Table 3.
Assessment of study results of included studies.
| References | HRQoL questionnaire | HRQoL questionnaire results Overall mean score (SD) or overall median score (IQR) | Difference in HRQoL (summary measure) Preoperative vs. postoperative | Conclusion(s) | Standardized mean difference (95% CI) | |||
|---|---|---|---|---|---|---|---|---|
| Preoperative | Postoperative | Preoperative vs. 6 months postoperative | Preoperative vs. 12 months postoperative | |||||
| 6 months | 12 months | |||||||
| Baumann et al. (8) | COMOT-15 | 46.4 (18.8) | 38.4 (20.5) | 39.5 (22.0) | p = 0.01 | p = 0.03 | Statistically significant improvement in HRQoL from pre- to 6 and 12 months postoperatively in COMOT-15 scores. | 0.34 (0.04, 0.63) |
| SF-36 | NR* | NR | NR | NR | NR | Overall mean score not reported. No significant changes in any subscale of the SF-36. | CD | |
| Lailach et al. (31)** | COMOT-15 | 42 | 33 (13–52) | p ≤ 0.001 | Statistically significant improvement in HRQoL from pre- to 6 months postoperatively in COMOT-15 and ZCMEI-21 scores. No significant changes in pre- and postoperative scores measured by SF-36. | 1.13 (0.84, 1.43) | ||
| SF-36 | 62 | 63 (45–86) | p > 0.05 | 0.24 (-0.03, 0.52) | ||||
| ZCMEI-21 | 33 (17–50) | 25 (8–41) | p ≤ 0.001 | 1.22 (0.93, 1.52) | ||||
| Nallapaneni et al. (32) | COMOT-15 | 47.7 (17.9) | 38.9 (17.9) | p = 0.01 | Statistically significant improvement in HRQoL from pre- to 6 months postoperative COMOT-15 score. | 0.49 (0.17, 0.82) | ||
| Cavaliere et al. (33) | COMOT-15 | 36.76 (13.1) | 26.88 (12) | p = 0.00011 | Statistically significant improvement in HRQoL from pre- to 12 months postoperative overall COMOT-15 scores. | 0.79 (0.39, 1.19) | ||
| Nurmukhamedova et al. (34) | COMOT-15 | 63.00 | 18.00 | P < 0.001 | Statistically significant improvement in HRQoL from pre- to 12 months postoperative overall COMOT-15 scores. | CD | ||
| Choi et al. (35) | CES | 69.1 (53.8–77.1) | 92.4 (86.7–96.9) | p < 0.001 | Statistically significant improvement in HRQoL from pre- to 12 months postoperatively in CES scores. | 6.99 (6.41, 7.59) | ||
| Nadol et al. (3) | CES | 56.9 (17) | 70 | 74.4 (17.9) | NR | NR | Statistically significant improvement in HRQoL from pre- to 6 and 12 months postoperative CES scores. Even statistically significant improvement in QoL between 6 months and 12 months follow-up. | 1.00 (0.69, 1.31) |
| Jung et al. (36) | CES | Primary surgery 44.4 (15.7) | 77.3 (17.4) | p < 0.001 | Both groups showed statistically significant improvement in HRQoL from pre- to 12 months postoperative CES scores. The primary surgery group showed more statistically significant improvement in HRQoL than revision surgery (p < 0.03) | 1.99 (1.25, 2.72) | ||
| CES | Revision surgery 50.7 (10.0) | 73.7 (10.8) | p < 0.001 | 2.21 (1.43, 2.97) | ||||
| Lucidi et al. (37) | CES | 57.8 (18) | 71.3 (13) Average follow-up 14.9 months | p = 0.000 | Statistically significant improvement in HRQoL from pre- to 14.9 months postoperative CES scores. | 0.86 (0.55, 1.17) | ||
| Nair et al. (38) | CES | 44.4 (13.7) | 88.3 (4.9) | p < 0.001 | Statistically significant improvement in HRQoL from pre- to 6 months postoperative overall CES scores. | 4.27 (3.38, 5.15) | ||
| Bächinger et al. (39) | ZCMEI-21 | 28.6 (13.6) | 21.8 (12.8) | p < 0.0001 | Statistically significant improvement in HRQoL from pre- to 6 months postoperative ZCMEI-21 scores. | 0.51 (0.24, 0.79) | ||
| Bächinger et al. (40) | ZCMEI-21 | 28.8 (13.9) | 21.9 (12.9) | p < 0.0001 | Statistically significant improvement of HRQoL from pre to 6 months postoperative in ZCMEI-21 scores. Even when subgroup analyses were done for CMED, the patients with COM with epitympanic cholesteatoma (p = 0.005) and COM without cholesteatoma (p = 0.0009) were significant. No statistically significant differences in HRQoL postoperatively between the patient groups. | 0.51 (0.24, 0.79) | ||
| Weiss et al. (41) | ZCMEI-21 | 25.1 (15.0) | 20.7 (13.2) | p = 0.004 | Statistically significant improvement in HRQoL from pre- to 6 months postoperative overall ZCMEI-21 score, which was also clinically relevant. | 0.31 (-0.07, 0.69) | ||
| Tailor et al. (42) | COMQ-12 | 28.3 (11.6) | 14.8 (10.6) | p < 0.001 | Statistically significant improvement in HRQoL (COMQ-12) and hearing-specific HRQoL (HHIA) scores from pre- to 12 months postoperative. General HRQoL (EQ-5D) was not significantly changed from before to after surgery. | 1.21 (0.80, 1.63) | ||
| HHIA | 42.9 (28.4) | 31.6 (27.5) | p = 0.012 | 0.40 (0.02, 0.79) | ||||
| EQ VAS | 74.8 (15.9) | 78.6 (17.0) | p = 0.143 | 0.23 (-0.15, 0.62) | ||||
| Bukurov et al. (43) | COMQ-12 | NR | NR | NR | SRM: 1.80 (95% CI 1.50;2.10) | Statistically significant improvement in HRQoL from pre- to postoperative COMQ-12 scores. After bias adjustment, the significance remained. However, the generic QoL SF-36 difference did not remain significant after bias adjustment. | NA | |
| SF-36 | NR | NR | NR | SRM: 0.16 (95% CI−0.03; 0.34) | ||||
| Baetens et al. (44) | COMQ-12 | 24.91 (9.48) | 9.35 (7.73) Average follow-up 2.35 years | p < 0.001 | Statistically significant improvement in HRQoL from pre- to 2.35 years postoperative COMQ-12 scores. | 1.80 (1.15, 2.44) | ||
*Only subscale scores were reported, no overall mean score. **No numerical values were reported, only graphically presented. These are estimated mean scores abstracted from the graphs. If two postoperative measurement moments were present, the mean percentage of change was calculated with the value of the longest follow-up period. SD, Standard Deviation; IQR, Interquartile Range; NR, Not Reported; NA, Not Applicable; COM, chronic otitis media; TPL, tympanoplasty; CWU, canal wall up; CWD, canal wall down; CWU-BOT, canal wall up bony obliteration technique; SF-36, Short Form Health Survey 36; COMOT-15, Chronic Otitis Media Outcome Test 15; ZCMEI-21, Zurich Chronic Middle Ear Inventory 21; CES, Chronic Ear Survey; COMQ-12, Chronic Otitis Media Questionnaire 12; HHIA, Hearing Handicap Inventory for Adults; SRM, Standardized Response Mean; CD, Cannot determine; EQ VAS, EuroQoL Visual Analog Scale; CMED, Chronic Middle Ear Diseases.