How professionals assess outcome in clinical hearing rehabilitation

Background: Denmark has currently no formal requirements for testing and documenting the aided listening performance and outcome obtained with hearing aids rehabilitation. Yet most professionals both validate and assess the aided listening experience in various ways as part of the fitting procedure and in follow-up assessments. The goal of the present study was to observe standard clinical practice and identify methods and actions currently used, and examine their potential for formalization and inclusion in guidelines, or replacement by existing formalized procedures.

Material and methods: The relevant professionals receive a major part of their training through supervised internships, and it is anticipated that much of their knowledge is tacit and informal. The general methods for the study therefore comprise a combination of interviews with and observations of professionals during hearing-aid fitting and at two-month follow-up. Observations and contextual inquiries of the clinical practice were made in three public hearing clinics in Denmark including 17 professionals, which were either medical audiologists (ENT doctors), audiology assistants or professionals in audiologopedics. These are the main categories of professionals involved in hearing-aid fitting in public clinics in Denmark. Each professional participated between two and ten hours in the present study.

Results: The results show that professionals assess outcome using methods, which are often individually and tacitly anchored covering 1) validation of basic hearing aid functionality, 2) patient awareness on gain with hearing aids, 3) access to knowledge on patient experiences through sound descriptions, 4) assessment of aided performance in real life and 5) non-auditory assessments.

Conclusion: Some of the informal methods observed may be formalized as a part of a more patient-centered communication strategy – other need further examination or may be replaced by existing, already validated formal frameworks, or by test batteries under development.

Acknowledgement: The collaboration within the BEAR project and funding by Innovation Fund Denmark and partners of the BEAR project (incl. Oticon, GN Resound and Widex) is sincerely appreciated.