What is hearing aid verification, and how is it different from validation? Why is verification an important part of the fitting process?
Peter Kossek: That is a great question! Ears are different so we cannot expect the hearing instruments (HIs) to perform in a predicable way in different ears. The purpose of verification in a hearing instrument fitting context is to collect objective information about the sound that the hearing instrument is producing in the ear canal of the individual client, instead of relying on estimations of the performance of the hearing instrument in an average person’s ear. Secondly, a fitting process without verification is mainly based on the dialogue between the professional and the client. This dialogue is an extremely important and necessary part of the process, but the information that the professional needs to effectively adjust the HI for the best benefit consistently requires more details and accuracy than we can expect from the typical hearing instrument user.
Angela Flores, AuD: Probe microphone measurement or PMM is a tool with which to conduct verification. It allows us to measure or verify how well the hearing instruments are performing in the ear relative to target gain, output, etc. There are several reasons to conduct verification—Peter has already mentioned one—we can’t always rely on our patients to provide accurate and detailed information. We also know that verification (as well as validation) are part of best practices guidelines both from the American Academy of Audiology (AAA) and the American Speech-Language-Hearing Association (ASHA). We also know from studies such as MarketTrak that verification may help to improve patient satisfaction and minimize return visits for adjustments. Verification also allows us the opportunity to demonstrate key hearing instrument features, such as noise reduction, to the patient. Demonstrating features via the PMM equipment can help the patient understand those features and improve their satisfaction. It also tells us, the professional, that those features are working the way they say they should.
So, let’s look at verification versus validation. Those terms are sometimes used interchangeably, but they should not be, as they are two different things, although both are important. Verification is an objective measure to determine if the hearing instruments meet a particular standard and are performing as expected. If we are running probe microphone measures to see if we matched a prescriptive gain target, we are performing verification. Think of it this way, last night I followed a recipe for a yummy Greek chicken that I had in a restaurant not that long ago. Following the recipe means putting in just the right amount of salt, olive oil, garlic, etc. – that’s verification. Tasting the chicken and thinking, “that tastes just like the restaurant’s version” is validation. When fitting hearing instruments, we need to know not only the objective measurements but also that the hearing instruments are meeting the goals of the patient. For example, if the patient’s main goal is to hear their granddaughter better, are the hearing instruments allowing that to happen? Validation can be measured through numerous tools such as questionnaires like the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox & Alexander, 1995) or through scales such as the Client Oriented Scale of Improvement or the COSI (Dillon, James, & Ginis, 1997). Obviously, good counseling and understanding the patient’s needs, limitations and expectations are also an integral part of what we do as professionals.
Both verification and validation are important steps in a successful fitting process.
Peter: We see verification as a natural and necessary link in the value chain. Hearing instrument manufacturers invested huge sums of money into development of advanced features to help the hearing impaired. And so at the end of the day, it’s really simple: Verification is a necessary step to ensure that the patient has maximized the full value of features of the hearing instrument and that the hearing instrument manufacturer’s technology is presented in the optimal context.
The AURICAL is a complete modular solution that is integrated in the OTOsuite hearing care platform by Otometrics. It is a fitting tool developed to help the audiologists help patients by maximizing the features of their hearing instrument. Specifically, the AURICAL FreeFit with a dedicated PMM module is the wireless and binaural probe system for the verification. It gives additional possibilities and freedom in the verification process because the patient is not limited by wired probes – ensuring a more comfortable fitting experience. You can read more about the AURICAL fitting solution at: audiologysystems.com/aurical.
Angela: Otometrics/Audiology Systems provides CEU courses to help audiologists and hearing care professionals stay up-to-date on the latest fitting techniques. In addition to assisting their patients in selecting the appropriate hearing instruments, audiologists and hearing care professionals are faced with choices and decisions about the protocols they use for assessments, fittings, and follow-up. Specifically, they must decide what test and tools to include, how (and when) to introduce them, and what findings to look for. For maximum impact, these selections must strike a balance between the potential patient outcomes and the time and ease of implementing them.
The FittingNOW! Series (0.7 CEUs) provides information on tools and techniques to facilitate these decisions. Gus Mueller is the featured speaker for the 2017 course.
The Hand-on AURICAL Training (0.7 CEUs) is designed to assist new users of the AURICAL fitting system in becoming more familiar with the system’s operation. Lastly, you may also join our AudiologyOnline webinar Verification & Counseling of Digital Hearing Instruments with the AURICAL PMM System. Further resources and information can be found at www.audiologysystems.com and on the Otometrics/Audiology Systems Expo on AudiologyOnline.
Cox, R., & Alexander, G. (1995). The Abbreviated Profile of Hearing Aid Benefit. Ear Hear, 16,176-186.
Dillon, H., James, A., & Ginis, J. (1997). Client Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids. JAAA, 8, 27-43.
Kochkin, S., Beck, D.L., Christensen, L.A., et al. (2010). MarkeTrak VIII: the impact of the hearing healthcare professionon hearing aid user success. Hear Rev, 17,12-34.