The Otitis Media-6 questionnaire: psychometric properties with emphasis on factor structure and interpretability
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RESEARCH
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The Otitis Media-6 questionnaire: psychometric properties with emphasis on factor structure and interpretability Christian Hamilton Heidemann1,2*, Christian Godballe1,2, Anette Drøhse Kjeldsen1,2, Eva Charlotte Jung Johansen3, Christian Emil Faber1,2 and Henrik Hein Lauridsen4
Abstract Background: The Otitis Media-6 questionnaire (OM-6) is the most frequently used instrument to measure health related quality of life in children with otitis media. The main objectives of this study are 1) to translate and cross-culturally adapt the OM-6 into Danish, and 2) to assess important psychometric properties including structural validity and interpretability of the OM-6 in a Danish population of children suffering from otitis media. Methods: The OM-6 was translated and cross-culturally adapted according to international guidelines. A longitudinal validation study enrolled 491 children and their families, and the measurement properties of the OM-6 were evaluated using the Cosmin taxonomy. The properties assessed were construct and structural validity (confirmatory factor analysis) including internal consistency, reproducibility (test-retest reliability and smallest detectable change), responsiveness and interpretability. Results: A total of 435 children were eligible to participate in the study. Analyses of structural validity and internal consistency indicated that parent appraisal of hearing and speech problems may be problematic. Both scales showed similarly good test-retest reliability and construct validity, were able to discriminate between diagnostic subgroups and responsive to change. Cut-off values of 16.7 and 30.0 were found to represent minimal important change for the patients. Conclusions: The Danish version of the OM-6 is a reliable, valid, responsive and interpretable questionnaire to measure quality of life in children with otitis media. This study sheds light on possible weaknesses of the instrument that needs to be acknowledged in the utilization of the instrument. However, despite these issues our results support the continuing use of OM-6 as a 1-factor functional health scale with a separate global health rating. Furthermore, indications of values representing minimal important change as perceived by the respondent are presented. Keywords: Cross-cultural adaptation, Validation, OM-6, Otitis media, Factor analysis, Minimal important change, Smallest detectable change
Introduction Otitis media (OM) is a common childhood disease and the leading cause of doctor consultations for pre-school children [1]. It can be divided in two major diagnostic subgroups: acute otitis media (AOM) and otitis media
* Correspondence: [email protected] 1 Department of ENT Head & Neck Surgery, Odense University Hospital, Odense C 5000, Denmark 2 Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense M 5230, Denmark Full list of author information is available at the end of the article
with effusion (OME) with great overlap between the two (see Table 1) [2-4]
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