title: A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas.
abstract: OBJECTIVE
  Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity.
  
  
  METHODS
  There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis.
  
  
  RESULTS
  All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity.
  
  
  CONCLUSIONS
  Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery.
authors.affiliation: The University of Jordan, Amman, Jordan. Electronic address: abdulrahman.al-shudifat@med.lu.se.
authors.forename: Abdul Rahman
authors.initials: AR
authors.lastname: Al-Shudifat
authors.affiliation: The University of Jordan, Amman, Jordan.
authors.forename: Babar
authors.initials: B
authors.lastname: Kahlon
authors.affiliation: The University of Jordan, Amman, Jordan.
authors.forename: Peter
authors.initials: P
authors.lastname: Höglund
authors.affiliation: The University of Jordan, Amman, Jordan.
authors.forename: Sven
authors.initials: S
authors.lastname: Lindberg
authors.affiliation: The University of Jordan, Amman, Jordan.
authors.forename: Måns
authors.initials: M
authors.lastname: Magnusson
authors.affiliation: The University of Jordan, Amman, Jordan.
authors.forename: Peter
authors.initials: P
authors.lastname: Siesjo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D009464:Neuroma, Acoustic / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D012647:Self-Assessment; D012680:Sensitivity and Specificity
keywords: Morbidity; Outcome after surgery; Quality of life; Vestibular schwannoma; Work capacity