A Validated, Disease Specific Quality Of Life Instrument For Acoustic Neuroma

Keywords: vestibular schwannoma, quality of life, gamma knife, outcome, registry

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     To design and validate the first patient-graded, disease-specific quality of life instrument for acoustic neuroma.
     A prospective instrument validation study was performed. One-hundred forty-three patients with acoustic neuroma completed the 80-question preliminary instrument and the SF-36 general health survey. 
     A chart review documented patient disease and treatment information. Statistical analysis was performed for item reduction and for evaluation of validity criteria. A repeat application of the final instrument was given for reliability testing.
     Analysis of item-total and item-item score correlations eliminated 38 items from the preliminary instrument.  Exploratory principal component factor analysis eliminated 16 additional items and identified a natural grouping of remaining items into 7 domains, forming the final 26-item instrument.  Test-retest reliability and internal consistency measures for the instrument were high.  All domain scores except facial and pain domains showed wide normal distributions.  Instrument domain scores correlated significantly with related SF-36 domain scores and correlated significantly with related visual analogue scale questions given with the preliminary survey.  Facial domain scores showed significant differences across House-Brackmann Grading System scores and correlated inversely with tumor size.  No domain in either the instrument or SF-36 had a strong correlation with pure-tone average or speech discrimination scores.  The instrument discriminated acoustic neuroma cases from controls better than the SF-36.
     This is a retrospective study.
     A new disease-specific quality of life instrument for acoustic neuroma has demonstrated strong validity and reliability. 
     With no validated equivalent, the new instrument should prove useful in future acoustic neuroma outcomes studies.


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