Quality of questionnaires for the assessment of otitis media with effusion in children

Objectives Audiometric tests provide information about hearing in otitis media with effusion ( OME ). Questionnaires can supplement this information by supporting clinical history‐taking as well as potentially providing a standardized and comprehensive assessment of the impact of the disease on a child. There are many possible candidate questionnaires. This study aimed to assess the quality and usability of parent / child questionnaires in OME assessment. Design and main outcome measures Fifteen, published questionnaires, commonly used in audiological departments (Auditory Behaviour in Everyday Life ( ABEL ), Children's Auditory Performance Scale ( CHAPS ), Children's Home Inventory for Listening Difficulties ( CHILD ), Children's Outcome Worksheets ( COW ), Evaluation of Children's Listening and Processing Skills ( ECL i PS ), Early Listening Function ( ELF ), Fisher's Auditory Problem Checklist ( FAPC ), Hearing Loss 7 ( HL ‐7), Listening Inventory for Education‐ Revised ( LIFE ‐R Student), Listening Inventory for Education UK Individual Hearing Profile ( LIFE ‐ UK IHP ), Littl EARS Auditory Questionnaire (Littl EARS ), Listening Situations Questionnaire ( LSQ ), Otitis Media 6 ( OM ‐6), Quality of Life in Children's Ear Problems ( OMQ ‐14), Parents’ Evaluation of Aural/Oral Performance of Children ( PEACH ) were assessed according to the following 8 criteria: conceptual clarity, respondent burden, reliability, validity, normative data, item bias, ceiling/ floor effects, and administrative burden. Results ECL i PS , Littl EARS and PEACH scored highest overall based on the assessment criteria established for this study. None of the questionnaires fully satisfied all 8 criteria. Although all questionnaires assessed issues considered to be of at least adequate relevance to OME , the majority had weaknesses with respect to the assessment of psychometric properties, such as item bias, floor/ceiling effects or measurement reliability and validity. Publications reporting on the evaluation of reliability, validity, normative data, item bias and ceiling/floor effects were not available for most of the questionnaires. Conclusions This formal evaluation of questionnaires, currently available to clinicians, highlights three questionnaires as potentially offering a useful adjunct in the assessment of OME in clinical or research settings. These were the ECL i PS , which is suitable for children aged 6 years and older, and either the Littl EARS or the PEACH for younger children. The latter two are narrowly focused on hearing, whereas ECL i PS has a broader focus on listening, language and social difficulties.