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 journalArticlepeer-review

18 Citations (Scopus)
363 Downloads (Pure)


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
Early online date11 Sept 2020
Publication statusPublished - Feb 2021

Bibliographical note

Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


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


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