The development of a Self-Rated ICF-based questionnaire (HEAR-COMMAND Tool) to evaluate Hearing, Communication, and Conversation disability: Multinational experts' and patients' perspectives.
Tahereh Afghah, Razan Alfakir, Markus Meis and 5 others
PMID 36451803WHAT IT FOUND
Experts and 109 respondents helped build a 120-item self-rated questionnaire to assess hearing, communication, and conversation disability.
Feedback led to revised wording and split items. This offers a framework for capturing broad functional impacts beyond pure audiometry, though it is not yet validated for clinical use.
Key findings
01The development team created a revised 120-item questionnaire (90 ICF-based and 30 demographic) after incorporating feedback from 109 respondents in Germany, the USA, and Egypt.
02Respondents indicated difficulty distinguishing whether functional problems were caused by hearing loss or other factors, leading to the addition of guidance clarifying the scope of the questions.
03Two items were split into four separate questions because respondents reported that their difficulty levels differed for the combined concepts (e.g., remembering things vs. recalling new information).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study reports on the development and preliminary content evaluation, not full psychometric validation (reliability, construct validity, or responsiveness). The respondent sample was not representative; it excluded users of cochlear implants, bone-anchored hearing aids, and individuals with hearing loss caused by accidents, skull injury, or infectious disease. Only one respondent was included for each of several hearing loss causes (congenital, ototoxicity, ear surgery). The tool is self-rated and relies on patient perception, which may be influenced by the inability to distinguish hearing-related issues from other health conditions, despite added guidance.
Declared interests
The study was funded by the Deutsche Forschungsgemeinschaft (German Research Foundation). No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not assume this questionnaire is a validated diagnostic instrument. It is a development study showing how experts and patients refined the wording and structure. The authors state the results are 'preliminary evidence to support the content validity,' meaning it has not yet been proven to accurately measure disability in a clinical trial or correlate reliably with objective outcomes.