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Karlsson E, Manchaiah V, Mäki-Torkko E, Granberg S, Gustafsson J, Dahlström Ö, Widén S. Hearing and Functioning in Everyday Life Questionnaire: Psychometric Evaluation and Revision. Am J Audiol 2024; 33:330-342. [PMID: 38497711 DOI: 10.1044/2024_aja-23-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
PURPOSE The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)-based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results. METHOD This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (n = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation. RESULTS The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure. CONCLUSION The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency.
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Affiliation(s)
- Elin Karlsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
- Swedish Institute of Disability Research (SIDR), Örebro University, Sweden
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Virtual Hearing Lab, Aurora, CO
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, India
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Sweden
| | - Sarah Granberg
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
| | - Johanna Gustafsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
- Centre for the Study of Professions, Oslo Metropolitan University, Norway
| | - Örjan Dahlström
- Department of Behavioral Sciences and Learning, Linköping University, Sweden
- Swedish Institute of Disability Research (SIDR), Linköping University, Sweden
| | - Stephen Widén
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden
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Karlsson E, Mäki-Torkko E, Granberg S, Widén S, Manchaiah V, Swarnalatha Nagaraj V, Pichora-Fuller KM, Selb M, Swanepoel DW, Yerraguntla K, Gustafsson J. Hearing and Functioning in Everyday Life Questionnaire: Development and Validation of an ICF-Based Instrument. Ear Hear 2023; 44:1498-1506. [PMID: 37340534 DOI: 10.1097/aud.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVES Self-assessment instruments are commonly used in audiological rehabilitation. However, several studies highlight the lack of multidimensionality in existing outcome measures, with the consequence that they only partially capture aspects of functioning in everyday life for people living with hearing loss. This study aimed to develop and investigate the content validity of a self-assessment instrument based on the validated Brief International Classification of Functioning, Disability, and Health Core Set for Hearing Loss. DESIGN The design was a two-part instrument development study. The first part focused on the item-generation process of the instrument, named the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) during an experts' workshop. The second part focused on international content validation of the instrument using group interviews. Strategic sampling was used and 30 adults with hearing loss from India, South Africa, and the United States participated in the group interviews. RESULTS The expert's workshop resulted in the first version of the HFEQ containing 30 items. The results from group interviews show that the content of the HFEQ was considered to be valid concerning its relevance, comprehensiveness, and comprehensibility. A majority (73%) of the HFEQ items were perceived by the participants as relevant and easy to comprehend. For the remaining 27% of the items, the content was perceived to be relevant in all countries, but some terms and expressions were reported to require rewording or clearer examples. These modifications will be made in the next step of the development process. CONCLUSION Content validation of the HFEQ demonstrates promising results, with participants perceiving the content as relevant and comprehensible. Further psychometric validation is required to investigate other psychometric properties, such as construct validity and reliability. The HFEQ has the potential to become a valuable new instrument for assessing everyday functioning in people with hearing loss in audiological rehabilitation and in research.
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Affiliation(s)
- Elin Karlsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Elina Mäki-Torkko
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Sarah Granberg
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Stephen Widén
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vinay Swarnalatha Nagaraj
- Audiology Group, Institute of Neuromedicine and Movement Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Melissa Selb
- ICF Research Branch and Swiss Paraplegic Research, Nottwil, Switzerland
| | - De Wet Swanepoel
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Krishna Yerraguntla
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Johanna Gustafsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Oosthuizen I, Kumar LMS, Nisha KV, Swanepoel DW, Granberg S, Karlsson E, Manchaiah V. Patient-Reported Outcome Measures for Hearing Aid Benefit and Satisfaction: Content Validity and Readability. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4117-4136. [PMID: 37708535 DOI: 10.1044/2023_jslhr-22-00535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE Numerous patient-reported outcome measures (PROMs) are available to measure hearing aid benefit and satisfaction. It is unclear to what extent currently available PROMs on hearing aid outcomes, often developed decades ago, meet current guidelines for good content validity and readability. This study evaluated the content validity and readability of PROMs that focus on perceived hearing aid benefit and/or satisfaction. METHOD A literature review was conducted to identify eligible instruments. Content validity evaluation included mapping extracted questionnaire items to the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. In addition, study design in content validity methodology was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments study design checklist for PROM instruments. Readability was estimated using the Simple Measure of Gobbledygook measure. RESULTS Thirteen questionnaires were identified and evaluated. Item content focused primarily on the components of environmental factors as well as activity limitations and participation restrictions with less emphasis on body functions and personal factors. The content validity methodology analysis revealed an underuse or lack of reporting of a qualitative methodology in assessing patient and professional perspectives. All the included questionnaires exceeded the recommended sixth-grade reading level. CONCLUSIONS The categories covered by hearing aid PROMs vary considerably, with no single instrument comprehensively covering all the key ICF components. Future development of hearing aid outcome measures should consider a mixed methodology approach for improved content validity and ensure an appropriate reading level.
