112 Chapter 6 digitally be presented as 9 scores (one per complaint and one impact score) including the difference in comparison to previous completed OQUA scores (Figure 2). As use and implementation of the OQUA in the Netherlands is increasing in both research and clinical practice, it becomes essential to evaluate the scores in relation to a reference group. Comparing scores will improve interpretability. This particularly applies to the measurement instrument scores with multiple subscales, where the meaning of which is not immediately clear.10 As the OQUA is the first PROM covering all common ear complaints and impact of the complaints in different subscales, each subscale should be evaluated separately and weighted within a ‘general population scale’ to become a more meaningful outcome instrument. Data from a general population can provide a reference point for a total-, item- or subscale score on a particular PROM in relation to the general population, adjusted for sex, age and other potentially important variables. The utility of this normative data extends to both pre-treatment and post-treatment phases. Prior to treatment, normative data can assist in tailoring treatment plans to address specific needs effectively and can support patients to express or discuss their expectations on treatment. For example “I would like the dizziness score to become within normal limits after surgery”. After treatment, normative data plays a pivotal role in evaluating complaints. By comparing a patient’s response profile with the general population, both at the onset of diagnostics and following therapy, healthcare professionals gain valuable insights into the efficacy of the intervention. This evaluation enables a comprehensive assessment of the impact of the treatment on an individual level, enhancing the ability to measure and communicate (realistic) therapeutic outcomes. Normative data of the OQUA can help to understand the impact of the different ear complaints in daily life. The aim of this study is to provide normative data of the OQUA, stratified for the eight most common ear complaints in the general population, defined as adults with no medical history of ear disease or current visits to an ENT surgeon. Methods Study population A nationally representative sample of 500 Dutch adults, with ages ranging between 18 and 91 years was recruited in the period between the 10th of November 2021 and the 16th of November 2021. Participants were recruited by an online independent panel
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