2019 Conference on Implantable Auditory Prostheses

14-19 July 2019

Granlibakken, Lake Tahoe

Page 162

M71: VALIDITY AND RELIABILITY OF THE COCHLEAR IMPLANT QUALITY OF LIFE (CIQOL)

PROFILE AND GLOBAL INSTRUMENTS IN COMPARISON TO LEGACY INSTRUMENTS

Theodore R McRackan

, Brittany N Hand

, Craig A Velozo

, Judy R Dubno

Medical University of South Carolina, Charleston, SC, USA

The Ohio State University, Columbus, OH, USA

Background: Patient-reported outcomes (PROs) are not routinely measured in adult cochlear

implant (CI) users. Validated and efficient instruments that measure PROs are valuable as they

may complement information from speech recognition outcomes and reveal the varied

communication and other experiences of CI users and how they contribute to quality of life

(QOL). To meet this need, the CIQOL item bank was developed according to the Patient-

Reported Outcomes Information System (PROMIS) and COnsensus-based Standards for the

Selection of health status Measurement INstruments (COSMIN) guidelines. Rigorous

psychometric analyses were applied to responses to the CIQOL item bank from a nationwide

sample (n=371) of adult CI recipients recruited through the CIQOL Development Consortium.

Two additional instruments were developed from the CIQOL item bank: (1) the CIQOL-35

Profile, which consists of 35 items in 6 domain constructs (communication, emotional,

entertainment, environment, listening effort, and social) and (2) the CIQOL-10 Global, which

contains 10 items that provide an overall CIQOL score.

Methods: In the present study, a new sample of 334 adult CI users provided responses to: (1)

the CIQOL instruments; (2) a CI-specific PRO (Nijmegen Cochlear Implant Questionnaire,

NCIQ); and (3) a general-health PRO (Health Utilities Index-3, HUI-3). Responses were

obtained again after 1 month. Here, we report the reliability and validity properties of the CIQOL-

35 Profile and CIQOL-10 Global instruments and compare these to the same properties for the

NCIQ and the HUI-3. Psychometric properties and construct validity of each instrument were

analyzed using confirmatory factor analysis (CFA), item response theory (IRT), and test-retest

reliability (using Pearson’s correlations).

Results: The NCIQ had poor construct validity, as a majority of the subdomains and the total

score had substantial CFA model misfit. In contrast, all six domains of the CIQOL-35 Profile and

the CIQOL-10 Global instrument had adequate to strong construct validity. Based on the CFA

results, IRT analysis could only be applied to the basic sound performance and activity limitation

subdomains of the NCIQ. IRT results showed strong psychometric properties for these two

NCIQ subdomains, all CIQOL-35 Profile domains, and the CIQOL-10 Global instrument. Test-

retest reliability was strong for the CIQOL-35 Profile, CIQOL-10 Global, and NCIQ but moderate

to weak for the HUI-3.

Conclusion: Overall, the CIQOL-35 Profile and CIQOL-10 Global were more psychometrically

sound than the NCIQ and the HUI-3. The CIQOL-35 Profile and CIQOL-10 Global demonstrate

validity, reliability, and efficiency as PRO instruments that can be used in clinical and research

settings to measure QOL-related communication, health, emotional, and social outcomes in

adult CI recipients.

Funding sources: Supported by grants from NIH/NIDCD, NIH/NCATS, and the American

Cochlear Implant Alliance.