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Content validity and readability of patient-reported questionnaire instruments of hearing disability

Manchaiah, Vinay; Granberg, Sarah; Grover, Vibhu; Saunders, Gabrielle; Hall, Deborah


Vinay Manchaiah

Sarah Granberg

Vibhu Grover

Gabrielle Saunders

Deborah Hall


Objective: The current study evaluates the content validity (i.e., domains assessed) and readability levels of patient-reported questionnaire instruments using internationally recognized
procedures and tools.

Design: A review of the literature to identify candidate instruments and a synthesis of information including mapping extracted items onto the World Health Organization’s – International Classification of Functioning, Disability, and Health (WHO-ICF) and estimating readability.

Study Sample: 14 patient-reported questionnaire instruments. Results: In general, item content focused on body function and on activity limitations and participation restrictions, with less emphasis on environmental and personal factors, and with different emphases across instruments. Many items did not clearly map onto any of the WHOICF categories (i.e., not coded items ranged from 3.7% to 39.1% across the 14 questionnaires). All 14 instruments exceeded the 6th grade reading level when calculated according to the FORCAST formula which is appropriate for assessing a non-narrative text.

Conclusions: Clinical assessment of hearing disability is only as comprehensive as the items covered by the chosen measurement instrument. Our findings confirmed the diversity of domains covered by hearing disability instruments, and gaps in assessment. Some concern is raised about whether the item content is appropriate for those respondents with poor literacy.


Manchaiah, V., Granberg, S., Grover, V., Saunders, G., & Hall, D. (2019). Content validity and readability of patient-reported questionnaire instruments of hearing disability. International Journal of Audiology, 58(9), 565-575.

Journal Article Type Article
Acceptance Date Mar 27, 2019
Online Publication Date Apr 24, 2019
Publication Date Apr 24, 2019
Deposit Date Mar 27, 2019
Publicly Available Date Apr 25, 2020
Journal International Journal of Audiology
Print ISSN 1499-2027
Electronic ISSN 1708-8186
Publisher Taylor & Francis Open
Peer Reviewed Peer Reviewed
Volume 58
Issue 9
Pages 565-575
Keywords Hearing disability, Hearing loss, Patient-reported questionnaire, Content validity,
Public URL
Publisher URL
Additional Information This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Audiology on 24.04.2019, available online:


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