 months after endonasal sinus surgery. Compared with male patients, female patients scored a significantly worse baseline in all SF-36 and one EQ-5D subscales and 3 months later in only one SF-36 subscale. Compared with the norm-based scores, both women's and men's SF-36 scores reached normal levels in seven subscales after 3 months. CONCLUSION: Compared with men, women assessed preoperative HRQOL as being worse. Most women's and men's SF-36 subscales reached normal levels at the 3-month follow-up.