Introduction
The Chronic Otitis Media Outcome Test 15 (COMOT-15) is a 15-item patient-reported measure of health-related quality of life in patients with chronic otitis media. I. Baumann, B. Kurpiers, P. K. Plinkert and M. Praetorius published it in 2009 in the German journal HNO. It has received more than 90 citations and is used in otologic outcomes research.
The COMOT-15 covers ear symptoms, hearing function and psychological well-being. This guide explains its items, its 0–100 scoring, its reliability evidence and its limitations.
Key Features of the COMOT-15
Purpose and Use
The COMOT-15 measures health-related quality of life in patients with chronic otitis media. The authors evaluated it for postoperative change and recommended it for otological outcome research.
Target Population
The COMOT-15 targets adults aged 18 and older with chronic otitis media, typically chronic suppurative otitis media or cholesteatoma.
Structure
The COMOT-15 contains 15 items:
Items
Content
Use
1–6
Ear symptoms, such as pain, discharge and tinnitus
Ear Symptoms subscale
7–9
Hearing function
Hearing Function subscale
10–13
Mental and psychosocial impact
Psychological Well-being subscale
14
Overall impact of chronic otitis media on quality of life
Recorded separately
15
Frequency of ear-related doctor visits in the past 6 months
Recorded separately
Scoring Method
Items 1–14 use a 6-point response scale from 0 to 5; higher scores indicate greater problems or impairment.
Subscales: Ear Symptoms (items 1–6), Hearing Function (items 7–9) and Psychological Well-being (items 10–13).Global Score: based on items 1–13.Transformation: the Global Score and subscales are converted to a 0–100 scale by dividing the sum of raw item scores by the sum of the item ranges and multiplying by 100.Item 14: a global rating of quality-of-life impairment.Item 15: the frequency of ear-related physician visits, on a 0–5 frequency scale.No validated diagnostic or severity cut-off exists; scores are interpreted on a continuum.
Administration Format
The COMOT-15 is self-administered and takes about 5–10 minutes. It can be completed on paper, online, in an in-person interview or by phone or video call. Clinicians should interpret the results in the context of the patient's otologic assessment.
Applications of the COMOT-15
The COMOT-15 supports several uses:
Monitoring: tracking quality of life before and after ear surgery.Treatment planning: describing how chronic otitis media affects a patient.Research: measuring disease-specific quality of life in otological outcome studies.Languages and availability
The original version is German, and an English version is documented in the literature. Other versions include:
Italian: cross-cultural adaptation and validationKannada: development and administration in KannadaChinese: a translation reported in a clinical studyFrench and Spanish: versions used or planned for validation in a registered clinical studyUse requires permission; the exact formal license has not been confirmed.
Reliability and Validity
The COMOT-15 is considered highly reliable and valid. Cronbach's alpha ranged from 0.89 to 0.91 across the overall and subscale scores, and test–retest correlations were above 0.8 for the principal scores.
The original study also demonstrated content validity, discrimination between patients with chronic otitis media and healthy controls, and agreement with a global disease-specific assessment. Furthermore, exploratory factor analysis supported the three-subscale structure.
Validation studies:
Development and validation of the Chronic Otitis Media Outcome Test 15 (COMOT-15) (2009): study linkComparison of two disease-specific instruments assessing health-related quality of life in chronic otitis media (2022): study linkValidation of the German Chronic Ear Survey and its psychometric comparison with the COMOT-15 (2023): study linkLimitations and Considerations
Keep these points in mind:
Low responsiveness: the original validation reported low responsiveness.Narrow focus: later literature notes a strong emphasis on hearing and incomplete coverage of symptoms such as discharge, pain, vertigo and tinnitus.Self-report biases: as a self-report measure, it may be affected by cultural and social desirability bias.Other Versions And Related Questionnaires
The COMOT-15 was developed from a 31-item alpha version, the COMOT-31. These questionnaires are related:
Chronic Ear Survey (CES)Zurich Chronic Middle Ear Inventory-21 (ZCMEI-21)Hearing Handicap Inventory for Adults (HHIA); see the ResRef HHIA guideAmsterdam Inventory for Auditory Disability and Handicap (mAIAD)SF-36Additional Resources
The original article: linkAn image of the COMOT-15 questionnaire: linkA systematic review of health-related quality of life after otologic surgery for chronic otitis media (2023): linkFor inquiries, contact Prof. Dr. I. Baumann, Universitäts-HNO-Klinik, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany, at ingo.baumann@med.uni-heidelberg.de.Browse more ENT questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the COMOT-15 measure?The COMOT-15 measures health-related quality of life in adults with chronic otitis media, across ear symptoms, hearing function and psychological well-being, plus overall impact and doctor visits.
