Introduction
The Otitis Media-6 (OM-6) is a 6-item caregiver-reported measure of health-related quality of life in children with chronic otitis media with effusion or recurrent acute otitis media. Richard M. Rosenfeld, Ari J. Goldsmith, Lynne Tetlus and Anna Balzano published it in 1997 in the Archives of Otolaryngology–Head & Neck Surgery. It has received about 280 citations.
The authors worked in pediatric otolaryngology at the State University of New York Health Science Center at Brooklyn and Long Island College Hospital. This guide explains the OM-6's domains, scoring, change scores and supporting evidence.
Key Features of the Otitis Media-6 (OM-6)
Purpose and Use
The OM-6 measures the impact of ear disease on a child's physical symptoms, hearing, speech, emotional well-being, daily activities and caregiver concerns. It is also designed to evaluate changes in quality of life after clinical intervention.
Target Population
The OM-6 targets children aged 6 months to 12 years with chronic otitis media with effusion or recurrent acute otitis media. A caregiver completes it on the child's behalf.
Structure
The OM-6 has 6 items, one for each domain, covering the preceding 4 weeks:
Physical suffering: ear pain, discomfort, discharge, ruptured eardrum, fever and balance problemsHearing lossSpeech impairmentEmotional distress: irritability, frustration, sadness, restlessness and poor appetiteActivity limitations: playing, sleeping, social activities and school or daycare attendanceCaregiver concerns about the child's ear infections or middle-ear fluidThe original form also includes a separate global ear-related quality-of-life rating, which is not part of the six-item summary score.
Scoring Method
Each item is scored on a 7-point scale from 1 (no problem) to 7 (greatest problem). The six item scores are summed and divided by 6, giving a mean summary score from 1.0 to 7.0; higher scores indicate poorer quality of life.
Change scores: subtract the follow-up mean score from the baseline mean score. Positive values indicate improvement, and negative values indicate deterioration. The article classifies change scores as:
Change score
Size of change
Less than 0.5
Trivial
0.5–0.9
Small
1.0–1.4
Moderate
Greater than 1.5
Large
No cut-off scores are reported.
Administration Format
A caregiver completes the OM-6 about the child's experience over the previous 4 weeks.
Applications of the Otitis Media-6 (OM-6)
The OM-6 supports pediatric clinical care and research:
Quality-of-life assessment: describing the impact of ear disease on a child and family.Intervention outcomes: measuring change after clinical intervention with change scores.Outcomes research: measuring quality of life in pediatric otitis media research.Languages and availability
Besides the original English version, Arabic, Portuguese, Turkish and Danish versions are reported. The Danish validation study obtained written permission from the original developers for translation and use. The OM-6 appears to require authorization for use or translation; an explicit public license could not be verified.
Reliability and Validity
The original development study demonstrated strong reliability, validity and responsiveness to clinical change. Later studies examined its factor structure and interpretability, and validated a parent-proxy version for infants and toddlers.
Validation studies:
Quality of life for children with otitis media (1997): study linkThe Otitis Media-6 questionnaire: psychometric properties with emphasis on factor structure and interpretability (2013): study linkValidations of the OM-6 parent-proxy survey for infants and toddlers with otitis media (2018): study linkLimitations and Considerations
Keep these points in mind:
Caregiver report: scores reflect the caregiver's view of the child's quality of life.No cut-off scores: no cut-offs are reported, so use the mean score and change scores.Permissions: use or translation appears to require authorization from the developers.Other Versions And Related Questionnaires
Related instruments include:
Otitis Media Outcome–22 (OMO-22): an expanded questionnaire derived from the OM-6Otitis Media-8 (OM8-30): a related but distinct questionnaire on the impact of otitis mediaQuality of Life in Children's Ear Problems (OMQ-14)Additional Resources
The original article: linkFor inquiries, contact Richard M. Rosenfeld, MD, MPH, Distinguished Professor of Otolaryngology, at richard.rosenfeld@downstate.edu.Browse more ENT questionnaires and pediatric questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the OM-6 measure?The OM-6 measures the quality-of-life impact of chronic or recurrent otitis media in children across physical suffering, hearing, speech, emotional distress, activity limitations and caregiver concerns.
How is the OM-6 scored?Each of the 6 items is rated from 1 (no problem) to 7 (greatest problem). The mean of the six items gives a summary score from 1.0 to 7.0, and higher scores mean poorer quality of life.
How do you interpret OM-6 change scores?Subtract the follow-up score from the baseline score. Changes below 0.5 are trivial, 0.5–0.9 small, 1.0–1.4 moderate and above 1.5 large, with positive values showing improvement.
Who completes the OM-6?A caregiver completes the OM-6 for a child aged 6 months to 12 years, describing the previous 4 weeks.
A Word from ResRef About the Otitis Media-6 (OM-6)
The OM-6 is a brief caregiver-reported instrument designed to assess the quality-of-life impact of chronic and recurrent otitis media in children. The original development study demonstrated strong reliability, validity, and responsiveness to clinical change.
References
Rosenfeld, R. M., Goldsmith, A. J., & Tetlus, L. (1997). Quality of Life for Children With Otitis Media. Archives of Otolaryngology - Head and Neck Surgery, 123(10), 1049–1054. https://doi.org/10.1001/archotol.1997.01900100019002Heidemann, C., Godballe, C., Kjeldsen, A., Johansen, E. C., Faber, C., & Lauridsen, H. (2013). The Otitis Media-6 questionnaire: psychometric properties with emphasis on factor structure and interpretability. Health and Quality of Life Outcomes, 11(1), 201. https://doi.org/10.1186/1477-7525-11-201Tao, J., Schulz, K., Jeffe, D. B., & Lieu, J. E. C. (2018). Validations of the OM‐6 Parent‐Proxy Survey for Infants/Toddlers with Otitis Media. Otolaryngology–Head and Neck Surgery, 158(5), 934–941. https://doi.org/10.1177/0194599817750372