A Profiling System for the Assessment of Individual Needs for Rehabilitation With Hearing Aids.
Wouter A Dreschler, I de Ronde-Brons
PMID 27815547WHAT IT FOUND
Eight audiologists sorted 533 patient hearing-aid goals into five useful categories: detection, speech in quiet, speech in noise, localization, and noise tolerance.
Focus or discrimination did not work, and about 11% did not fit.
Key findings
01Eight audiologists fully agreed on the primary AVAB dimension for 296 of 533 COSI targets, and overall agreement was substantial (Cohen's kappa .81).
02At least five dimensions could be used reliably, but focus or discrimination was selected as the primary dimension in less than 2% of judgments and showed weak to fair agreement, so the authors say it should be excluded.
03About 11% of COSI targets were marked as not possible to categorize, and five of eight observers said tinnitus was a missing dimension.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The COSI goals were collected retrospectively from routine care, and the clinicians who set them were not aware of the study, so some goals were too vague for categorization. The study tested agreement among eight audiologists at one audiological center; it did not follow patients or measure hearing aid benefit, so it cannot show that the profile improves selection or outcomes. The agreement metric was based on the primary dimension, but some targets could relate to more than one dimension, making the primary choice partly arbitrary. Focus or discrimination had weak to fair agreement and was rarely used, and about 11% of targets did not fit the six dimensions; tinnitus and listening effort were identified as missing.
The easy way to misread this
Do not read this as proof that using the profile improves hearing aid selection or patient outcomes. The study only tested whether eight audiologists could sort existing COSI goals into AVAB dimensions, and the authors describe it as a first step.