Handbook of Outcome Measures in Audiology
RATING: (4 of 5 ears)
AUTHORS: Carole E. Johnson and Jeffrey L. Danhauer
PUBLISHER: Singular Publishing Group
REVIEWER: Joanne Schupbach, MS, MA, Rush University and Rush Presbyterian–St. Luke's Medical Center, Chicago, Illinois
SYNOPSIS: This text and accompanying CD-ROM provide an overview of the use of outcome measures in various aspects of audiology. The book is extremely detailed yet straightforward to read given the scope of the issues. It begins with a description of the complexity of outcome measures, discusses how to analyze problems with specific measures and provides clinical vignettes to illustrate the role of outcome measures. Chapter Two defines these measures, describes different measurement methods, and addresses the importance of outcome measures to our professional viability. Chapter Three's review on levels of evidence details the hierarchy of scientific thoroughness necessary when determining the value of audiologic information. Chapter Four focuses on identification and selection of appropriate measurement scales, reviews the reliability and validity with selected outcome measures and discusses ways to assess consumer satisfaction. The next chapter is an interesting highlight on the use of computer software and the Internet with outcome measures. The second section of the book describes the use of outcome measures in specific practice areas including early intervention programs, diagnostic audiology, hearing conservation, and aural rehabilitation for both children and adults. The final section (Chapters 11-15) deal with the use of outcome measures across service delivery sites including health-care networks, residential care facilities, public schools and university training institutions. Each chapter ends with recommended readings and a listing of the appendices found on the companion CD-ROM. Review exercises and learning activities are listed to test your knowledge and to encourage further learning opportunities.
REVIEW: The introduction to the book presents an important challenge regarding the use of outcome measures in our clinical practices in order to prove positive patient benefits to third party reimbursers. The authors extend the challenge to the training of our future professionals who will need to design and to implement clinical research in their daily practices.
The book is divided into three sections. The initial chapters of the book do an excellent job of reviewing the key components of outcome measure design, identifying psychometric characteristics, and describing how to evaluate and to apply the appropriate measure for use in clinical practice. Their use of vignettes, tables and figures assists in the understanding of the (somewhat dry) material and provides a well-organized way to access this information. The chapter on computer use is a brief overview of potential computer applications in an office but is probably best suited for the less computer agile audiologist rather than the computer whiz. Chapters Six through Thirteen focus on outcome measures in specific areas of practice. The EHDI chapter provides a concise review of joint statements and has four tables describing the benchmarks and quality indicators for EHDI. This chapter also does a fairly good job of reviewing the computer data base systems available for tracking. The chapter on diagnostic audiology outcomes is a good reminder about assessing test or protocol validity and determining the test utility on specific patient populations prior to using it. I found the hearing conservation chapter quite informative although I have limited exposure and experience in this area. The need for developing sensitive outcome measures with EHDI programs was highlighted in the aural rehabilitation section. This chapter emphasizes that although we have come a long way in the establishment of EHDI programs, we have a long way to go. The discussion of outcome measures in adult rehabilitation used a vignette to convey a worst case scenario (everyone's nightmare) of an outcome measure. However, it was reassuring t find that there are several options and not always one single answer.
Section Three discusses outcome measures across service delivery sites beginning with healthcare networks. This is a good chapter for new practitioners who have had little exposure to managed care or for the audiologist developing a business plan to start a private practice. The chapter explains the major types of managed care organizations, details characteristics of a high quality hearing plan and provides "food for thought" if you're thinking about affiliating with a network or remaining independent. The chapter on residential care really points to an underserved and undervalued population that can benefit from aural rehabilitation but the need for outcome measures is great to convince the "powers that be" of the positive benefit.
Up to this point the book is thought provoking and it ends where it began. The authors challenge our university training programs to prepare students to deal with the growing needs of our profession and to stress the necessity of evidence based practice.
CRITIQUE: This book is designed for every practitioner in every practice setting. It provides a thorough review of current outcome measures, measurement methods, levels of evidence and how to select and identify appropriate measurement scales. Another very appealing feature is that each chapter follows up with pertinent worksheets, checklists and other topical information, all at your fingertips, that can be printed from the CD-ROM. Best of all, this book is thought provoking, challenging and motivating. Since reading this book, I've thought a great deal about my own practice techniques, how to better implement outcome measures and how to cultivate and train our students in best practice methods.