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October 1997

Quality of Life for Children With Otitis Media

Author Affiliations

Anna Balzano
From the Division of Pediatric Otolaryngology, State University of New York, Health Science Center at Brooklyn, and Long Island College Hospital, Brooklyn, NY.

Arch Otolaryngol Head Neck Surg. 1997;123(10):1049-1054. doi:10.1001/archotol.1997.01900100019002

Objective:  To evaluate changes in health-related quality of life for children with otitis media.

Design:  Cohort study using a 6-item quality-of-life survey (OM-6) representing the domains of physical suffering, hearing loss, speech impairment, emotional distress, activity limitations, and caregiver concerns.

Setting:  Hospital-based pediatric otolaryngology practice in a metropolitan area.

Patients:  One hundred eighty-six children aged 6 months to 12 years (median age, 3.4 years) with chronic otitis media with effusion or recurrent acute otitis media.

Intervention:  The OM-6 was completed at entry by the child's caregiver and again at least 4 weeks after routine clinical care. Otoscopic findings, static admittance, tympanometric width, audiometric thresholds, and ear-related global quality of life (10-point visual scale) were recorded concurrently.

Main Outcome Measures:  Test-retest reliability, construct validity, and responsiveness to longitudinal change of the OM-6 survey score (mean value of the 6 items).

Results:  Excellent test-retest reliability was obtained for the survey score (R=0.87) and individual survey items (R≥0.71). The median survey score was 2.8 (95% confidence interval, 2.7-3.0) of a maximum 7.0, with higher values indicating poorer quality of life. Construct validity was shown by significant correlations between the survey score and global ear-related quality of life (R=–0.64), between physical suffering and physician visits in the past month (R=0.47), and between caregiver concerns and antibiotics consumed in the past month (R=0.26). The mean change in survey scores after tympanostomy tubes was 1.7, with a standardized response mean of 1.7 (95% confidence interval, 1.4-2.0), indicating large responsiveness to change. The change score was reliable (R=0.82) and correlated well with the degree of reported clinical change (R=0.66).

Conclusions:  The OM-6 is a valid, reliable, and responsive measure of quality of life for children with otitis media. The brevity and ease of administration make the OM-6 ideal for use in outcomes studies, clinical trials, and routine clinical care.Arch Otolaryngol Head Neck Surg. 1997;123:1049-1054