Response-shift bias and parent-reported quality of life in children with otitis media.
OBJECTIVE
To validate the 6-item quality-of-life survey (OM-6) and to investigate response-shift bias regarding children with otitis media.


METHODS
Otorhinolaryngology department of a university hospital that serves the southernmost part of the Netherlands.


METHODS
Seventy-seven children (age range, 12-38 months) experiencing persistent otitis media with effusion and scheduled for placement of tympanostomy tubes.


METHODS
The OM-6 measures health-related quality of life in 6 domains: physical suffering, hearing loss, speech impairment, emotional distress, activity limitations, and caregiver concerns.


METHODS
Parents completed the OM-6 before surgery (pretest) and 6 weeks after surgery (posttest). At the posttest, parents also completed a retrospective version of the pretest (retrospective pretest).


RESULTS
For most items, the test-retest reliability was good (R>0.8). The internal consistency of the OM-6 was satisfactory (alpha =.79). The construct validity, determined by correlating the ear-related global quality-of-life measure and the OM-6 summary score, was fair (R = -0.77, P<.01). Prospective change in quality of life on the OM-6 ranged from moderate (standardized response mean >/=0.5) to large (standardized response mean >/=0.8). Response-shift bias was present at the group level (t = -3.3, P<.01). Retrospective change was significant for hearing loss (z = -3.3, P<.05) and ear-related global quality of life (z = -3.6, P<.05).


CONCLUSIONS
The validity of the OM-6 has been proved in a Dutch population. The data suggest that parents underestimate the seriousness of hearing loss and overestimate the quality of life of their child before surgery, indicating a response shift. Treatment results could lead parents to realize that the situation before surgery had been worse than they thought.
Timmerman
Angelique A
AA
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Maastricht, The Netherlands. ATI@skno.azm.nl
Anteunis
Lucien J C
LJ
Meesters
Cor M G
CM
D002675:Child, Preschool; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010034:Otitis Media with Effusion / Q000150:complications / Q000628:therapy*; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D013064:Speech Disorders / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires