Evaluating Random Error in Clinician-Administered Surveys: Theoretical Considerations and Clinical Applications of Interobserver Reliability and Agreement

Identification of potential invasive alien species in Spain through horizon scanning

Invasive alien species have widespread impacts on native biodiversity and ecosystem services. Since the number of introductions worldwide is continuously rising, it is essential to prevent the entry, establishment and spread of new alien species through a systematic examination of future potential threats. Applying a three-step horizon scanning consensus method, we evaluated non-established alien species that could potentially arrive, establish and cause major ecological impact in Spain within the next 10 years. Overall, we identified 47 species with a very high risk (e.g. Oreochromis niloticus, Popillia japonica, Hemidactylus frenatus, Crassula helmsii or Halophila stipulacea), 61 with high risk, 93 with moderate risk, and 732 species with low risk. Many of the species categorized as very high or high risk to Spanish biodiversity are either already present in Europe and neighbouring countries or have a long invasive history elsewhere. This study provides an updated list of potential invasive alien species useful for prioritizing efforts and resources against their introduction. Compared to previous horizon scanning exercises in Spain, the current study screens potential invaders from a wider range of terrestrial, freshwater, and marine organisms, and can serve as a basis for more comprehensive risk analyses to improve management and increase the efficiency of the early warning and rapid response framework for invasive alien species. We also stress the usefulness of measuring agreement and consistency as two different properties of the reliability of expert scores, in order to more easily elaborate consensus ranked lists of potential invasive alien species.

Assessment of Reliability and Validity of the Cochlear Implant Skills Review: A New Measure to Evaluate Cochlear Implant Users' Device Skills and Knowledge

Purpose The Cochlear Implant Skills Review (CISR) was developed as a measure of cochlear implant (CI) users' skills and knowledge regarding device use. This study aimed to determine intra- and interrater reliability and agreement and establish construct validity for the CISR. Method In this study, the CISR was developed and administered to a cohort of 30 adult CI users. Participants included new CI users with less than 1 year of CI experience and experienced CI users with greater than 1 year of CI experience. The CISR administration required participants to demonstrate skills using the various features of their CI processors. Intra- and interrater reliability were assessed using intraclass correlation coefficients, agreement was assessed using Cohen's kappa, and construct validity was assessed by relating CISR performance to duration of CI use. Results Overall reliability for the entire instrument was 92.7%. Inter- and intrarater agreement were generally substantial or higher. Duration of CI use was a significant predictor of CISR performance. Conclusions The CISR is a reliable and valid assessment measure of device skills and knowledge for adult CI users. Clinicians can use this tool to evaluate areas of needed instruction and counseling and to assess users' skills over time.

The Influence of Destination Image on Tourist Loyalty and Intention to Visit: Testing a Multiple Mediation Approach

Pakistan holds an important geographical status, but extremism and sabotage have severely damaged the tourism industry. In the present study, we examined the impact of destination image (DI) on tourist loyalty (TL) and intension to visit (IV) in Pakistan. Additionally, the study analyzed the mediation effects of electronic word of mouth (eWOM) and tourist satisfaction (TS) on these relationships. Data was collected from 780 tourists in Pakistan. We used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to obtain the results. Our results demonstrated the positive relationships among DI, eWOM, TS, TL, and IV. This study also disclosed that eWOM has a partial mediation effect on the DI–TL relationship, and both eWOM and TS fully mediate the association between DI and IV. Hence, tourist satisfaction can be enhanced by eWOM and destination image, which directly effect tourist loyalty and intention to visit in Pakistan. The proposed framework and research findings will help stakeholders significantly to recognize the multi-facet association in the tourism industry of Pakistan. Testing the above relationships through multiple mediators is a relatively novel idea.

