Development of a new outcomes instrument for conductive hearing loss.

OBJECTIVE: The objective was to design and validate a disease-specific outcomes instrument for use in conductive hearing loss (CHL). STUDY DESIGN: The study was a retrospective survey of 47 patients recently treated for CHL with either a hearing aid or surgery. Patients were tested with the newly designed instrument (the Hearing Satisfaction Scale [HSS]), previously validated hearing-specific instruments, and a generic quality-of-life instrument. SETTING: The study was performed in an academic tertiary referral center. MAIN OUTCOME MEASURES: These included test-retest reliability, internal consistency reliability, content validity, criterion validity, and construct validity of the HSS. RESULTS: Test-retest reliability (r = 0.72, p < 0.001) and internal consistency reliability were adequate (Cronbach's alpha was 0.83 and 0.74 for the two subscales of the HSS). Criterion validity for individual items was adequate (r = 0.45, p = 0.02) using audiometric data as the criterion standard. Construct validity was also high using results from other instruments; both convergent and divergent validity of the HSS was demonstrated. In addition, the HSS demonstrated the ability to differentially discriminate between subgroups when grouped by level of hearing loss. CONCLUSIONS: The HSS is a valid and reliable instrument for use in outcomes research on conductive hearing loss.

Special hearing aid considerations in elderly patients with auditory processing disorders.

Elderly individuals often have more deficits in speech understanding than would be expected in younger individuals with the same degree of hearing loss. Such deficits may be attributed to the complex nature of age-related changes that occur throughout the central auditory nervous system and are generally referred to as auditory processing disorders. These deficits have been related to poorer performance with hearing aids, reduced satisfaction with hearing aids, and reduced prognosis for successful benefit from hearing aid use. Intervention strategies that enhance signal to noise ratio are often successful in overcoming the debilitating effects of auditory processing disorder in the elderly.