Psychometric qualities of questionnaires for the assessment of otitis media impact.

BACKGROUND: The assessment of impact and evaluation of treatment effects in chronic otitis media (OM) calls for a much broader approach than just examining the presence of middle ear effusion or hearing loss. It is increasingly recognised that this condition may result in a comprised quality of life. Several studies have used proxy completed questionnaires to objectify the illness experience associated with chronic OM. OBJECTIVE OF REVIEW: To review questionnaires which have been developed to describe the effects of chronic OM on the daily functioning of children. Psychometric properties have been evaluated, in addition to discriminative and evaluative qualities. TYPE OF REVIEW: A systematic review of publications pertaining to developed questionnaires related with chronic OM. SEARCH STRATEGY: Systematic literature searches of PubMed (1966-January 2007) and EMBASE (1989-January 2007) were conducted, supplemented by using free text words to identify publications after January 2005. RESULTS: The included 15 questionnaires were developed for children with recurrent or persistent OM, describing functional health status (FHS), while two questionnaires also evaluate the effect of tympanostomy tubes insertion. The questionnaires generally cover six impact areas (physical symptoms, child development, educational performance, emotional/practical burden and general health status) with physical symptoms being the most prominant. CONCLUSIONS: The OM8-30, OMO-22 and OM-6 adequately reflect the multidimensional aspects of FHS in chronic OM. The OMO-22 and OM8-30 show the best psychometric properties for the discrimination of impact severity between children, while the OM-6 was found to have the best qualities for the evaluation of clinical change. Clinical applicability is crucial for the assessment of FHS in chronic OM, but requires a trade-off with necessary psychometric properties.

The initial development of an instrument for the description of "otitis media with effusion specific behavior" in young children.

The objective of this study was a preliminary evaluation of a newly developed questionnaire concerning behavior of young children with recurrent Otitis Media with Effusion (OME) and documenting behavioral change after tympanostomy tube insertion. A sample of 95 parent-child pairs were interviewed using an age specific questionnaire: after diagnosing OME and scheduling for surgery, at the day care theatre a few weeks later, and 6 weeks after the intervention. The levels of internal consistency were varying from still insufficient to fairly good for the different subscales of the construct "OME-specific behavior" and these levels were comparable for both age specific questionnaires. As expected, parental report proved to be stable during time, but behavioral changes were reported after tympanostomy tubes insertion. The questionnaires seem to assess a decline in behavior expected to be specific for OME. Implications for future research are discussed, while considering the influence of parental concerns on behavioral reports.

Dimensions of hostility and myocardial infarction in adult males.

The present case-control study investigated the association between dimensions of hostility and myocardial infarction (MI) in adult males. Hostility was measured with the Buss-Durkee Hostility Inventory (BDHI), which assesses two distinct dimensions of hostility, namely experiential and expressive hostility. Cases were 81 males who were admitted in hospital because of a first MI. The reference group consisted of 168 age-matched, healthy male neighbourhood controls. Analyses revealed that especially experiential hostility (comprised of the subscales Resentment and Suspicion) was significantly associated with MI. These results are in contrast with the findings of previous studies, which showed expressive hostility to be positively related to coronary heart disease (CHD). Explanations for these contradictory findings are discussed.

Hostility and myocardial infarction in men.

This case-control study examines the association of hostility (as measured by the Cook-Medley Hostility Scale) with myocardial infarction in adult males from The Netherlands. Subjects included patients with first myocardial infarction (MI; N = 81), who were compared with a neighbourhood control (NC) group (N = 168). Cases had somewhat higher scores on the Cook-Medley Hostility Scale, although the differences between cases and controls were not statistically significant. Multivariate analysis revealed the presence of an interaction between hostility and age, suggesting that the association of hostility with MI is age-dependent. The results indicate that hostility only constitutes a risk indicator for first MI in men who are younger than 50 yr of age.