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Affiliation(s)
- Ilze Oosthuizen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Aurora, CO
| | | | | | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Aurora, CO
- Ear Science Institute Australia, Subiaco, Western Australia
- Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Aurora
| | - Sarah Granberg
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Elin Karlsson
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Aurora, CO
- Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance Clinic, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, India
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Afghah T, Alfakir R, Meis M, van Leeuwen L, Kramer SE, Hammady M, Youssif M, Wagener KC. The development of a Self-Rated ICF-based questionnaire (HEAR-COMMAND Tool) to evaluate Hearing, Communication, and Conversation disability: Multinational experts' and patients' perspectives. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1005525. [PMID: 36451803 PMCID: PMC9701723 DOI: 10.3389/fresc.2022.1005525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022]
Abstract
Objective An instrument that facilitates the advancement of hearing healthcare delivery from a biomedical model to a biopsychosocial one that underpins the International Classification of Functioning, Disability, and Health framework (ICF) brief and comprehensive Core Sets for Hearing Loss (CSHL) is currently unavailable. The objective is to describe the process of developing and validating a new questionnaire named the HEAR-COMMAND Tool created by transferring the ICF CSHL into a theory-supported, practically manageable concept. Design A team from Germany, the USA, the Netherlands, and Egypt collaborated on development. The following ICF domains were considered; "Body Functions" (BF), "Activities and Participation" (AP), and "Environmental Factors" (EF). The development yielded English, German, and Arabic versions. A pilot validation study with a total of 109 respondents across three countries, Germany, Egypt, and the USA was conducted to revise the item terminology according to the feedback provided by the respondents. Results The questionnaire included a total of 120 items. Ninety items were designed to collect information on the functioning and 30 items inquiring about demographic information, hearing status, and Personal Factors. Except for the "Body Structures" (BS) domain, all the categories of the brief ICF CSHL were covered (a total of 85% of the categories). Moreover, the items covered 44% of the comprehensive ICF CSHL categories including 73% of BF, 55% of AP, and 27% of EF domains. Overall, the terminology of 24 ICF-based items was revised based on the qualitative analysis of the respondents' feedback to further clarify the items that were found tod be unclear or misleading. The tool highlighted the broad connection of HL with bodily health and contextual factors. Conclusions The HEAR-COMMAND Tool was developed based on the ICF CSHL and from multinational experts' and patients' perspectives with the aim to improve the execution of audiological services, treatment, and rehabilitation for adult patients with HL. Additional validation of the tool is ongoing. The next step would be to pair the tool with BS categories since it was excluded from the tool and determine its effectiveness in guiding hearing health care practitioners to holistically classify categories influencing hearing, communication, and conversation disability.
