Quality of Life Instruments in Ménière's Disease

Abstract

Evaluate the sensitivity of quality of life (QoL) instruments over time in patients with Ménière's disease using general, symptom-specific, and disease-specific QoL instruments. Prospective study using QoL instruments administered serially over 4 months in patients undergoing treatment for Ménière's disease. Sixty-one people aged 33 to 71 years with active, unilateral, cochleovestibular Ménière's disease refractory to medical management completed two general QoL instruments, Sense of Coherence (SOC) and World Health Organization Quality of Life-Abbreviated Version (WHOQOL-BREF), one symptom-specific QoL instrument, Vertigo Symptom Scale (VSS), and one disease-specific QoL instrument, Ménière's Disease Patient Oriented Severity Index (MDPOSI). All measures were administered at baseline and again 2 and 4 months later. Disease- and symptom-specific instruments including the MDPOSI and VSS were positively correlated with vertigo control category (Pearson's R=0.345, MDPOSI; 0.279, VSS), indicating sensitivity to the frequency of vertigo spells. These instruments were also sensitive to changes in vertigo over time. Standardized response means showed greatest responsiveness to change on the MDPOSI (0.80) and the VSS (0.79). Standardized response means for SOC and WHOQOL-BREF were 0.03, and 0.32, respectively, suggesting poor responsiveness to change of symptoms. The VSS and MDPOSI were highly correlated (Pearson's r coefficient 0.744; P<.001). A disease-specific QoL instrument such as the MDPOSI and a symptom-specific instrument such as the VSS more accurately reflect changes in control of vertigo in people with Ménière's disease over time than do general QoL instruments. These instruments can be used to determine the life impact of Ménière's disease and how aggressive therapy should be for the patient.