Evaluation of health-related quality of life in individuals with vestibular disease using disease-specific and general outcome measures

Background and Purpose. The Dizziness Handicap Inventory (DHI) is a condition-specific health status measure for persons with vestibular disease, and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) is a generic health status assessment. The purposes of this study were (1) to describe the relationship between the DHI and the SF-36, (2) to examine the reliability and responsiveness of these measures for persons in a vestibular rehabilitation program, and (3) to compare health-related quality of life between individuals with vestibular disease and the general population. Subjects. Ninety-five patients, aged 25 to 88 years ((X) over bar=57.0, SD=14.9), were assessed. Methods. To determine reliability, 20 subjects completed both questionnaires twice, 24 to 48 hours apart. Thirty-one subjects completed both questionnaires before and after 6 to 8 weeks of vestibular rehabilitation to establish responsiveness. To establish the relationship between the two assessment tools, 95 subjects completed both questionnaires. Results. Each test was moderately to highly reliable (intraclass correlation coefficients [2,1]=.64-.95), but the tests were poorly to moderately correlated to each other (r=.11-.71). The DHI was more responsive to change than the SF-36. The SF-36 scores of individuals were lower than scores of the general population. Conclusion and Discussion. The DHI and the SF-36 provide reliable and responsive measurements, but they appear to provide different information about the health status of patients with vestibular disease. Compared with the general population, patients with vestibular disease had lower scores for health-related quality of life, but these scores improved after 6 to 8 weeks of treatment. Future studies should clarify whether this improved health status is due to vestibular rehabilitation.