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Affiliation(s)
- Tahereh Afghah
- Hörzentrum Oldenburg gGmbH, Germany and Cluster of Excellence Hearing4all, Oldenburg, Germany,Correspondence: Tahereh Afghah
| | - Razan Alfakir
- Department of Speech-Language and Hearing Sciences, Auburn University, Auburn, AL, United States
| | - Markus Meis
- Hörzentrum Oldenburg gGmbH, Germany and Cluster of Excellence Hearing4all, Oldenburg, Germany
| | - Lisette van Leeuwen
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Sophia E. Kramer
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Mahmoud Hammady
- Department of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division, Sohag University Hospital, Sohag, Egypt
| | - Mostafa Youssif
- Department of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division, Sohag University Hospital, Sohag, Egypt
| | - Kirsten C. Wagener
- Hörzentrum Oldenburg gGmbH, Germany and Cluster of Excellence Hearing4all, Oldenburg, Germany
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MacDermid JC, Walton DM. Development and validation of the ND10 to measure neck-related functional disability. BMC Musculoskelet Disord 2022; 23:605. [PMID: 35739498 PMCID: PMC9219202 DOI: 10.1186/s12891-022-05556-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous neck-specific patient-reported outcome measures (PROMs) have tended to measure both symptoms and disability. This multi-staged study developed and evaluated a neck-specific PROM focusing on functional disability. Methods This study integrated findings from systematic reviews on neck-specific outcome measures, patient interviews, qualitative studies on neck disability, and iterative item testing to develop a 10-item measure of neck-related disability (ND10). Content validity was assessed by classifying items using the International Classification of Functioning, Disability and Health (ICF) and perspective linking. Patients (n = 78) with neck pain completed cognitive interviews, exploring items of the Neck Disability Index (NDI) and ND10, and completed structured questions related to literacy and relevance. Test–retest reliability and internal consistency were evaluated using intraclass correlation coefficients, Bland Altman graphs, and Cronbach’s alpha. Concurrent convergent validity was evaluated by comparing the ND10 to the NDI, Single Assessment Numeric Evaluation (SANE), and Disabilities of the Arm, Shoulder and Hand (DASH). Known group validity was determined by comparing ND10 scores from patients, who rated their neck as more or less than 1/2 of “normal” on the SANE, using t-tests. Results The ND10 requires respondents to make rational judgements about their neck-related body function and disability. It has high internal consistency (0.94) and re-test reliability (0.87; SEM = 3.2/100; MDC = 7.5); and no re-test bias (mean re-test difference of 0.6). It followed expected correlation patterns, being highly correlated with related multi-item PROMs (r = 0.85–0.91), and moderately correlated to the single-item SANE. More patients agreed that the ND10 was easily readable than did so for the NDI (84% vs 68%; p < 0.05). All the PROMs distinguished the patients who perceived themselves as being abnormal/normal defined by a dichotomized SANE (p < 0.01). Conclusion The ND10 is reliable and valid for measuring neck-related functional disability. Longitudinal and cross-cultural translation studies are needed to support future use. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05556-7.
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Affiliation(s)
- Joy C MacDermid
- Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. .,School of Physical Therapy, Western University, London, ON, Canada.
| | - David M Walton
- School of Physical Therapy, Western University, London, ON, Canada
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Assouly K, Smit AL, Stegeman I. Effect of electrical stimulation with a cochlear implant on tinnitus impact: protocol of an individual patient data meta-analysis. BMJ Open 2022; 12:e063432. [PMID: 35715189 PMCID: PMC9208004 DOI: 10.1136/bmjopen-2022-063432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/31/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Tinnitus is the perception of sound without an external stimulus, often experienced as a ringing, buzzing sound. While several studies have shown a reduction in tinnitus distress following cochlear implantation, others showed an increase or no change after implantation. At this stage, clinicians have little certainty when counselling their patients prior to implantation regarding tinnitus post-implantation. To help clinicians to counsel cochlear implant (CI) candidates on the risk of developing or improving tinnitus after implantation, we aim to assess the effect of electrical stimulation with a CI on tinnitus impact for individual adult patients with tinnitus. We will also apply prediction models to individual patient data (IPD) of clinical trials to find predictive factors of the effect of electrical stimulation on tinnitus impact. METHOD AND ANALYSIS The IPD meta-analysis is a follow-up project of the systematic review on cochlear implantation in patients with tinnitus as a primary complaint. First, the systematic searches will be updated to date. Methodological quality of eligible studies will be assessed using the Risk of Bias In Non-randomised Studies of Intervention tool (ROBINS-I). Based on a data-sharing agreement, authors of the eligible studies will be invited to share their deidentified and complete IPD. The primary outcome is the effect of electrical stimulation with a CI on tinnitus impact 1 month or more post-implantation. IPD meta-analysis will be used to assess the primary outcome, while differentiating the tinnitus impact questionnaires. Second, linear regression analyses will be used to model the effect of electrical stimulation on tinnitus impact based on relevant predictors. ETHICS AND DISSEMINATION The Medical Research Involving Human Subject Act does not apply, and ethical approval is not required. The study results will be made accessible to the public in a peer-review open access journal. PROSPERO REGISTRATION NUMBER CRD42022319367, review ongoing.
