Validation of the Hearing Utility Measure (HUM) in Cochlear Implant Candidates and Users

Abstract

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