67 The Otology Questionnaire Amsterdam 4 Data collection of cohort one was carried out between October 2016 and December 2016 and for cohort two between February 2017 and August 2018. Participants For the assessment of construct validity and test-retest reliability, a consecutive cohort of 194 patients visiting the ENT surgeons were recruited at Amsterdam UMC, location VUmc, Amsterdam, and at the Amstelland Hospital, Amstelveen, the Netherlands. For the assessment of responsiveness, a second prospective cohort of 50 consecutive patients undergoing ear surgery was recruited one week before their scheduled surgery. Patients were eligible to participate if they were 18 years and over, had an ear complaint, were not known to have a learning disability or cognitive impairment and had a good written understanding of the Dutch language. Procedures and measurements All patients were asked to complete the questionnaires online. Patients in the first cohort were asked to complete the OQUA and GHSI (see below). After 6-14 days, patients were again asked to complete both questionnaires, assuming that this time interval was sufficient to minimise recall bias, yet short enough for their ear complaints and impact to remain unchanged. Patients in the second cohort were asked to complete the OQUA and GSHI approximately 1 week before their surgery (T0) and again after 3 months after surgery, including two GRSs (T1). The OQUA consists of eight types of ear complaints domains and one impact domain in a 34-item questionnaire. Every complaint domain consists of a minimal of two types of items: one item for severity of the complaint measured with a Visual Analogue Scale (VAS; range 0-100) and one or more item(s) about the frequency of a specific aspect of the complaint measured with a five-point Likert response scale, ranging from ‘almost never’ (0 points) to ‘almost always’ (5 points). For both domains, a higher score indicates more complaints or higher impact. The GHSI contains eighteen items and measures the effect of health problem on the quality of life of a person9. The response to each question is based on a five-point Likert scale ranging from high health status through to low health status. A total score and 3 different subscales can be calculated (general subscale, social support score and physical health score). All scores range from 0-100. A higher score means less impact and better health status.9 Two ‘GRS questions’ were administered at 3-month follow-up. Patients were asked about the change in ear complaints before and after surgery and the change of impact of the
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