Meaningful adult hearing health outcome measures: Research applications

The pure-tone audiogram is the clinical gold standard for adult hearing assessment. However, speech is a complex acoustic signal and the audiogram does not directly capture communication difficulties. Moreover, restoring audibility does not assure communication challenges resolve. To work towards meaningful outcome measurements, the U.S. National Institutes of Health, Defense Health Agency, and Veteran’s Administration commissioned a report from the National Academies of Science, Engineering, and Medicine (NASEM). The NASEM committee report, “Measuring Meaningful Outcomes for Adult Hearing Health Interventions,” was released May 7, 2025. The committee came to consensus on two recommended outcome domains: understanding speech in complex listening environments and hearing-related psychosocial health. Recommended measurements include the Words-in-Noise (WIN) test and Abbreviated Profile of Hearing Aid Benefit (APHAB) global score (speech understanding), and the Revised Hearing Handicap Inventory (RHHI) (hearing-related psychosocial health). These outcome measures are recommended across settings (clinic, research), indications (age-related hearing loss, noise-induced hearing loss, etc.), and interventions (hearing aids, pharmaceuticals, etc.). Because the committee was tasked with identifying domains that are important across patients, settings, and interventions, supplementary measures likely will be needed. This presentation will focus on the recommended outcome domains and measures including considerations in their use.