Validity, discriminative ability, and reliability of the hearing-related quality of life questionnaire for adolescents
Funding for this study was obtained from the American Hearing Research Foundation (AHRF) Wiley H. Harrison Memorial Research Award and the Clinical and Translational Science Award to Washington University, funded by NIH/National Center for Research Resources (NCRR)/National Center for Advancing Translational Science (NCATS) grant (UL1RR024992). Dr. Lieu was supported in part by a National Institutes of Health (NIH) grant (K23 DC006638). Dr. Rachakonda also was supported by a training grant (5T32DC000022-2). Dr. Jeffe was supported in part by funding from the National Cancer Institute (NCI) Cancer Center Support Grant (P30 CA091842) to the Siteman Cancer Center for services provided through the Health Behavior, Communication, and Outreach Core. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of the AHRF, NCRR, NCATS, NCI, or NIH. The authors have no funding, financial relationships, or conflicts of interest to disclose.
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).
Multisite observational study.
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.
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.
The HEAR-QL is a sensitive, reliable, and valid measure of hearing-related QOL for adolescents.
Level of Evidence
2b. Laryngoscope, 124:570–578, 2014