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Affiliation(s)
- Kelly Assouly
- Department of Otorhinolaryngology and Head & Neck Surgery, UMC Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, UMC Utrecht, Utrecht, The Netherlands
- Cochlear Technology Centre Belgium, Mechelen, Belgium
| | - Adriana L Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, UMC Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, UMC Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, UMC Utrecht, Utrecht, The Netherlands
- UMC Utrecht Brain Center, UMC Utrecht, Utrecht, The Netherlands
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Neal K, McMahon CM, Hughes SE, Boisvert I. Listening-Based Communication Ability in Adults With Hearing Loss: A Scoping Review of Existing Measures. Front Psychol 2022; 13:786347. [PMID: 35360643 PMCID: PMC8960922 DOI: 10.3389/fpsyg.2022.786347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Hearing loss in adults has a pervasive impact on health and well-being. Its effects on everyday listening and communication can directly influence participation across multiple spheres of life. These impacts, however, remain poorly assessed within clinical settings. Whilst various tests and questionnaires that measure listening and communication abilities are available, there is a lack of consensus about which measures assess the factors that are most relevant to optimising auditory rehabilitation. This study aimed to map current measures used in published studies to evaluate listening skills needed for oral communication in adults with hearing loss. Methods A scoping review was conducted using systematic searches in Medline, EMBASE, Web of Science and Google Scholar to retrieve peer-reviewed articles that used one or more linguistic-based measure necessary to oral communication in adults with hearing loss. The range of measures identified and their frequency where charted in relation to auditory hierarchies, linguistic domains, health status domains, and associated neuropsychological and cognitive domains. Results 9121 articles were identified and 2579 articles that reported on 6714 discrete measures were included for further analysis. The predominant linguistic-based measure reported was word or sentence identification in quiet (65.9%). In contrast, discourse-based measures were used in 2.7% of the articles included. Of the included studies, 36.6% used a self-reported instrument purporting to measures of listening for communication. Consistent with previous studies, a large number of self-reported measures were identified (n = 139), but 60.4% of these measures were used in only one study and 80.7% were cited five times or fewer. Discussion Current measures used in published studies to assess listening abilities relevant to oral communication target a narrow set of domains. Concepts of communicative interaction have limited representation in current measurement. The lack of measurement consensus and heterogeneity amongst the assessments limit comparisons across studies. Furthermore, extracted measures rarely consider the broader linguistic, cognitive and interactive elements of communication. Consequently, existing measures may have limited clinical application if assessing the listening-related skills required for communication in daily life, as experienced by adults with hearing loss.
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Affiliation(s)
- Katie Neal
- Department of Lingustics, Macquarie University, Sydney, NSW, Australia
| | - Catherine M McMahon
- Department of Lingustics, Macquarie University, Sydney, NSW, Australia.,Hearing, Macquarie University, Sydney, NSW, Australia
| | - Sarah E Hughes
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.,National Institute of Health Research (NIHR), Applied Research Collaboration (ARC), West Midlands, United Kingdom.,Faculty of Medicine, Health and Life Science, Swansea University, Swansea, United Kingdom
| | - Isabelle Boisvert
- Hearing, Macquarie University, Sydney, NSW, Australia.,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Dahlin Redfors Y, Jönsson R, Finizia C. A validation study of the Swedish version of the Glasgow hearing aid benefit profile evaluated in otosclerosis subjects. Laryngoscope Investig Otolaryngol 2022; 7:807-815. [PMID: 35734042 PMCID: PMC9195022 DOI: 10.1002/lio2.