an outcome variable. First, because quality of life is assessed through self-report, the conflict of interest that arises with all self-reports in disability determination applies equally to measures of quality of life. In addition, the committee concludes that definitions of quality of life, including health-related quality of life, are not sufficiently precise for such assessments to provide useful outcome measures. Finally, the labeling of hearing-related self-assessments as measures of quality of life is to be discouraged, as it is a doubly indirect form of assessment.

Self-reports can provide valuable, albeit indirect, information about an individual’s functioning in daily life. For this reason, they can and should be used as outcome measures in predictive validation studies that do not involve claimants.

Tests that purport to measure or predict functional hearing ability in daily life must be validated against real-world criteria measured in natural settings. Validation in a simulated test environment is appropriate if a strong relation between the simulated and naturalistic settings can be demonstrated or assumed.

Research Recommendation

Research Recommendation 6-1. Research is needed on the prevalence of hearing loss in the workplace and on its effects on worker performance. In conjunction with this, the effectiveness of workplace accommodations, including devices and other types of accommodation, needs to be established.

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