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Abstract-
Outcomes measurement in audiology has received much attention because of the need to demonstrate efficacy of treatment, provide evidence for third-party payment, carry out cost-benefit analyses, and justify resource allocation. Outcomes measurement shows the benefits obtained from a hearing aid and determines the costs of obtaining those benefits. In this article, we discuss why the seemingly simple issue of outcomes measurement is highly complex and the use of generic and disease-specific tools and the relationship between them; we also provide information regarding the International Classification of Functioning (ICF) system for selecting outcome measures. We then discuss factors complicating outcomes measurement, including discrepancies between clinically derived outcomes and functional outcomes, the ways clinicians can affect outcomes, and factors intrinsic to the patient that influence outcomes. We conclude that if the vision of moving quickly and efficiently from bench to chairside is to be realized, then clinicians must routinely measure hearing aid outcomes and researchers investigate their validity and usefulness.
Key words: audiology, hearing aid, hearing loss, International Classification of Functioning Disability and Health, measurement, outcome assessment (healthcare), outcomes, quality of life, treatment outcome, World Health Organization.
Abbreviations: APHAB = Abbreviated Profile of Hearing Aid Benefit, CD = compact disc, COSI = Client Oriented Scale of Improvement, CUA = cost-utility analysis, DTG = delayed treatment group, HHIE/A = Hearing Handicap Inventory for the Elderly or for Adults, HINT = Hearing in Noise Test, ICD = International Classification of Disease, ICF = International Classification of Functioning Disability and Health, ITG = immediate treatment group, PIADS = Psychosocial Impact of Assistive Devices Scale, PPDIS = Performance-Perceptual Discrepancy, PPT = Performance-Perceptual Test, QALY = quality-adjusted life year, SADL = Satisfaction with Amplification in Daily Life, SD = standard deviation, SNR = signal-to-noise ratio, SRTN = Speech Reception Threshold in Noise, VA = Department of Veterans Affairs, WHO = World Health Organization, WHODAS II = World Health Organization Disability Assessment Schedule.
INTRODUCTION: WHY MEASURE OUTCOMES?
The measurement of outcomes in audiology has received much attention in recent years [1-3] because of the need to demonstrate efficacy of treatment for consumers, provide evidence for third-party payment, carry out cost-benefit analyses, and justify allocation of resources [4-5]. While outcomes measurement is critical for all audiological services, much of the recent attention...