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/03/2022] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives The aim of this study was to translate the Glasgow Benefit Hearing Aid Profile (GHABP) to Swedish, and to analyze its validity and reliability in patients undergoing rehabilitation with surgery or hearing aids. Methods The GHABP was translated to Swedish following published guidelines. One version of the questionnaire was adapted to fit the surgical intervention. A modification was made to the questionnaire by removing the answer option “not applicable” (N/A) since it was found confusing by the subjects. A prospective multicenter cohort study was performed to validate the questionnaire. One hundred and twenty‐three individuals diagnosed with otosclerosis were included in the study prior to the intervention. The individuals were divided into three groups based on the intervention and previous hearing aid experience. Pure tone audiometry was performed 1 month prior and 1 year after the intervention. The Swedish version of the GHABP was completed by the individuals prior to the intervention, as well as 6 and 12 months after the intervention. Validity and reliability were assessed. Results The Swedish versions of the GHABP were well accepted by the included individuals. The questionnaires showed good psychometric properties, with comparable results for the two different interventions and three separate intervention groups. Initial disability was more pronounced in more challenging listening situations. Disability was reduced after the intervention. The “Use,” “Benefit,” and “Satisfaction” domains demonstrated beneficial results; however, a ceiling effect was noted in the same domains. The reliability was overall very high. Conclusion The Swedish version of the GHABP had good psychometric properties, with high validity and reliability. The same outcomes were found for the hearing aid and surgery groups. A ceiling effect was observed that can affect the questionnaire's ability to distinguish between subjects and measures over time. Level of evidence 2c
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Affiliation(s)
- Ylva Dahlin Redfors
- Department of Otorhinolaryngology, Head, and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Otorhinolaryngology, Head, and Neck Surgery Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
| | - Radoslava Jönsson
- Department of Otorhinolaryngology, Head, and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Otorhinolaryngology, Head, and Neck Surgery Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head, and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Department of Otorhinolaryngology, Head, and Neck Surgery Region Västra Götaland, Sahlgrenska University Hospital Gothenburg Sweden
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MacDermid JC. ICF Linking and Cognitive Interviewing Are Complementary Methods for Optimizing Content Validity of Outcome Measures: An Integrated Methods Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:702596. [PMID: 36188847 PMCID: PMC9397968 DOI: 10.3389/fresc.2021.702596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022]
Abstract
Content validity is a fundamental requirement of outcome measures. After reviewing operational needs and existing definitions, content validity we as defined as: the extent to which a measure provides a comprehensive and true assessment of the key relevant elements of a specified construct or attribute across a defined range, clearly and equitably for a stated target audience and context. ICF linkage rules from 2002, 2005, and 2019 have provide increasingly clear processes for describing and evaluating content of outcome measures. ICF Core Sets provide international reference standards of the core constructs of importance for different health conditions. Both are important as reference standards during content validation. To summarize their use as reference standards, the following summary indicators were proposed: (1) Measure to ICF linkage, (2) Measure to (Brief or Comprehensive) Core Set Absolute Linkage, (3) Measure to (Brief or Comprehensive) Core Set Unique Linkage, (4) Core Set Representation, and (5) Core Set Unique Disability Representation. Methods to assess how respondents engage with content are needed to complement ICF-linking. Cognitive interviewing is an ideal method since it used to explore how respondents interpret and calibrate response to individual items on an outcome measure. We proposed a framework for classifying these responses: Clarity/Comprehension, Relevance, Inadequate response definition, Reference Point, Perspective modification, and Calibration Across Items. Our analysis of 24 manuscripts that used ICF linking for content validation since updated linking rules were published found that authors typically used linking to validate existing measures, involved multiple raters, used 2005 linking rules, summarized content at a concept level (e.g., impairment, activity, participation) and/or use core sets as a reference standard. Infrequently, ICF linking was used to create item pools/conceptual frameworks for new measures, applied the full scope of the 2019 linking rules, used summary indicators, or integrated ICF-linking with qualitative methods like cognitive interviews. We conclude that ICF linkage is a powerful tool for content validity during development or validation of PROM. Best practices include use of updated ICF linking rules, triangulation of ICF linking with participant assessments of clarity and relevance preferably obtained using cognitive interview methods, and application of defined summary indicators.
