Cross-Cultural Translation and Adaptation of the Consumer Ear Disease Risk Assessment (CEDRA) Questionnaire in Danish

Abstract

This study aimed to cross-culturally translate and adapt the Consumer Ear Disease Risk Assessment (CEDRA) questionnaire into Danish for remote ear, nose, and, throat assessments in adult, first-time hearing aid users when used in conjunction with audiometric measures and visual images of the tympanic membrane. Employing field-specific guidelines, the tool underwent a rigorous translation process. This was succeeded by field testing via cognitive debriefing with 30 intendent respondents and a pilot test involving 600 adult, potential first-time hearing aid users from 2020–2022. Test–retest reliability analysis in 113 respondents revealed high consistency and reproducibility, with most items showing Spearman’s correlation coefficients of 0.82 or higher and a Pearson’s correlation of 0.92 for the total score. The tool demonstrated moderate discriminative ability in identifying individuals at high and low risk of complicated hearing loss and targeted ear diseases, supported by an area under the curve of 0.82 on the receiver operating characteristics curve. Our findings suggest that the Danish-translated version of CEDRA is a reliable and effective screening instrument when used with audiometry and tympanometry, warranting further validation in a larger population.