Analysis of data from the International Outcome Inventory for Hearing Aids (IOI-HA) using Bayesian Item Response Theory

Arne Leijon, Harvey Dillon, Louise Hickson, Martin Kinkel, Sophia E. Kramer, Peter Nordqvist

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Scopus)


Objective: IOI-HA response data are conventionally analysed assuming that the ordinal responses have interval-scale properties. This study critically considers this assumption and compares the conventional approach with a method using Item Response Theory (IRT). Design: A Bayesian IRT analysis model was implemented and applied to several IOI-HA data sets. Study sample: Anonymised IOI-HA responses from 13273 adult users of one or two hearing aids in 11 data sets using the Australian English, Dutch, German and Swedish versions of the IOI-HA. Results: The raw ordinal responses to IOI-HA items do not represent values on interval scales. Using the conventional rating sum as an overall score introduces a scale error corresponding to about 10 − 15% of the true standard deviation in the population. Some interesting and statistically credible differences were demonstrated among the included data sets. Conclusions: It is questionable to apply conventional statistical measures like mean, variance, t-tests, etc., on the raw IOI-HA ratings. It is recommended to apply only nonparametric statistical test methods for comparisons of IOI-HA results between groups. The scale error can sometimes cause incorrect conclusions when individual results are compared. The IRT approach is recommended for analysis of individual results.

Original languageEnglish
Pages (from-to)81-88
Number of pages8
JournalInternational Journal of Audiology
Issue number2
Publication statusPublished - 2021


  • Hearing aids
  • IOI-HA
  • Item Response Theory
  • behavioural measures

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