Outcome Domains of Successful Hearing Rehabilitation: A Delphi Review

Abstract

A variety of outcome measures are currently used for the assessment of hearing rehabilitation services. However, there is to date no consensus about which outcome measures should be used, and little understanding as to how well the outcomes addressed by existing outcome measures reflect successful hearing rehabilitation according to patients and clinicians. The principles of experience-based co-design suggest that health service providers, policymakers, and researchers should come together with patients and their families to design health services and define what metrics should be used for their success.

Objectives

This study aimed to obtain a consensus view of what outcome domains should be used to measure successful hearing rehabilitation according to end-users of hearing rehabilitation services and stakeholders involved in hearing services provision.

Methods

A sample of hearing services patients identified by not-for-profit consumer organisations and professional stakeholders involved in the provision of hearing services in Australia developed an exhaustive set of potentially relevant and important outcomes of hearing rehabilitation. These were then developed into two questionnaires by the research team, which were disseminated to a national sample of hearing services consumers and professional stakeholders involved in hearing services delivery as part of an online Delphi process. Respondents were asked to rate statements based on how important they were as measures of successful hearing rehabilitation. The respondent ratings were summarised, and the summary was returned to respondents along with the statements for re-rating. This process was repeated until consensus was reached. These were then presented to a consensus workshop involving a subset of participants to determine a final set of outcome domains that should be targeted for the assessment of delivered hearing services.

Results

Fifteen domains of successful hearing rehabilitation were identified by patients and twelve were identified by professional stakeholders via the online Delphi process. The final consensus workshop determined that four that should be targeted for the assessment of hearing services delivery: Communication Ability, Well-being, Personal Relationships, and Reduction of Participation Restrictions.

Conclusion

These results may be used by clinicians and hearing services to inform the development of clinically appropriate and patient-centred outcome metrics for successful hearing rehabilitation. Further work is required to develop or agree on standardised outcome measures for each of the identified domains that may be applied in clinical practice and research.

David Allen

Senior Research Audiologist, Honorary Research Fellow

Dr David Allen is Head of Research at Incept Labs and a Senior Research Audiologist at the National Acoustic Laboratories.