Questionnaire Module puts evidence-based care a click away

 by Arild Rasmussen, Project Director 

Hearing instrument and assistive device technology is more capable than ever before, offering the promise of improved quality of life for people with hearing loss. However, hearing care professionals often remark that they have not found a good solution for the efficent documentation of outcomes when fitting new and experienced users with hearing devices. The updated Noah 4 Questionnaire Module offers a simple, Noah-integrated solution to address exactly this challenge.

Documenting Effectiveness Efficiently

While hearing professionals have been performing verification and validation measures for years they have not done as well at measuring hearing quality nor the perceived impact of the fitting on communication. Whether required by payors, or to monitor the effectiveness of your interventions, keeping a close watch on outcomes gives you insights that can be used to enhance your patient care.

In some cases, you may be able to compare your outcomes to normative data and see if you are pushing the envelope towards a higher level of care for your patients. In addition, taking the time to do this will ensure you address the problems your patient cares most about.

By integrating three standardized questionnaires into Noah, the updated Noah 4 Questionnaire Module allows you to efficiently integrate evidence-based documentation tools into the patient care process.

The COSI questionnaire

The Client Oriented Scale of Improvement (COSI) is an open-ended questionnaire, developed by Harvey Dillon, PhD, and colleagues at the National Acoustics Lab in Australia. It is comprised of Needs Assessment and Outcome Assessment sections. In the Needs Assessment section, patients list five very specific situations where they want to improve hearing or communication. These goals are then ranked in order of importance. After a short period, for example 2 weeks, a professional can review the patient’s progress using the first of two Outcome Assessment sections. Later, you can document Final Ability.

This assessment could be timed to take place at 4-6 weeks post-fitting, coinciding with the end of the trial period.

The APHAB questionnaire

In 1995, Robyn Cox, PhD, and Genevieve Alexander, MA, of the Hearing Aid Research Laboratory (HARL) at the University of Memphis developed the Abbreviated Profile of Hearing Aid Benefit (APHAB). The APHAB is a 24-item self-assessment inventory in which patients report the amount of trouble they are having with communication or noise in various every-day situations. Benefit is calculated by comparing the patient’s reported difficulty in the unaided condition with the difficulty the person experiences when using amplification. The APHAB produces scores for four subscales: Ease of Communication (EC), Reverberation (RV), Background Noise (BN), and Aversiveness (AV).

The APHAB is great for comparing results among different patients. It also allows two different hearing aids to be compared directly with each other. 

An integral component of the APHAB are three sets of normative data against which each patient’s responses can be compared. These norms were collected by Robyn Cox and colleagues at HARL and are valid for the United States.

The IOI-HA questionnaire

The International Outcome Inventory for Hearing Aids (IOI-HA) was developed at an international workshop on "Measuring Outcomes in Audiological Rehabilitation Using Hearing Aids" in Eriksholm in Denmark. It is the newest addition to the Questionnaire Module and we hope you put it to good use. 

The IOI-HA was originally developed to be used as a supplement in an outcomes-measurement battery. The idea was to have one measure that would allow for outcomes to be compared across studies and across borders. To that end, a long list of approved translations of the IOI-HA are available (see 

Since its release, it has gained support due to its ease of use, simple scoring methodology, strong psychometric properties, and for some translations and some populations, available normative data. The IOI-HA covers a set of seven core outcome items which are sufficiently general to apply to many different technologies, and studies across the globe.  The result is a mini-profile which will detail average wear time, perceived helpfulness of the device(s) in challenging situations, residual challenges, overall benefit, residual participation restrictions, continued effect of the hearing loss on communication partners, and effect of the hearing aid on enjoyment of life. 


An Integrated Solution

Since these questionnaires are integrated in Noah, all three outcome measures are available with a single click for use with any patient. What’s more, Noah’s electronic versions of these questionnaires provide an efficient way to store and retrieve the results in a format familiar to those accustomed to filling out the paper-based versions. 

If you  have not yet updated your Questionnaire Module, click here to download the newest version.