University of Oulu

Juha T. Laakso, Juha Silvola, Timo Hirvonen, Samuli Suutarla, Ilkka Kivekäs, Riitta Saarinen, Lotta Haavisto, Jaakko Laitakari, Antti A. Aarnisalo, Aarno Dietz, Jussi Jero, Maija Hytönen, Saku T. Sinkkonen, Development of otology specific outcome measure: Ear Outcome Survey-16 (EOS-16), Journal of Otology, Volume 16, Issue 3, 2021, Pages 150-157, ISSN 1672-2930,

Development of otology specific outcome measure : Ear Outcome Survey-16 (EOS-16)

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Author: Laakso, Juha T.1; Silvola, Juha2; Hirvonen, Timo1;
Organizations: 1Department of Otorhinolaryngology – Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2Department of Ear, Nose, and Throat – Division of Surgery, Akershus University Hospital, Lørenskog, Norway
3Department of Otorhinolaryngology, Kymenlaakso Central Hospital, Kotka, Finland
4Department of Otorhinolaryngology – Head and Neck Surgery, Tampere University Hospital and Tampere University, Tampere, Finland
5Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
6Department of Otorhinolaryngology – Head and Neck Surgery, Oulu University Hospital and PEDEGO Research Unit, University of Oulu and Medical Research Center Oulu, Finland
7Department of Otorhinolaryngology – Head and Neck Surgery, Kuopio University Hospital and University of Kuopio, Kuopio, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.5 MB)
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Language: English
Published: Elsevier, 2021
Publish Date: 2021-09-17


Purpose: An important outcome measure of patient care is the impact on the patient’s health-related quality of life (HRQoL). Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms, hearing problems, psychosocial impact, and the need for care. The optimal length of the recall period has not been studied. For these reasons, a new survey is needed that would cover most chronic ear diseases.

Methods: A preliminary 24-item survey (EOS-24) was created. Untreated adult patients (included n = 186) with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument. The recruiting otologists evaluated the severity of the disease and the disability caused by it. A control group was recruited. Based on the patients’ responses in different diagnosis groups, the items were reduced according to pre-defined criteria. The resulting survey was validated using a thorough statistical analysis.

Results: The relevance and necessity of the original 24 items were thoroughly investigated, leading to the exclusion of 8 items and the modification of 1. The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups, thus constituting the final instrument, EOS-16. The most suitable recall period was three months.

Conclusions: EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population. The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.

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Series: Journal of otology
ISSN: 1672-2930
ISSN-L: 1672-2930
Volume: 16
Issue: 3
Pages: 150 - 157
DOI: 10.1016/j.joto.2021.01.003
Type of Publication: A1 Journal article – refereed
Field of Science: 3125 Otorhinolaryngology, ophthalmology
Copyright information: © 2021 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (