Validation and Preference-Based Scoring of the York Binaural Hearing-Related Quality of Life Questionnaire for Young People.

objectivesThe York Binaural Hearing-Related Quality of Life questionnaire for Young People (YBHRQL-Y) is a 3-item measure of hearing-related quality of life devised specifically for use with young people (children aged 8 to 16 years old) with hearing loss. This research had three objectives: (1) to assign numerical values where a higher value corresponds to better perceived overall health status ("health utility weights") to each of 27 unique combinations of difficulties with speech understanding, sound localization, and listening effort ("hearing health states"); (2) to assess its validity and reproducibility when used with young people with hearing loss; (3) to assess the feasibility of a proxy version designed to be completed by the parents/guardians of young people with hearing loss.

designHealth utility weights were obtained by conducting time trade-off interviews with a cross-sectional sample of 155 young adults, aged 18 to 24 years old, recruited from social media and UK universities. To assess validity and reproducibility, the YBHRQL-Y and other established instruments measuring functional hearing and hearing-related quality of life in children were administered to young people with hearing loss at two time points, 2 wk apart. In total, 71 children aged 8 to 16 yr old with at least a severe hearing loss took part and were recruited from social media, relevant charities, and support groups in the United Kingdom. The feasibility of obtaining information about the binaural hearing-related quality of life of young people with hearing loss indirectly was assessed by administering a proxy version of the YBHRQL-Y to the parents or guardians of the young people who participated in the research. A total of 71 parents or guardians were recruited from social media, relevant charities, and support groups in the United Kingdom.

resultsThe health utility weights elicited from young adults varied monotonically with the level of hearing-related impact described on each of the three dimensions of the YBHRQL-Y, such that the greater the degree of hearing-related impact, the poorer the corresponding health state was judged to be by the respondents. Convergent validity analyses suggested that the domains of the YBHRQL-Y measure the intended constructs and the overall measure relates to the respondent's health-related quality of life. Test-retest analyses suggested it was reliable and showed good agreement between administrations. Pairwise analysis of responses from the young person with hearing loss and those of their parent/guardian suggested that the proxy measure had poor reliability and poor agreement with the measure administered directly to the young person with hearing loss.

conclusionsThe YBHRQL-Y is a valid and reliable measure of hearing-related quality of life when administered directly to a young person aged 8 to 16 with at least a severe hearing loss. An individual's preference-based score, derived from the preferences of young adults, successfully integrates information about binaural-related hearing across the domains of speech understanding, sound localization, and listening effort. The combination of brief age-appropriate questions, good psychometric performance across time, and a preference-based scoring method makes the YBHRQL-Y a straightforward means to assess hearing-related quality of life in young people with hearing loss.