How is the COMOT-15 scored?Items are rated 0 to 5. The Global Score (items 1–13) and the three subscales are converted to 0–100, where higher scores mean greater impairment. Items 14 and 15 are recorded separately.
Does the COMOT-15 have a cut-off score?No. No validated diagnostic or severity cut-off exists, so scores are interpreted continuously, with higher scores reflecting greater impairment.
How long does the COMOT-15 take?It takes about 5 to 10 minutes. Patients can complete it on paper or online, or answer it in an interview or by phone or video call.
A Word from ResRef About the COMOT-15
The COMOT-15 is a concise patient-reported outcome measure for assessing health-related quality of life in adults with chronic otitis media. Its strong original reliability and subsequent use in multiple clinical studies support its value for otologic outcomes research.
References
Baumann, I., Kurpiers, B., Plinkert, P. K., & Praetorius, M. (2009). Entwicklung und Validierung des Chronic Otitis Media Outcome Test 15 (COMOT-15). HNO, 57(9), 889–895. https://doi.org/10.1007/s00106-008-1870-3Cavaliere, M., Capriglione, P., Cavaliere, F., De Corso, E., Zanoletti, E., Motta, G., Iengo, M., & Cantone, E. (2021). Cross-cultural adaptation and Italian validation of chronic otitis media outcome test 15 (COMOT-15). Acta Otorhinolaryngologica Italica, 41(3), 277–281. https://doi.org/10.14639/0392-100x-n1184Prabhu, P., Chandrashekar, A., Jose, A., Ganeshan, A., & Kiruthika, L. (2018). Development and Administration of Chronic Suppurative Otitis Media Questionnaire-12 (COMQ-12) and Chronic Otitis Media Outcome Test-15 (COMOT-15) in Kannada. International Archives of Otorhinolaryngology, 22(2), 108–112. https://doi.org/10.1055/s-0037-1603644Mlynski, R., Bächinger, D., Langanke, T., Lailach, S., Neudert, M., & Weiss, N. M. (2022). Comparison of two disease‑specific instruments assessing health-related quality of life in patients with chronic otitis media. European Archives of Oto-rhino-laryngology: Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 279(2), 703–711. https://doi.org/10.1007/s00405-021-06702-yKnoke, M., Neudert, M., Zahnert, T., & Lailach, S. (2023). [Validation of the German language version of the Chronic Ear Survey and its psychometric comparison with an established German language measurement instrument. German version]. HNO, 71(9), 572–582. https://doi.org/10.1007/s00106-023-01334-6Xie, M., Li, S., Yang, R., Zhou, Y., Gao, X., Duan, M., & Lu, L. (2025). Efficacy of endoscopic full-thickness cartilage-perichondrium complex tympanoplasty in the treatment of adhesive otitis media: a retrospective study. Acta Oto-laryngologica, 145(7), 594–600. https://doi.org/10.1080/00016489.2025.2501604Schouwenaar, E. M. M., Hellingman, C. A., & Waterval, J. J. (2023). Health-related quality of life after otologic surgical treatment for chronic otitis media: systematic review. Frontiers in Neurology, 14, 1268785. https://doi.org/10.3389/fneur.2023.1268785