Related Experiment Video
Updated: Jun 19, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Validation of the Hearing Utility Measure (HUM) in Cochlear Implant Candidates and Users
Peter R Dixon1, Anuja H Shah1, Theodore R McRackan1
1Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Objective:
To validate the Hearing Utility Measure (HUM), a tool designed to quantify hearing loss impact on health and quality of life for use in economic evaluation.
Study Design:
Prospective cohort.
Setting:
Tertiary academic center.
Methods:
Cochlear implant (CI) candidates were enrolled between June 25, 2020, and March 17, 2024. Participants completed HUM alongside other assessments, including Health Utilities Index, Mark-3 (HUI-3), Speech, Spatial and Qualities of Hearing Scale (SSQ-49), Cochlear Implant Quality of Life Profile (CIQOL-35), and Tinnitus Handicap Inventory (THI) at the time of CI evaluation and 12 months post-activation. A subgroup with stable hearing status completed HUM twice, 6 months apart, to assess test-retest reliability.
Results:
Among 1315 participants, HUM showed strong correlations with CIQOL-global (r = 0.69; 95% CI: 0.66-0.72) and SSQ-overall (r = 0.70; 95% CI: 0.67-0.73), supporting construct validity. HUM Tinnitus domain correlated negatively with THI (-0.75; -0.77, -0.73), as expected. Test-retest reliability was excellent (Intraclass Correlation Coefficient [ICC] 0.90, 95% CI: 0.83-0.94). HUM hearing utility was higher for candidates with single-sided deafness (SSD) (0.76) than with traditional and asymmetric hearing loss (0.58, P < .001). Median HUM improved from 0.70 to 0.78 for SSD recipients (P = .002) and 0.57 to 0.75 for traditional recipients (P < .001).
Conclusion:
HUM is a reliable, valid, and responsive measure of hearing-related health in adults with advanced hearing loss. Unlike traditional instruments such as SSQ and CIQOL, which capture patient-reported outcomes but are not designed for economic analysis, HUM is a preference-based utility instrument that enables cost-effectiveness evaluation. It outperforms the available HUI-3 by better reflecting hearing loss impact and complements existing nonutility instruments used in clinical and health policy decision-making.
