A Data-Driven Synthesis of Research Evidence for Domains of Hearing Loss, as Reported by Adults With Hearing Loss and Their Communication Partners.

The synthesis could not perform meta-analysis or formal risk-of-bias assessment because the included studies differed too much in design and data type. It included only English-language publications from May 1982 onward, so non-English perspectives and work outside that date range may be missing. All communication partner data came from spouses or partners, not children, friends, colleagues, or carers, so partner burden outside the couple is not represented. Many studies did not fully describe hearing status, and communication partners' own hearing was rarely reported, so some partner complaints may reflect their undiagnosed hearing loss. The frameworks only contain complaints that appeared in the included studies; if a study did not ask about something, or a participant did not mention it, that issue will not appear. Qualitative study quality was mixed: 24 of 34 studies did not justify their methods, and 20 of 34 did not discuss researcher bias. Quantitative study reporting was often poor, especially for sample size and ethics. Severity analysis was limited: only 27 studies reported hearing status, only 18 could be classified, and severe-to-profound data were too sparse for subdomain breakdown.

Do not treat the DoHL frameworks as proof that any assessment or rehabilitation approach changes these complaints. They describe what patients and spouses reported, and the paper says complaint counts show how often a topic appears in the literature, not how important it is.