Abstract
The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment on four different subscales pertaining to different listening situations. Using a very large patient cohort, this study aims to show how answers are distributed within the four subscales before and after hearing aid fitting, and what benefit the patients experience. The results are discussed on the basis of the available literature. Between April 2013 and March 2016, 35,000APHAB questionnaires from nine German statutory health insurance providers were evaluated. The average values before and after hearing aid fitting, as well as the benefit, were determined for all four APHAB subscales and analyzed graphically. The results of the subjective evaluation of hearing impairment before and after hearing aid fitting and the resultant benefit were plotted by percentile distribution graphs and boxplots. The data were analyzed statistically. There was no overlap of the interquartile ranges before and after hearing aid fitting in any of the APHAB subscales. In three scales (EC, BN and RV), the median improvement after hearing aid fitting was nearly 30percentage points. In the AV subscale, this value was slightly negative. The percentile distribution graphs used in this study allow individual evaluation of subjective hearing impairment before and after hearing aid fitting, as well as of the resultant benefit, on the background of ahuge database. Additionally, it is demonstrated why presentation as boxplots and the average benefit values calculated from these is problematic.
Highlights
Abb. 6 8 BN-Skala, Boxplots vor und nach einer Hörgeräteversorgung (HGV) sowie des resultierenden Nutzens
Da die Werte normalverteilt sind und auf individuellen Angaben beruhen, ist es eigentlich kaum möglich, einen fixen Abbreviated Profile of Hearing Aid Benefit (APHAB)-Grenzwert zu definieren, ab dem man von einer erfolgreichen HGV sprechen kann
Löhler J, Wollenberg B, Schlattmann P, Hoang N, Schönweiler R (2016) Associations between the probabilities of frequency-specific hearing loss and unaided Abbreviated Profile of Hearing Aid Benefit (APHAB) scores
Summary
Insbesondere sollen die Ergebnisse für die 4 Subskalen des APHAB vor und nach einer HGV sowie des resultierenden Nutzens mittels Perzentilverteilungskurven und Boxplots dargestellt werden, sodass individuelle Ergebnisse nicht nur wie bisher anhand von Durchschnittsergebnissen, sondern zusätzlich mittels statistischer Streumaße und damit hinsichtlich signifikanter Unterschiede vor und nach einer HGV besser interpretiert werden können. Nach Cox wird eine Verbesserung von 5 Prozentpunkten pro APHAB-Score und 22 Prozentpunkten in diesen 3 Skalen zusammen als signifikanter Nutzen einer HGV interpretiert [14]. Bisher sind auf einer größeren Datenbasis basierend nur die durchschnittlichen Hörverbesserungen im APHAB durch eine HGV publiziert worden [6]. Die vorliegende Studie untersucht anhand eines sehr großen Datensatzes die prozentuale Hörverbesserung („benefit“) im Rahmen einer HGV nach der Hilfsmittel-Richtlinie für alle 4 APHAB-Sub-
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