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Affiliation(s)
- Joy C. MacDermid
- Department of Surgery, School of Physical Therapy, Western University, London, ON, Canada
- Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
- *Correspondence: Joy C. MacDermid
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Keidser G, Naylor G, Brungart DS, Caduff A, Campos J, Carlile S, Carpenter MG, Grimm G, Hohmann V, Holube I, Launer S, Lunner T, Mehra R, Rapport F, Slaney M, Smeds K. The Quest for Ecological Validity in Hearing Science: What It Is, Why It Matters, and How to Advance It. Ear Hear 2021; 41 Suppl 1:5S-19S. [PMID: 33105255 PMCID: PMC7676618 DOI: 10.1097/aud.0000000000000944] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/10/2020] [Indexed: 12/03/2022]
Abstract
Ecological validity is a relatively new concept in hearing science. It has been cited as relevant with increasing frequency in publications over the past 20 years, but without any formal conceptual basis or clear motive. The sixth Eriksholm Workshop was convened to develop a deeper understanding of the concept for the purpose of applying it in hearing research in a consistent and productive manner. Inspired by relevant debate within the field of psychology, and taking into account the World Health Organization's International Classification of Functioning, Disability, and Health framework, the attendees at the workshop reached a consensus on the following definition: "In hearing science, ecological validity refers to the degree to which research findings reflect real-life hearing-related function, activity, or participation." Four broad purposes for striving for greater ecological validity in hearing research were determined: A (Understanding) better understanding the role of hearing in everyday life; B (Development) supporting the development of improved procedures and interventions; C (Assessment) facilitating improved methods for assessing and predicting ability to accomplish real-world tasks; and D (Integration and Individualization) enabling more integrated and individualized care. Discussions considered the effects of variables and phenomena commonly present in hearing-related research on the level of ecological validity of outcomes, supported by examples from a few selected outcome domains and for different types of studies. Illustrated with examples, potential strategies were offered for promoting a high level of ecological validity in a study and for how to evaluate the level of ecological validity of a study. Areas in particular that could benefit from more research to advance ecological validity in hearing science include: (1) understanding the processes of hearing and communication in everyday listening situations, and specifically the factors that make listening difficult in everyday situations; (2) developing new test paradigms that include more than one person (e.g., to encompass the interactive nature of everyday communication) and that are integrative of other factors that interact with hearing in real-life function; (3) integrating new and emerging technologies (e.g., virtual reality) with established test methods; and (4) identifying the key variables and phenomena affecting the level of ecological validity to develop verifiable ways to increase ecological validity and derive a set of benchmarks to strive for.
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Affiliation(s)
- Gitte Keidser
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
- Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Linköping University, Linköping, Sweden
| | - Graham Naylor
- Hearing Sciences—Scottish Section, School of Medicine, University of Nottingham, Glasgow, United Kingdom
| | | | - Andreas Caduff
- Applied Physics Department and the Center for Electromagnetic Research and Characterization, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jennifer Campos
- KITE—Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Simon Carlile
- School of Medical Sciences, University of Sydney, Sydney, Australia
- X-The Moonshot Factory, Mountain View, California, USA
| | - Mark G. Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Giso Grimm
- Auditory Signal Processing and Cluster of Excellence “Hearing4all”, Department of Medical Physics and Acoustics, University of Oldenburg, Oldenburg, Germany
| | - Volker Hohmann
- Auditory Signal Processing and Cluster of Excellence “Hearing4all”, Department of Medical Physics and Acoustics, University of Oldenburg, Oldenburg, Germany
| | - Inga Holube
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, and Cluster of Excellence “Hearing4all”, Oldenburg, Germany
| | - Stefan Launer
- Department of Science and Technology, Sonova AG, Staefa, Switzerland
| | - Thomas Lunner
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
| | - Ravish Mehra
- Facebook Reality Labs Research, Redmond, Washington, DC, USA
| | - Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Malcolm Slaney
- Machine Hearing Group, Google Research, Mountain View, California, USA
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11
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Looi V, Boulton R, Timmer BHB, Wilson WJ. The suitability and readability of cochlear implant information brochures for potential adult recipients. Int J Audiol 2021; 61:293-300. [PMID: 34106814 DOI: 10.1080/14992027.2021.1930206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Adult cochlear implant (CI) candidates seeking to make an informed decision about cochlear implantation can find themselves needing to quickly understand large volumes of complex information provided by different professionals in different formats. This study investigates the suitability, within a health literacy context, of one of those sources of information: the CI brochure. DESIGN A single-observation design. STUDY SAMPLE Thirty English passages of approximately 100-words each were sampled from 15 sections of seven CI brochures. All brochures were readily available to the general public on the Australian websites of four CI manufacturers at the time of the analysis (June 2019). RESULTS Analyses by two examiners using the Suitability Assessment of Materials (SAM) classified all 15 sections from all seven CI brochures as being "not suitable" for general, adult readers. Analyses by the same examiners using four readability formulae (Flesch Reading Ease Scale, Fry Readability Graph, Flesch-Kincaid Readability Formula, and the Fog index) showed sampled passages from the 15 sections were written at a level best suited for persons with 10 to 14 years of schooling. CONCLUSIONS Brochures intended for adult CI candidates should be revised to improve their suitability and readability for adult CI candidates. Specific recommendations are suggested.
