IHS - International Hearing Society Verification and Validation Methods Questions and Answers — Questions and Answers
Question 1: A client returns for a follow-up appointment two weeks after being fitted with new hearing aids. The practitioner wants to use a standardized questionnaire to efficiently assess the overall success of the fitting, including daily use, benefit, satisfaction, and quality of life. Which of the following validation tools is most suitable for this purpose?
- Real Ear Insertion Gain (REIG)
- Hearing Handicap Inventory for the Elderly - Screening (HHIE-S)
- International Outcome Inventory for Hearing Aids (IOI-HA) (Correct answer)
- Otoscopy
Correct answer: International Outcome Inventory for Hearing Aids (IOI-HA)
The International Outcome Inventory for Hearing Aids (IOI-HA) is a widely used post-fitting validation tool designed to assess multiple domains of success, including daily use, benefit, satisfaction, and overall quality of life. REIG is an objective verification measure, the HHIE-S is typically a pre-fitting screening tool, and otoscopy is a physical examination of the ear.
Question 2: In probe microphone measurements, what does the Real Ear Aided Response (REAR) represent?
- The sound pressure level at the eardrum for a specific input signal with the hearing aid turned on and in place. (Correct answer)
- The difference in sound pressure level between the unaided and aided conditions.
- The sound pressure level measured in a 2cc coupler in a test box.
- The patient's subjective rating of loudness for a given input signal.
Correct answer: The sound pressure level at the eardrum for a specific input signal with the hearing aid turned on and in place.
The REAR is the fundamental measurement of the sound pressure level (SPL) across frequencies at the tympanic membrane with the hearing aid in the ear and turned on. It shows exactly what the eardrum is receiving from the amplified signal, making it a critical verification measure.
Question 3: A patient is skeptical about the benefit of directional microphone technology in their new hearing aids. Which of the following verification procedures would be the most effective objective demonstration of this feature?
- Administering the APHAB questionnaire before and after activating the feature.
- Increasing the overall gain in the programming software to make sounds louder.
- Performing functional gain testing in the soundfield with a single speaker.
- Comparing speech mapping results with a signal from the front (0° azimuth) versus a signal from the rear (180° azimuth). (Correct answer)
Correct answer: Comparing speech mapping results with a signal from the front (0° azimuth) versus a signal from the rear (180° azimuth).
Comparing the hearing aid's output on a speech map for sounds originating from the front versus sounds from the rear provides a direct, visual, and objective demonstration of how the directional microphones are attenuating noise from behind the listener. This is the most effective way to verify this feature's function in the patient's ear.
Question 4: Which of the following is considered a method of hearing aid validation, not verification?
- Using the Client Oriented Scale of Improvement (COSI). (Correct answer)
- Speech mapping to prescriptive targets.
- Measuring Real Ear Insertion Gain (REIG).
- Test box analysis against manufacturer specifications.
Correct answer: Using the Client Oriented Scale of Improvement (COSI).
Validation assesses whether the hearing aid is meeting the patient's real-world needs. The COSI is a subjective outcome measure where the client identifies specific listening goals and then rates their improvement, making it a pure validation tool. The other options are all objective measurements of the hearing aid's performance, which are forms of verification.
Question 5: A client fitted using a prescriptive formula reports that speech is clear, but certain environmental sounds, like running water or a kitchen fan, are uncomfortably loud. The initial verification was performed using only an average speech signal. What is the most appropriate next step using real-ear verification?
- Switch to a different prescriptive formula like NAL-NL2 or DSL v5.
- Measure the Real Ear Aided Response for a loud input (e.g., REAR85 or REAR90) to check the MPO setting. (Correct answer)
- Perform unaided soundfield testing to re-establish hearing thresholds.
- Decrease the overall gain across all channels by 10 dB.
Correct answer: Measure the Real Ear Aided Response for a loud input (e.g., REAR85 or REAR90) to check the MPO setting.
The client's complaint is specific to loud sounds, not average speech. The Maximum Power Output (MPO) of the hearing aid controls the ceiling for loud inputs. The correct verification step is to measure the output in the ear using a loud input signal (like 85 or 90 dB SPL) to ensure the MPO is set to a level that is safe and comfortable for the user.
Question 6: The primary purpose of using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire is to:
- Determine the specific listening situations that are most important to an individual client.
- Quantify the amount of difficulty a patient experiences in various listening situations, comparing their performance with and without hearing aids. (Correct answer)
- Measure the electroacoustic characteristics of the hearing aid in a test box.
- Screen for 'red flag' conditions that require medical referral before a fitting.
Correct answer: Quantify the amount of difficulty a patient experiences in various listening situations, comparing their performance with and without hearing aids.
The APHAB is specifically designed to be administered before a fitting (unaided) and after a period of use (aided). By comparing the scores, it quantifies the reduction in perceived hearing difficulty across different domains (e.g., Ease of Communication, Background Noise), thereby measuring hearing aid benefit. The COSI is better for identifying specific client-chosen situations (A).
IHS - International Hearing Society Verification and Validation Methods Questions and Answers
A client returns for a follow-up appointment two weeks after being fitted with new hearing aids.
The practitioner wants to use a standardized questionnaire to efficiently assess the overall success of the fitting, including daily use, benefit, satisfaction, and quality of life.
Which of the following validation tools is most suitable for this purpose?