A multilinguistic analysis of spelling among children with cochlear implants

This study examines the spelling of nine elementary school children with cochlear implants (CIs) who use spoken language, and compares their performance with children who have typical hearing and children who are hard of hearing (HH). Compared to children with typical hearing, children with CIs did not produce a significantly different percentage of misspelled words (p = 0.431, d = 0.38), but their spelling errors comprised significantly lower percentages of homophone substitutions (p = 0.019, r = 0.61) and legal vowel errors (p = 0.011, r = 0.61). Children with CIs and children who are HH did not produce a significantly different percentage of misspelled words (p = 0.521, d = 0.31) or a significantly different distribution of categorical spelling errors. Results suggest that children with CIs utilize similar linguistic strategies as their peers who are HH but different strategies than peers with typical hearing when attempting to spell unfamiliar words.

Factors Associated With Self-Reported Hearing Aid Management Skills and Knowledge

PURPOSE

Hearing aid management describes the skills and knowledge required for the handling, use, care, and maintenance of the hearing aid. The importance of hearing aid management skills and knowledge is evidenced by their association with hearing aid outcomes. However, the nature of this association and the influence of participant factors on this association are unknown. Accordingly, the aims of the current study were to (a) investigate participant factors that influence hearing aid management skills and knowledge and (b) investigate the impact of hearing aid management skills and knowledge on hearing aid outcomes.

METHOD

Factors associated with hearing aid management skills and knowledge were investigated through an e-mail- and paper-based self-report survey, including the Hearing Aid Skills and Knowledge Inventory (Bennett, Meyer, Eikelboom, & Atlas, 2018b) and the International Outcomes Inventory for Hearing Aids (Cox & Alexander, 2002). The study sample included 518 adult hearing aid owners, ranging in age from 18 to 97 years (M = 71 years, SD = 14 years), 61% male and 39% female, recruited from seven hearing clinics across Australia.

RESULTS

Participant factors found to be associated with hearing aid skills and knowledge included participants' age, gender, style of hearing aid, age of current hearing aid, and total years of hearing aid ownership. Higher levels of hearing aid management skills and knowledge were found to be associated with better hearing aid outcomes, specifically higher self-reported satisfaction with hearing aids, perceived benefit from hearing aids, and overall outcome of the hearing aid fitting as evaluated by the International Outcomes Inventory for Hearing Aids.

CONCLUSIONS

Hearing aid management difficulties were greatest for older people, women, and owners of behind-the-ear style of hearing aids, suggesting that clinicians need to be cognizant of the additional needs for these three groups. The positive association between hearing aid outcomes and hearing aid skills and knowledge emphasizes the importance of education and training on hearing aid management for successful aural rehabilitation.

Evaluating Hearing Aid Management: Development of the Hearing Aid Skills and Knowledge Inventory (HASKI)

PURPOSE

Although hearing health care clinicians provide training on hearing aid handling and management as part of the rehabilitation program, clinical studies suggest that the level of management skill demonstrated by hearing aid owners is low. In the absence of a comprehensive clinical survey to identify these shortfalls in clinical training, the objective of this study was to develop and report the psychometric properties of the Hearing Aid Skills and Knowledge Inventory (HASKI: a self-administered version and a clinician-administered version). The HASKI evaluates the knowledge and skills required for hearing aid management. A secondary aim was to report the prevalence of hearing aid management difficulties in an Australian population.

METHOD

The development of the HASKI and the investigation of its psychometric properties in a prospective convenience cohort of 518 adult hearing aid owners, ranging in age from 18 to 97 years (M = 71 years, SD = 14), 60% male, 38% female, and 2% undisclosed, recruited from 7 hearing clinics across Australia, were used.

RESULTS

The HASKI (both the self-administered and clinician administered) demonstrated high internal consistency, interdimensional relationships, construct validity, test-retest reliability, interobserver reliability, and criterion validity. A range of aptitudes were observed from low to full competency, with 99% of participants indicating difficulty with at least 1 item on the survey.

CONCLUSIONS

The Hearing Aid Skills and Knowledge Inventories are valid and reliable measures of hearing aid handling and management skills with good potential for use in clinical settings. Hearing aid management is an area of difficulty for the majority of hearing aid owners, indicating the need for clinicians to improve the efficacy of hearing aid management training delivered.