PubMed · 9309830
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T Jauhiainen. 1997. Comments on global ear and hearing care programmes.. https://pubmed.ncbi.nlm.nih.gov/9309830/
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This article addresses one specific aspect of treatment evaluation research, namely the dependent variables used to evaluate the effectiveness of treatment programs provided in audiological rehabilitation. First, some underlying principles that should guide the design of all treatment evaluation research are presented. Second, issues specifically related to the selection of outcome measures are discussed. It is argued that treatment effectiveness research should incorporate individualized outcome measures. That is, a unique set of outcome measures should be identified for each of the persons who participate in the treatment program. Further, each outcome measure should make it possible to document changes related to each participant's involvement in the specific activity identified in the objective of the intervention program. Finally, other types of dependent variables that should be considered when conducting treatment effectiveness research are discussed. Specifically, information should be collected to identify all the factors that either facilitated or constituted an obstacle to the implementation of the treatment program or the successful attainment of the targeted goal of the program. Also, information should be obtained to describe the impacts and consequences of the intervention program.
The aim of this article is to highlight some elements (e.g. the view on truth, causality, context and methods) in three different meta-theoretical approaches to assessment and to discuss their implications: external realism, critical realism, and anti-realism. Although there are many differences between external realism and anti-realism, their main shortcoming is the failure to answer one of the basic questions in assessment research: 'What works for whom in what circumstances?' In order to answer this question, one needs a deep-structure ontology and a theory including mechanisms and contexts, which one finds in critical realism. An adequate approach to an evaluation process can be described as follows. The point of departure is a theory describing how mechanisms work in context and what the expected outcomes are. Hypotheses are formulated suggesting answers to the question 'What might work for whom in what circumstances? Data are collected in order to answer the question. Different methods are used which can shed light on the phenomenon. The outcome of the evaluation process is to find the conditions under which a specific outcome is produced.
Clinical audiologists were surveyed to determine the terms that their patients use to describe their reaction to hearing aid fitting problems. From this survey, a vocabulary of 40 frequently reported terms was developed. A second survey of hearing aid fitting experts was conducted to determine their methods of troubleshooting a hearing aid fitting when the patient reports one of the frequently reported terms. There was a high degree of agreement among the 24 experts. Principal components analysis resulted in ten components that explained 90.8% of the variance in the experts' responses. These results can be applied as an expert system for fine-tuning hearing aid fittings.