Editorial Predicting Hearing Aid Outcomes DOI: 10.3766/jaaa.25.2.1
T
he world we live in today is very different than it was when I attended graduate school in the 1990s, and yet in some ways it is very much the same. Incredibly powerful technology is now embedded in our everyday lives as it has never been before, and hearing aid technology has likewise advanced dramatically. As a profession, we have an unprecedented number of options and powerful technologies to help the hearing impaired population. While this development and continual improvement in hearing aid products has made our professional lives easier in many ways (e.g., no more tiny screwdrivers), there are a number of challenges involved in fitting hearing impaired patients that newer hearing aids alone cannot solve and most likely never will. If you are one of the lucky audiologists who fit hearing impaired patients with amplification, you have experienced the tremendous personal satisfaction that comes with having a successful fitting and a pleased patient. What you have also likely experienced is walking out to the waiting room only to find the patient sitting there with all the accoutrements you gave him or her at the hearing aid delivery and fitting. We all know what this means. Two patients may have the same configuration of hearing loss and be fitted with the same product, and yet both of the above scenarios can occur. Why? Of course the answer is very complex. Each patient who walks through your office door has a unique set of circumstances (e.g., financial and psychosocial) and personality traits above and beyond the physical hearing impairment. Our effectiveness in rehabilitating our patients begins with understanding their unique needs. No detail is too small, starting with the clinic environment and how we introduce ourselves to the patient all the way through to the follow-up visit and beyond. To have a successful fitting and satisfied patient we have been trained as audiologists to carry out verification of the performance of hearing aids through electroacoustic analysis and real-ear measurements (REM). By completing these steps we have ensured the hearing aid is doing what it should and that the patient is receiving appropriate audibility. Our scientific community has for decades touted the benefits of including verification, and, in fact, it has been shown to improve patient satisfaction (Kochkin et al, 2010). However, we all know that these objective measures by themselves in no way guarantee that a patient will be satisfied once they leave the office. This is why as a profession we must embrace validation as well. Validation refers to the positive (or negative) outcomes that appropriately fitted hearing aids result in. Appropriately managing hearing impaired patients requires both verification and validation, and here are the frightening statistics. According to Kochkin et al (2010), only 55% of respondents report being “satisfied” or “very satisfied” with their hearing aid fitting while 23% report being “somewhat satisfied.” Validation is now becoming a financial issue in our field. Recently, as more and more
insurance companies begin to react to consumers’ request for a hearing technologies benefit, the insurance industry is looking to us for data that describe the efficacy of hearing technologies for the hearing impaired. However, this is not easy research to do for the very reasons given above. Humes (1999) illustrated this by showing that validation of hearing aids is in fact a multidimensional construct and is extremely complex. The author reported that only 60–70% of the variance in total outcome could be explained when as many as 13 variables (e.g., satisfaction, hearing aid use) were assessed. In this issue of the JAAA, Bra¨nnstro¨m and colleagues, in their article “Prediction of IOI-HA Scores Using Speech Reception Thresholds and Speech Discrimination Scores in Quiet,” compare the psychometric properties of the International Outcome Inventory for Hearing Aids (IOI-HA) to previous reported studies. The IOI-HA was developed by Cox and Alexander in 2002 for assessing hearing aid (HA) rehabilitation efficacy. The device consists of seven domains, evaluating several dimensions of hearing aid fitting outcomes (e.g., hearing aid usage, benefit, quality of life, and satisfaction) (Cox and Alexander, 2002). The specific aim of the Bra¨nnstro¨m et al study was to investigate the relationship between pure-tone average, speech recognition threshold, and speech understanding in quiet and determine if scores on the IOI-HA could be predicted. The authors catalogued a number of descriptive variables (e.g., age, gender, first-time/experienced HA users) to use in the analysis. Results from this article detail how clinicians could potentially use this data to help set realistic hearing aid expectations for hearing impaired patients seeking amplification, which could lead to high patient satisfaction. This study adds support to the notion that there is more to a successful hearing aid fitting than just the audiogram—a fact repeatedly demonstrated over the years.
Devin L. McCaslin Deputy Editor-in-Chief REFERENCES Cox RM, Alexander GC. (2002) The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version. Int J Audiol 41(1):30–35. Humes LE. (1999) Dimensions of hearing aid outcome. J Am Acad Audiol 10(1):26–39. Kochkin S, Beck DL, Christensen LA, et al. (2010) MarkeTrak VIII: the impact of the hearing healthcare professional on hearing aid user success. Hear Rev 17(4):12–34.
Visit JAAA online at http://www.audiology.org/resources/journal
Delivered by Ingenta to: Economics Dept IP : 91.198.127.179 On: Tue, 28 Jun 2016 17:37:13
T
he world we live in today is very different than it was when I attended graduate school in the 1990s, and yet in some ways it is very much the same. Incredibly powerful technology is now embedded in our everyday lives as it has never been before, and hearing aid technology has likewise advanced dramatically. As a profession, we have an unprecedented number of options and powerful technologies to help the hearing impaired population. While this development and continual improvement in hearing aid products has made our professional lives easier in many ways (e.g., no more tiny screwdrivers), there are a number of challenges involved in fitting hearing impaired patients that newer hearing aids alone cannot solve and most likely never will. If you are one of the lucky audiologists who fit hearing impaired patients with amplification, you have experienced the tremendous personal satisfaction that comes with having a successful fitting and a pleased patient. What you have also likely experienced is walking out to the waiting room only to find the patient sitting there with all the accoutrements you gave him or her at the hearing aid delivery and fitting. We all know what this means. Two patients may have the same configuration of hearing loss and be fitted with the same product, and yet both of the above scenarios can occur. Why? Of course the answer is very complex. Each patient who walks through your office door has a unique set of circumstances (e.g., financial and psychosocial) and personality traits above and beyond the physical hearing impairment. Our effectiveness in rehabilitating our patients begins with understanding their unique needs. No detail is too small, starting with the clinic environment and how we introduce ourselves to the patient all the way through to the follow-up visit and beyond. To have a successful fitting and satisfied patient we have been trained as audiologists to carry out verification of the performance of hearing aids through electroacoustic analysis and real-ear measurements (REM). By completing these steps we have ensured the hearing aid is doing what it should and that the patient is receiving appropriate audibility. Our scientific community has for decades touted the benefits of including verification, and, in fact, it has been shown to improve patient satisfaction (Kochkin et al, 2010). However, we all know that these objective measures by themselves in no way guarantee that a patient will be satisfied once they leave the office. This is why as a profession we must embrace validation as well. Validation refers to the positive (or negative) outcomes that appropriately fitted hearing aids result in. Appropriately managing hearing impaired patients requires both verification and validation, and here are the frightening statistics. According to Kochkin et al (2010), only 55% of respondents report being “satisfied” or “very satisfied” with their hearing aid fitting while 23% report being “somewhat satisfied.” Validation is now becoming a financial issue in our field. Recently, as more and more
insurance companies begin to react to consumers’ request for a hearing technologies benefit, the insurance industry is looking to us for data that describe the efficacy of hearing technologies for the hearing impaired. However, this is not easy research to do for the very reasons given above. Humes (1999) illustrated this by showing that validation of hearing aids is in fact a multidimensional construct and is extremely complex. The author reported that only 60–70% of the variance in total outcome could be explained when as many as 13 variables (e.g., satisfaction, hearing aid use) were assessed. In this issue of the JAAA, Bra¨nnstro¨m and colleagues, in their article “Prediction of IOI-HA Scores Using Speech Reception Thresholds and Speech Discrimination Scores in Quiet,” compare the psychometric properties of the International Outcome Inventory for Hearing Aids (IOI-HA) to previous reported studies. The IOI-HA was developed by Cox and Alexander in 2002 for assessing hearing aid (HA) rehabilitation efficacy. The device consists of seven domains, evaluating several dimensions of hearing aid fitting outcomes (e.g., hearing aid usage, benefit, quality of life, and satisfaction) (Cox and Alexander, 2002). The specific aim of the Bra¨nnstro¨m et al study was to investigate the relationship between pure-tone average, speech recognition threshold, and speech understanding in quiet and determine if scores on the IOI-HA could be predicted. The authors catalogued a number of descriptive variables (e.g., age, gender, first-time/experienced HA users) to use in the analysis. Results from this article detail how clinicians could potentially use this data to help set realistic hearing aid expectations for hearing impaired patients seeking amplification, which could lead to high patient satisfaction. This study adds support to the notion that there is more to a successful hearing aid fitting than just the audiogram—a fact repeatedly demonstrated over the years.
Devin L. McCaslin Deputy Editor-in-Chief REFERENCES Cox RM, Alexander GC. (2002) The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version. Int J Audiol 41(1):30–35. Humes LE. (1999) Dimensions of hearing aid outcome. J Am Acad Audiol 10(1):26–39. Kochkin S, Beck DL, Christensen LA, et al. (2010) MarkeTrak VIII: the impact of the hearing healthcare professional on hearing aid user success. Hear Rev 17(4):12–34.
Visit JAAA online at http://www.audiology.org/resources/journal
Delivered by Ingenta to: Economics Dept IP : 91.198.127.179 On: Tue, 28 Jun 2016 17:37:13
