title: Responsiveness of the 7-item Eustachian Tube Dysfunction Questionnaire.
abstract: OBJECTIVE
  Baro-challenge-induced Eustachian tube (ET) dysfunction is defined as the presence of aural discomfort, popping, or pain, which only arises in case of ambient pressure changes, without abnormalities on otoscopy or tympanometry. Our primary aim was to determine the discriminative power of the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) in patients with baro-challenge-induced ET dysfunction in comparison with that in healthy controls. The secondary aim was to determine the responsiveness of ETDQ-7 in patients with baro-challenge-induced obstructive ET dysfunction who underwent balloon dilation tuboplasty (BDET).
  
  
  METHODS
  The accuracy of the diagnostic test was determined on the basis of the area under the curve in receiver-operating curve (ROC) analysis. Responsiveness to change of ETDQ-7 was assessed by exploring preoperative and postoperative ETDQ-7 scores using Cohen's kappa coefficient. Patients were asked whether their complaints improved, remained stable, or deteriorated after BDET. The findings of subjective evaluation were then compared with the difference in the ETDQ-7 score after BDET.
  
  
  RESULTS
  In the baro-challenge-induced ET dysfunction group, the median preoperative total ETDQ-7 score was 26, decreasing to 16 after BDET. ROC analysis demonstrated excellent discriminative power for the baro-challenge-induced ET dysfunction group. Cohen's kappa coefficient was 0.633, indicating that there was substantial agreement between the ETDQ-7 values before and after BDET.
  
  
  CONCLUSIONS
  ETDQ-7 can discriminate between patients with baro-challenge-induced ET dysfunction and healthy controls and can therefore be useful in its diagnosis. Furthermore the ETDQ-7 is responsive to change in patients with baro-challenge-induced ET dysfunction who have undergone BDET, although a larger sample size is required to confirm these preliminary findings.
authors.affiliation: Antwerp University Hospital, Otorhinolaryngology and Head and Neck Surgery, Edegem, Belgium; University of Antwerp, School of Medicine and Health Sciences, Wilrijk, Belgium. vincent.van.rompaey@uza.be.
authors.forename: Shari
authors.initials: S
authors.lastname: Van Roeyen
authors.forename: Paul
authors.initials: P
authors.lastname: Van de Heyning
authors.forename: Vincent
authors.initials: V
authors.lastname: Van Rompaey
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001274:Atmospheric Pressure; D004106:Dilatation; D005064:Eustachian Tube / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D038781:Otoscopy; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult