title: Validity, discriminative ability, and reliability of the hearing-related quality of life questionnaire for adolescents.
abstract: OBJECTIVE
  The prevalence of hearing loss (HL) in adolescents has grown over the past decade, but hearing-related quality of life (QOL) has not been well-measured. We sought to develop a reliable, valid measure of hearing-related QOL for adolescents and the Hearing Environments And Reflection on Quality of Life (HEAR-QL).
  
  
  METHODS
  Multisite observational study.
  
  
  METHODS
  Adolescents with HL and siblings without HL were recruited from five centers. Participants completed the HEAR-QL and validated questionnaires measuring generic pediatric QOL (PedsQL), depression and anxiety (RCADS-25), and hearing-related QOL for adults (HHIA) to determine construct and discriminant validity. Participants completed the HEAR-QL 2 weeks later for test-retest reliability. We used exploratory principal components analysis to determine the HEAR-QL factor structure and measured reliability. Sensitivity and specificity of the HEAR-QL, PedsQL, HHIA, and RCADS-25 were assessed. We compared scores on all surveys between those with normal hearing, unilateral, and bilateral HL.
  
  
  RESULTS
  A total of 233 adolescents (13-18 years old) participated: 179 with HL, 54 without HL. The original 45-item HEAR-QL was shortened to 28 items after determining factor structure. The resulting HEAR-QL-28 demonstrated excellent reliability (Cronbach's alpha = 0.95) and construct validity (HHIA: r = .845, PedsQL: r = .587; RCADS-25: r = .433). The HEAR-QL-28 displayed excellent discriminant validity, with higher area under the curve (0.932) than the PedsQL (0.597) or RCADS-25 (0.529). Teens with bilateral HL using hearing devices reported worse QOL on the HEAR-QL and HHIA than peers with HL not using devices.
  
  
  CONCLUSIONS
  The HEAR-QL is a sensitive, reliable, and valid measure of hearing-related QOL for adolescents.
  
  
  METHODS
  2b.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Tara
authors.initials: T
authors.lastname: Rachakonda
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Shin
authors.forename: Leila
authors.initials: L
authors.lastname: Mankarious
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fanning
authors.forename: Marci M
authors.initials: MM
authors.lastname: Lesperance
authors.forename: Judith E C
authors.initials: JE
authors.lastname: Lieu
mesh_terms: D000293:Adolescent; D005260:Female; D006309:Hearing; D034381:Hearing Loss / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Adolescents; hearing loss; quality of life; validation study
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