Aktueller Stand der Lebensqualitätsmessung bei Patienten mit chronischer Otitis media und Schallleitungsschwerhörigkeit

Abstract

The evaluation of results after middle ear reconstruction has been mainly based on functional parameters. In clinical practice as well as in otological research, the pure tone audiogram represents the gold standard in the assessment of the postoperative outcome. In order to assess the patient's subjective outcome, outcome analyzes focus increasingly on the health-related quality of life (HRQOL). However, the evaluation of HRQOL requires reliable and validated measuring instruments. A modest number of validated questionnaires for determination of the disease-specific HRQOL in patients with chronic otitis media and/or conductive hearing loss are currently available. Three of seven available questionnaires were developed and validated in the German-speaking countries, the Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Stapesplasty Outcome Test 25 (SPOT-25). In this review, all seven available disease-specific measuring instruments as well as the generic questionnaires, which were used in previous clinical trials, are explained and current findings of quality-of-life research in patients with chronic otitis media and/or conductive hearing loss are presented.

English translation and validation of the Zurich chronic middle ear inventory (ZCMEI‐21‐E) assessing quality of life in chronic otitis media: A prospective international multicentre study

“…Similar results have been previously obtained in a Turkish cohort . Yet, the latter results should be interpreted with care as the questionnaire used in this study was a translated version of the German Chronic Otitis Media Outcome Test (COMOT‐15), which has never been validated for the Turkish language . The finding of worse HRQoL in bilateral COM may warrant further investigation beyond our current study.…”

“…As generic questionnaires have been deemed unsuitable for reliable detection of various aspects of HRQoL in COM, disease‐specific questionnaires have been developed for several languages (reviewed in Ref. and ).…”

Establishing the minimal clinically important difference (MCID) of the Zurich Chronic Middle Ear Inventory (ZCMEI-21) in patients treated for chronic middle ear disease

“…Interestingly, the mean ZCMEI-21 total score change increased in 5-point steps as a moderate change was associated with a ZCMEI-21 total score change around 10 and a large change with a ZCMEI-21 total score change around 15. This is the first study evaluating the MCID for a questionnaire measuring HRQoL in COM [19]. This sets the ZCMEI-21 apart from other questionnaires measuring HRQoL in COM as the results can now be interpreted with regard to their clinical meaningfulness and treatment modalities.…”

Qualität in der Mittelohrchirurgie – eine kritische Standortbestimmung

“…Die Zahl an Lebensqualitätsmessinstrumenten, mit denen die Beeinträchtigung von Erkrankten und der Therapieerfolg von behandelten Ohrpatienten gemessen werden kann, ist beachtlich und weiter steigend [131]. Auch wenn die Fülle der beschriebenen Bewertungsinstrumente auf den ersten Blick unnötig erscheint, so ist sie für eine differenzierte Beurteilung dennoch erforderlich.…”

“…Auch wenn die Fülle der beschriebenen Bewertungsinstrumente auf den ersten Blick unnötig erscheint, so ist sie für eine differenzierte Beurteilung dennoch erforderlich. In der Vergangenheit wurden häufig selbsterstellte Fragelisten für Patienten und Symptomdokumentationslisten als Ergänzung zu objektiven oder funktionellen Parametern herangezogen [131][132][133][134][135]. Die Bemühungen, mit diesen Listen eben solche Faktoren zu erfassen und messbar zu machen, die sich nicht in ABG oder prozentualen Heilungsraten abbilden lassen, sind nachvollziehbar und korrekt.…”