Evaluation of the psychometric properties of the endoscopic endonasal sinus and skull base surgery questionnaire (EES‐Q) in a prospective cohort study

Abstract

The patients' perspective on health has become increasingly important when assessing treatment outcomes. Recently, the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) was developed to determine the impact of endoscopic endonasal surgery on health-related quality of life (HRQoL). The aim of this study was to evaluate the test-retest reliability, construct validity and responsiveness of the EES-Q.Design: Prospective cohort study.Setting: University Medical Center Groningen, tertiary referral hospital, the Netherlands.Participants: One hundred patients who underwent endoscopic endonasal surgery because of sinus or anterior skull base pathology.Main outcome measures: Test-retest reliability, construct validity and responsiveness. Results:The EES-Q domains exhibited good test-retest reliability (ICC > 0.90).Construct validity was corroborated by significant positive and negative correlations between the EES-Q and the Sino-Nasal Outcome Test-22 (SNOT-22) and postoperative health status (P < 0.01) respectively. The correlation between the social EES-Q domain and the ability to move and perform usual activities (EuroQol-5D-3L[EQ-5D-3L]) was significant positive (P < 0.01). In patients with paranasal sinus pathology, the EES-Q was responsive to clinical change (Cohen's d = 0.6). Conclusion:The EES-Q is a reliable and acceptable responsive disease-specific HRQoL instrument. The expected construct validity of the EES-Q is supported by the results in this study. Inconveniences in social functioning had the greatest negative impact on postoperative health status rating. This reflects the importance of a multidimensional HRQoL assessment after EES. The results indicate that the EES-Q is a promising disease-specific tool for the HRQoL assessment after endoscopic endonasal sinus or anterior skull base surgery.

Quality‐of‐life instruments in endoscopic endonasal skull base surgery—A practical systematic review

“…Of the initial 2885 unique articles identified, a total of 7 investigations were included, 2–8 yielding 6 unique QOL instruments (Fig. 1).…”

“…The EES‐Q is a 30‐item questionnaire developed to assess QOL after endoscopic endonasal surgery 4,5 . It assesses QOL related to sinonasal morbidity as well as more general psychological and social functioning.…”

Extending the use of the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire in a cross‐sectional study: Patients with chronic rhinosinusitis versus healthy controls

“…To the best of our knowledge, there is currently no validated instrument for CRS available that fully meets all these requirements. The EES‐Q does adequately assess all three health domains, but currently, it only is validated for EES 7,8 . Therefore, this study aimed to evaluate the ability of the EES‐Q to discriminate between CRS patients and healthy individuals.…”

“…Psychometric properties of the EES‐Q were evaluated on 100 patients undergoing EES. This showed a good test–retest reliability, a significant construct validity and acceptable responsiveness 8 …”

“…The maximum number of missing answers was three per subject per domain. In accordance with our previous study on the evaluation of the psychometric properties of the EES‐Q 100 participants per group was considered an adequate number 8 …”