Content validity and readability of patient-reported questionnaire instruments of hearing disability

Abstract

Objective: The current study evaluates the content validity (i.e., domains assessed) and readability levels of patient-reported questionnaire instruments using internationally recognized procedures and tools. Design: A review of the literature to identify candidate instruments and a synthesis of information including mapping extracted items onto the World Health Organization's-International Classification of Functioning, Disability, and Health (WHO-ICF) and estimating readability. Study Sample: 14 patient-reported questionnaire instruments. Results: In general, item content focused on body function and on activity limitations and participation restrictions, with less emphasis on environmental and personal factors, and with different emphases across instruments. Many items did not clearly map onto any of the WHO-ICF categories (i.e., not coded items ranged from 3.7% to 39.1% across the 14 questionnaires). All 14 instruments exceeded the 6 th grade reading level when calculated according to the FORCAST formula which is appropriate for assessing a non-narrative text. Conclusions: Clinical assessment of hearing disability is only as comprehensive as the items covered by the chosen measurement instrument. Our findings confirmed the diversity of domains covered by hearing disability instruments, and gaps in assessment. Some concern is raised about whether the item content is appropriate for those respondents with poor literacy.

Validation of the Brief International Classification of Functioning, Disability and Health (ICF) core set for hearing loss: an international multicentre study

“…The Brief ICF core set for HL covers items on a wide range of issues and has the advantage of including categories from the environmental component to represent multidimensional aspects of HL, which seem to be missing in existing hearing disability questionnaires (Manchaiah et al 2019).…”

Validation of the International Classification of Functioning, Disability and Health (ICF) core sets from 2001 to 2019 – a scoping review

“…Valid ICF core sets promote the robustness of instruments developed based on the ICF corset, and the questionable validity of core sets is a less than ideal foundation for an instrument. However, the use of validated instruments, in general, may be uncommon in clinical settings; for example, studies in the audiological field showed that many of the instruments used in audiological rehabilitation have not been validated, and there is a need for evidence-based instruments [81,82]. These examples from the audiological field can be assumed to be similar to and representative of other fields.…”

Listening-Based Communication Ability in Adults With Hearing Loss: A Scoping Review of Existing Measures

“…The prevalence of detection-based measures in the included articles points to a focus within outcome studies to undertake measurement at the level of impairment (i.e., hearing) and not at the level of disability or handicap (World Health Organization, 2001). These findings suggest that within published studies, assessment of hearing is conceptualised as an isolable function that is independent or disconnected from its role in listening and communication (Manchaiah et al, 2019). While detection-based measures are valuable for classifying hearing levels, they provide limited information about functional listening ability in communicative contexts.…”