Development of a novel self-assessment hearing loss and communication disability tool (HEAR-COMMAND Tool) based on the ICF standard

Authors: Tahereh Afghah1*; Razan Al Fakir2; Markus Meis3; Lisette van Leeuwen4; Sophia E Kramer4; Kathleen Lea2; Mahmoud Hammady5; Mostafa Yossif5; Mohamed Abd Al-Ghaffar5; Kirsten C Wagener1

1Hörzentrum Oldenburg gGmbH and Cluster of Excellence Hearing4all, Oldenburg

2Auburn University

3Cochlear GmbH & Co. KG

4Amsterdam University Medical Center

5Sohag University Hospital

Background The biological characteristic of hearing loss (HL) can change an individual’s behavior and interplay between personal determinants, context, daily functioning, and perceived disability. To enhance the effectiveness of the biomedical model of HL, there is a significant need to bring the World Health Organization’s International Classification of Functioning, Disability, and Health framework (ICF) Core Sets for Hearing Loss (CSHL) into audiology practice to evaluate daily functioning. It is well-accepted that the ICF can facilitate hearing healthcare. To address hearing and HL-related communication impairment, a new questionnaire named “HEAR-COMMAND tool” was developed based on the ICF standard.

Method In attempts, a team from Germany, the USA, the Netherlands, and Egypt collaborated on the development of a questionnaire in English, German, and Arabic languages. The concept of the ICF CSHL categories was converted to easily understandable questions, enabling the patients to grade their disability degree. The validation studies were conducted with an overall of 109 respondents for the initial and 139 for the revised versions of the questionnaire.

Results In total, 90 ICF-based and 30 additional questions regarding personal factors and HL were developed which together cover 85% and 44% of the brief and comprehensive CSHL categories, respectively. The content evaluation was performed according to experts’ and patients’ perspectives and feedback. The results showed that the questionnaire was found highly capable of revealing the degree of impairment in daily functioning in individuals with HL.

Conclusion The tool has the capability to bring the ICF CSHL into audiology practice, facilitate the paradigm shift in hearing healthcare, and enhance the hearing healthcare delivery model for HL at international levels. Furthermore, it can be used as a systematic therapy corridor for documentation and quality assurance of rehabilitation and audiological services.


Link to the HEAR-COMMAND Tool: