Cochlear Implant Quality of Life (CIQOL): Development of a Profile Instrument (CIQOL-35 Profile) and a Global Measure (CIQOL-10 Global)

Abstract

Purpose: Valid, reliable, and efficient patient-reported outcome measures are needed to quantify quality of life (QOL) outcomes after cochlear implantation to supplement information obtained from performance-based outcomes. We previously developed the Cochlear Implant Quality of Life (CIQOL) item bank to serve as the source of items for subsequent instruments. This study reports the development and psychometric properties for 2 of these new instruments, the CIQOL-35 Profile and the CIQOL-10 Global. Method: Cochlear implant (CI) users referred from the CIQOL Development Consortium (n = 371), consisting of 20 CI centers across the United States, provided responses to the 81-item CIQOL item bank, which are grouped into 6 QOL domains (communication, emotional, entertainment, environment, listening effort, and social). Responses to the 81 CIQOL items were analyzed using item response theory to determine individual item difficulty, discrimination, and model fit to select the set of items for the profile instrument and global measure that would optimize their measurement characteristics. Results: The 35-item CIQOL-35 Profile instrument assesses outcomes represented in the 6 domains of the CIQOL final item pool. The 10-item CIQOL-10 Global measure produces a single, overall QOL score. After ensuring the upper and lower ends of the item difficulty continuum were represented (item difficulty range: −2.48 to 2.47), the items with the highest discrimination ability for each domain were selected for the CIQOL-35 Profile instrument (discrimination range: 0.67-1.37). Items were selected for the CIQOL-10 Global measure in a similar manner. Conclusion: The CIQOL-35 Profile and CIQOL-10 Global instruments provide psychometrically sound and efficient measures that can be used to assess QOL in adult CI users in both clinical and research settings.

Improvements in Hearing and in Quality of Life after Sequential Bilateral Cochlear Implantation in a Consecutive Sample of Adult Patients with Severe-to-Profound Hearing Loss

“…Generic QoL instruments typically underestimate the impact of BICI. Meta-analysis with hearing or CI-specific QoL instruments shows large improvements in patients with BICI and medium improvements when comparing bilateral to unilateral CI [33]. Our results are in agreement with these findings.…”

The Impact of Cochlear Implantation: Cognitive Function, Quality of Life, and Frailty in Older Adults

“…61 More recently, McRackan et al have developed the Cochlear Implant Quality of Life (CiQOL) instruments to analyze six domains influenced by cochlear implantation (communication, emotional, entertainment, environment, listening effort, and social). 62 63 Ultimately, studies using CiQOL pre- and postoperatively may be able to characterize the impact of cochlear implantation on these specific aspects of a patient's life. Other disease-specific scales include the Glasgow Benefit Inventory (to measure the impact of an otolaryngologic intervention), Hearing Handicap Inventory for Adults/Elderly (HHIE), and Speech Spatial and Qualities of Hearing Scale (SSQ).…”

Mythbusters! The Truth about Common Misconceptions in Cochlear Implantation

“…68 The areas impacted by CI include communication, listen effort, independence, emotional well-being, ability to participate in entertainment activities, social interactions, and environmental awareness. 69 The recent validation of a patient-reported outcome measure questionnaire, the CIQOL-35, will expand our understanding further of the impact of CI on patients' experienced quality of life with these devices. 70 There is also significant improvements in QOL for patients with bilateral CIs beyond speech recognition, as bilateral users have improved task performance for binaural squelch, the head shadow effect, and summation.…”