Patient factors associated with novel ear-q appearance, psychosocial and social scales: a cross-sectional study and regression analysis

Introduction The EAR-Q is a rigorously validated patient-reported outcome measure which evaluates ear appearance and health-related quality of life (HRQL) in patients with congenital or acquired ear conditions. The aim of this study was to conduct an exploratory analysis to examine factors associated with EAR-Q appearance and HRQL scale scores. Methods 862 participants, aged 8-29 years, with a congenital or acquired ear condition, completed the EAR-Q as part of an international field-test study. Patients responded to demographic and clinical questions as well as the EAR-Q. Univariable and multivariable linear regression analyses were used to determine which factors were significant predictors for scores on the EAR-Q Appearance, Psychological, and Social scales. Results Most participants were male (57.4%), awaiting treatment (55.0%), and had a microtia diagnosis (70.4%), with a mean age of 13 (±4) years. Worse ear appearance scores were associated (p<0.02) with male gender, microtia, no history of treatment, ear surgery within 6 months, unilateral involvement, and greater self-reported ear asymmetry. Decreased psychological scores were associated (p<0.01) with increasing participant age, no treatment history, recent ear surgery and dissatisfaction with ears matching/overall. Lower social scores were associated (p≤0.04) with no treatment history, those awaiting surgery, ear surgery within the last 6 months, bilateral involvement, and self-reported ears matching/appearance overall. Conclusion This analysis identifies patient factors that may influence ear appearance and HRQL scale scores. The findings provide evidence of patient factors that should be adjusted for when undertaking future observational research designs using the EAR-Q in this patient population.