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

Abstract

Objectives To translate and validate the Zurich Chronic Middle Ear Inventory (ZCMEI‐21) for the English language in order to provide an English instrument to assess health‐related quality of life in chronic otitis media (COM). Design Pilot translation study including cognitive debriefings, prospective multicentre cross‐sectional psychometric validation study. Setting Four tertiary referral centres in three different English‐speaking countries (UK, USA and Australia). Participants Adult patients suffering from COM. Main outcome measures The English translation of the ZCMEI‐21 (ZCMEI‐21‐E) and the five‐level version of the EQ‐5D questionnaire. The EQ‐5D, which constitutes a generic measure of health‐related quality of life, consists of a descriptive system score and a visual analogue scale. Statistical outcomes included single‐item descriptive statistics, internal consistency (Cronbach's α) as an indicator of reliability, as well as construct validity. Results A total of 124 patients suffering from COM were included. The mean age was 50.1 years (SD 16.9 years), and 72 (58.1%) were males. The Cronbach's α of the ZCMEI‐21‐E was 0.91, suggesting an excellent internal consistency. The Spearman's correlation coefficient of the ZCMEI‐21‐E total score was 0.55 (P < 0.0001) for convergent construct validity with EQ‐5D descriptive system score and 0.57 (P < 0.0001) with the EQ‐5D visual analogue scale. Conclusions The ZCMEI‐21‐E is a new validated questionnaire that provides clinicians with a short, comprehensive and reliable instrument to quantify health‐related quality of life in patients suffering from COM. The ZCMEI‐21‐E may be of use in clinical routine as well as in outcome research and monitoring.

Mastoid cavity obliteration leads to a clinically significant improvement in health-related quality of life

“…The ZCMEI-21 was used to assess HRQoL [15]. The ZCMEI-21 as a disease-specific questionnaire for chronic middle ear disease has been translated in several languages [21,22,30] and is used in clinical settings for research and clinical practice [11,15]. The ZCMEI-21 consists of four subscales concerning ear signs and symptoms, hearing function, psychosocial impact, and the use of medical resources.…”

“…However, disadvantages of the GBI include the exclusively retrospective application, and therefore, changes in HRQoL cannot be reported reliably. In contrast, the Zurich Chronic Middle Ear Inventory-21 (ZCMEI-21) was designed as a disease-specific instrument assessing disease-specific symptoms and their impact on quality of life in chronic otitis media (COM) [11,15,[21][22][23]. The responsiveness to change of the ZCMEI-21 has been recently investigated, thus increasing its clinical utility and facilitating comparisons among different surgical interventions [24].…”

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

“…In this study, the MCID was ascertained in the German version of the ZCMEI-21. Nonetheless, since the ZCMEI-21 was validated in other languages using robust and wellestablished methods [10,12,20], 5 points can be considered to be an appropriate estimate for the MCID of the translated versions of the ZCMEI-21. However, the MCID should ideally be specifically established for each translation.…”

“…The Zurich Chronic Middle Ear Inventory (ZCMEI-21) is a questionnaire available in several languages and assesses specific symptoms and their impact on quality of life in chronic otitis media (COM) [1,[10][11][12][13][14]. The ZCMEI-21 was designed as a disease-specific instrument to assess healthrelated quality of life in patients suffering from COM [1].…”

The evaluation of canal wall up cholesteatoma surgery with the Glasgow Benefit Inventory

“…The measurements of cholesteatoma surgical outcomes are, in general, presented in terms of the disease control rate and hearing results, but reports of, and the interest for, health-related quality of life (HRQoL) assessments are increasing [4]. Amongst HRQoL assessments with the inclusion of cholesteatomas, various questionnaires have been used, such as the chronic ear survey (CES) [5][6][7], the five-item quality of life survey (COM-5) [8], the Chronic Otitis Media Questionnaire 12 (COMQ-12) [9], the Korean version of the chronic ear survey (K-CES) [10], and the Zurich Chronic Middle Ear Inventory (ZCMEI-21E) [11]. The Glasgow Benefit Inventory (GBI) is a questionnaire designed for post-interventional HRQoL changes in otorhinolaryngological (ORL) procedures.…”