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Affiliation(s)
- Valerie Looi
- Advanced Bionics (Asia Pacific), Sydney, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Reese Boulton
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Barbra H B Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Sonova AG, Staefa, Switzerland
| | - Wayne J Wilson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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12
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Karlsson E, Gustafsson J. Validation of the international classification of functioning, disability and health (ICF) core sets from 2001 to 2019 - a scoping review. Disabil Rehabil 2021; 44:3736-3748. [PMID: 33535017 DOI: 10.1080/09638288.2021.1878562] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To investigate and summarize the literature on the validation of International classification of functioning, disability and health (ICF) core sets from 2001 to 2019 and explore what research methods have been used when validating ICF core sets.Methods: The current study is a scoping review using a structured literature search.Results: In total, 66 scientific articles were included, of which 23 ICF core sets were validated. Most validation studies were conducted in Europe using a quantitative methodology and were validated from the perspective of patients. Analysis methods differed considerably between the studies, and most ICF core sets were validated only once for a single target population or from a single perspective. The comprehensive core sets were validated more often than the brief core sets, and core sets for stroke and low back pain were validated most often.Conclusion: The results of the current study show that only 66% of the existing ICF core sets are validated. Many of the validation studies are conducted in a European context and from a single perspective. More validation studies of ICF core sets from the perspective of both patients and professionals are needed.Implications for rehabilitationICF core sets aim to facilitate assessments in clinical settings and research.Validation studies indicate in general that the ICF core sets are valid and relevant for patients and professionals in the specific areas explored and thus can be used in rehabilitation settings.To improve the quality of ICF core sets, more validation studies are needed for ICF core sets not yet tested and for ICF core sets that have been validated only in one study or for one specific population or target group.
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Affiliation(s)
- Elin Karlsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Johanna Gustafsson
- Audiological Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
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13
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Karlsson E, Mäki-Torkko E, Widén S, Gustafsson J, Manchaiah V, Mahomed-Asmail F, Swanepoel DW, Yerraguntla K, Granberg S. Validation of the Brief International Classification of Functioning, Disability and Health (ICF) core set for hearing loss: an international multicentre study. Int J Audiol 2020; 60:412-420. [PMID: 33207960 DOI: 10.1080/14992027.2020.1846088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Hearing loss (HL) affects the everyday functioning of millions of people worldwide. The Brief International Classification of Functioning Disability and Health (ICF) core sets for HL was developed to meet the complex health care needs of adults with HL. Because the brief core set for HL has not yet been validated internationally, this study aimed to investigate its validity from an international perspective. DESIGN A cross-sectional validation study based on data from structured interviews with adults with HL. STUDY SAMPLE Participants (n = 571) from India, South Africa, Sweden and the US were included. RESULTS A six-factor solution explained 71% of the variance, focussing on issues related to communication, the social environment, participation in society, health care services, support, relationships and emotions (α = 0.915). Three ICF categories demonstrated low reliability - temperament and personality functions, seeing functions and school education. CONCLUSION The Brief ICF core set for HL is valid for adults with HL internationally. However, to further increase its international validity, we recommend adding the categories d920 recreation and leisure and replacing d850 school education with the more inclusive block, d810-d839 education.
