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Angelique A. Timmerman, MA; Lucien J. C. Anteunis, PhD; Cor M. G. Meesters, PhD

Arch Otolaryngol Head Neck Surg. 2003;129:987-991.

Objectives  To validate the 6-item quality-of-life survey (OM-6) and to investigate response-shift bias regarding children with otitis media.

Setting  Otorhinolaryngology department of a university hospital that serves the southernmost part of the Netherlands.

Patients  Seventy-seven children (age range, 12-38 months) experiencing persistent otitis media with effusion and scheduled for placement of tympanostomy tubes.

Survey  The OM-6 measures health-related quality of life in 6 domains: physical suffering, hearing loss, speech impairment, emotional distress, activity limitations, and caregiver concerns.

Intervention  Parents completed the OM-6 before surgery (pretest) and 6 weeks after surgery (posttest). At the posttest, parents also completed a retrospective version of the pretest (retrospective pretest).

Results  For most items, the test-retest reliability was good (R>0.8). The internal consistency of the OM-6 was satisfactory ( = .79). The construct validity, determined by correlating the ear-related global quality-of-life measure and the OM-6 summary score, was fair (R = -0.77, P<.01). Prospective change in quality of life on the OM-6 ranged from moderate (standardized response mean 0.5) to large (standardized response mean 0.8). Response-shift bias was present at the group level (t = -3.3, P<.01). Retrospective change was significant for hearing loss (z = -3.3, P<.05) and ear-related global quality of life (z = -3.6, P<.05).

Conclusions  The validity of the OM-6 has been proved in a Dutch population. The data suggest that parents underestimate the seriousness of hearing loss and overestimate the quality of life of their child before surgery, indicating a response shift. Treatment results could lead parents to realize that the situation before surgery had been worse than they thought.

From the Departments of Otorhinolaryngology–Head and Neck Surgery, University Hospital of Maastricht (Ms Timmerman and Dr Anteunis), and Medical, Clinical and Experimental Psychology, University of Maastricht (Dr Meesters); the Netherlands. The authors have no financial interest in this article.

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