Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

Abstract

Purpose: To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. Methods: Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. Results: Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively). Conclusion: Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.

Individual Hearing Aid Benefit in Real Life Evaluated Using Ecological Momentary Assessment

“…Explanations based on audiometric findings, however, are quite likely to fall short in the self-assessment of hearing abilities. As in established questionnaires, such as the Speech, Spatial, and Qualities of Hearing Scale ( Gatehouse & Noble, 2004 ) and the APHAB ( Cox & Alexander, 1995 ), EMA still captures the subjective perspective on activity limitations, and perfect agreement with audiometric findings is neither intended nor achieved ( Banh et al., 2012 ; Dornhoffer et al., 2020 ; von Gablenz et al., 2018 ). Complex, temporally dynamic interactions of personality and context, which probably impact the self-assessment of abilities, are in general difficult to disentangle and certainly require complementary methods and a larger study sample when EMA data are concerned.…”

Results of Active Middle Ear Implantation in Patients With Mixed Hearing Loss After Middle Ear Surgery: A Prospective Multicenter Study (the ROMEO Study)

“…Similar results were revealed in another study evaluating subjective satisfaction following VSB surgery [ 13 ]. In a study on the assessment of the benefits of conventional HAs, significant increases in the AV subscale scores were observed in the aided condition relative to that in the unaided condition [ 14 ]. We assumed that as the hearing threshold decreased after surgery, the amount of external sound perceived increased, and this noise made some patients feel uncomfortable.…”

Objective and Subjective Outcomes in Patients with Hearing Aids: A Cross-Sectional, Comparative, Associational Study

“…Several studies regarded patient-reported outcome measures (PROMs) as indicators of benefits [Wilson and Stephens, 2003;Williams et al, 2009;Hickson et al, 2010;Hickson et al, 2014;Chang et al, 2016;Wu et al, 2019]. Other studies assessed benefits using both objective and subjective measures [Mendel, 2007;Chang et al, 2008;Meister et al, 2015;Dornhoffer et al, 2020;Kwak et al, 2020]. There is some ambiguity in the relationships between objective audiologic tests and PROMs, and research results are far from consistent.…”

“…Meister et al [2015] found that the pure tone aver-age (PTA) thresholds were negatively associated with subjective outcomes [Meister et al, 2015]. However, other studies reported absent or low-to-weak correlations among PROMs and hearing sensitivity and speech recognition scores [Mendel, 2007;Dornhoffer et al, 2020;Kwak et al, 2020]. Studies in this area often have a limited range of HL -concentrated in moderate [Mendel, 2007;Wu et al, 2019;Dornhoffer et al, 2020;Kwak et al, 2020].…”