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Affiliation(s)
- Elin Karlsson
- Faculty of Medicine and Health, Audiological Research Centre, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Elina Mäki-Torkko
- Faculty of Medicine and Health, Audiological Research Centre, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Stephen Widén
- Faculty of Medicine and Health, Audiological Research Centre, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Johanna Gustafsson
- Faculty of Medicine and Health, Audiological Research Centre, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Krishna Yerraguntla
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Sarah Granberg
- Faculty of Medicine and Health, Audiological Research Centre, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.,Swedish Institute of Disability Research (SIDR), Örebro University, Örebro, Sweden
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14
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Manchaiah V, Kelly-Campbell RJ, Bellon-Harn ML, Beukes EW. Quality, Readability, and Suitability of Hearing Health-Related Materials: A Descriptive Review. Am J Audiol 2020; 29:513-527. [PMID: 32551926 DOI: 10.1044/2020_aja-19-00040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives The objective of this descriptive review was to determine the quality, readability, and suitability of ear and hearing health information and materials for patients and their significant others. Method A literature search was conducted between August 2018 and April 2019 in the databases CINAHL Complete, MEDLINE, and PsychInfo. Inclusion and exclusion criteria were used to shortlist studies. Data regarding quality, suitability, and readability were extracted from the included studies. Data were assessed qualitatively. Results There were 34 studies included in this review. Of those, eight examined quality, 33 assessed readability, and four investigated the suitability of materials. The range of materials assessed included diagnostic reports, patient education materials (PEMs), patient-reported outcome measures, and websites. Quality elements were examined in studies focusing on website information. Findings indicated that most websites were of poor quality. Suitability was examined in studies focusing on PEMs such as hearing aid user guides. Findings indicated that most of the existing materials were not suitable for the intended populations. The reading grade level of information across all four categories was found to be higher than the recommended fifth or sixth reading grade level for health-related materials. Revisions of some diagnostic reports and PEMs showed that improvements are possible. Conclusions This review suggests that ear- and hearing-related materials generally have lower quality and suitability with higher readability (more difficult to read). Development of materials that are suitable, of high quality, and at the appropriate readability levels is required to improve accessibility of ear- and hearing-related materials.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
| | | | | | - Eldré W. Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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15
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Giugliani R, Harmatz P, Lin SP, Scarpa M. Assessing the impact of the five senses on quality of life in mucopolysaccharidoses. Orphanet J Rare Dis 2020; 15:97. [PMID: 32306998 PMCID: PMC7168888 DOI: 10.1186/s13023-020-01368-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 03/24/2020] [Indexed: 01/08/2023] Open
Abstract
Background The mucopolysaccharidoses (MPSs) are lysosomal storage disorders associated with progressive multi-organ and skeletal abnormalities. Clinical manifestations can affect each of the five senses: hearing, vision, smell, taste, and touch. Main body of the abstract On 24–26 May 2018, 46 specialists with expertise in managing symptoms of MPS and experts specialized in evaluating and managing impairments in each one of the five senses gathered in Lisbon, Portugal at the “MPS & the five senses” meeting to discuss how loss of one or multiple senses can affect activities of daily living (ADL) and quality of life (QoL) in MPS patients and best practices in evaluating and managing the loss of senses in these individuals. The meeting confirmed that MPS can affect the senses considerably, but how these impairments affect ADL and overall QoL from a patient’s perspective remains unclear. A better insight may be achieved by prospectively collecting patient-reported outcome (PRO) data internationally in a standardized way, using a standard battery of tools. To identify relevant PRO tools, a systematic literature review and a selection of existing published questionnaires, focused on adults with no intellectual delay, were performed after the meeting. The search strategy identified 33 PRO tools for hearing, 30 for speech, 125 for vision, 49 for touch (including pain and upper limb function), and 15 for smell/taste. A further selection was made based on several criteria, including applicability/relevance for MPS, applicability in different countries (languages)/cultures, availability in English, ease of use, validation, and normative data, resulting in a final set of 11 tools. In addition to these sense-specific PRO tools, a general QoL tool, the EuroQol (EQ)-5D-5 L, was selected to assess overall QoL and reveal coping behaviors. Short conclusion MPS can affect each of the five senses, but current knowledge on the impact of sense impairments on QoL/ADL in MPS patients remains limited. Collection of data in a standardized fashion using sense-specific patient-reported outcome tools and a general QoL tool may fill the current knowledge gap.
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Affiliation(s)
- Roberto Giugliani
- Department of Genetics/UFRGS, Medical Genetics Service/HCPA, DR BRASIL Research Group/HCPA, and INAGEMP, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil.
| | - Paul Harmatz
- Department of Gastroenterology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Shuan-Pei Lin
- Department of Genetics and Metabolism, MacKay Children's Hospital, Taipei, Taiwan
| | - Maurizio Scarpa
- Regional Center for Rare Diseases, University Hospital of Udine, Udine, Italy
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