Validation of a Disease-Specific Quality-of-Life Instrument for Acoustic Neuroma: The Penn Acoustic Neuroma Quality-of-Life Scale

Objectives/Hypothesis: To design and validate the first disease-specific quality-of-life instrument for acoustic neuroma, the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale. Study Design: Prospective instrument validation. Methods: One hundred forty-three patients with acoustic neuromas completed the 80-question preliminary instrument and the general Short Form-36 Health Survey (SF-36). A chart review documented patient information. Statistical analysis was performed for item reduction and evaluation of validity criteria. Results: 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 seven domains, forming the final 26-item PANQOL scale. Test-retest reliability and internal consistency measures for the instrument were high. PANQOL domain scores correlated significantly with related SF-36 domain scores and correlated significantly with related visual analogue scale questions given with the preliminary instrument. PANQOL face domain scores showed significant differences across the House-Brackmann grading system scores and correlated inversely with tumor size. No domain in either the PANQOL or SF-36 had a strong correlation with pure-tone average or speech discrimination scores. The PANQOL scale discriminated acoustic neuroma cases from controls better than the SF-36. Conclusions: We have developed the first validated disease-specific quality of life instrument for patients with acoustic neuromas. Given the lack of a validated equivalent, this tool has the potential to become a critical outcome measure for studies evaluating treatment of patients with acoustic neuromas.