Measuring ability

A researcher looking at multiple computer screens

Projects within measuring ability

Core-outcome scales, development of hearing-test materials and methods, objective measures and ecological momentary assessments.
A female clinician using an otoscope on a female participant

Nottingham Hearing BioResource

Project lead: Ian Wiggins

Funders: NIHR Nottingham BRC; CRN East Midlands Under-Served Communities

The Nottingham Hearing BioResource (NHB) represents our effort to begin leveraging the power of large, open, accessible datasets towards transforming the way treat and manage hearing loss and hearing-related conditions in future.
Large-scale datasets, such as the UK Biobank and the Human Connectome Project, have proved extremely powerful for facilitating research into mechanisms of human health and disease.  However, a limitation of existing datasets is that hearing health phenotypes are captured at a rudimentary level, with even basic pure-tone audiometry data rarely being available. This severely limits the scope of the questions that can be asked of these datasets from an auditory perspective. The Nottingham Hearing BioResource (NHB) represents our effort to begin leveraging the power of large, open, accessible datasets in a way that could transform how we treat and manage hearing loss and hearing-related conditions in future.


A person cuts some hair from the back of a person's head

Hair cortisol: a potential biomarker for stress

Project leads: Sally Thornton, Derek Hoare

Funder: NIHR Nottingham BRC 

Stress could plausibly derive from a sensory deficit such as hearing loss (HL). Yet hair cortisol concentration (HCC) in association with stress, depression or anxiety has not been measured in people with HL. We are measuring HCC alongside symptoms of anxiety, stress, depression in participants with and without HL.
Currently we are: 1) prospectively assessing HCC in people with and without HL, and; 2) investigating associations between HCC and psychological responses, as well as; 3) piloting paediatric work to assess if it's feasible to assess HCC in children.


CROSSSD (CoRe Outcome Set for Single-Sided Deafness)

Project leads: Derek Hoare and Kathryn Fackrell

PhD student: Roulla Katiri

Funder: NIHR Nottingham BRC

Researchers have been assessing the benefits and harms (known as ‘outcomes’) of the available treatments for single-sided deafness (SSD) inconsistently. The CROSSSD international initiative used structured communication techniques to achieve consensus among healthcare users and professionals working in the field. The product is a core outcome domain set that determines what is critically important to assess in all clinical trials of SSD interventions.

By involving healthcare users with experience in SSD treatments, audiologists, ENT surgeons, clinical researchers, and industry representatives; the CROSSSD study gathered international opinions via Delphi surveys and a web-based consensus meeting and found agreement on three measures that should always be reported on in SSD intervention studies. The core outcomes are (1) Spatial orientation, (2) Group conversations in noisy social situations, and (3) Impact on social situations.

If all future SSD intervention studies measure these core outcomes as a minimum, we can more easily compare results of different studies, improve research quality, and enhance clinical decision-making.

Further research is currently underway to help determine ‘how’ these core outcomes should best be measured.





Test methods for group conversation: Operationalising conversational success

Project leads: Lauren Hadley and Graham Naylor

PhD student: Raluca Nicoras

Funder: WSAudiology

A project dedicated to investigating the perception of conversation success as experienced by people with normal hearing and people with hearing loss in one-to-one and group conversations. 



Development and vaildation of a questionnaire to assess hyperacusis in young children

Project lead: Derek Hoare

PhD student: Iskra Potgieter

Funder: NIHR Nottingham BRC

This project seeks to obtain qualitative data on the lived experiences of children with hyperacusis; to develop a prototype questionnaire to assess hyperacusis in children; and to validate the hyperacusis questionnaire.



Mother-Child Inter-Brain Synchrony during free play: An fNIRS hyperscanning study

Project lead: Douglas Hartley

PhD student: Efstratia Papoutselou

Funder: NIHR Nottingham BRC

We are investigating the neural mechanisms that support everyday interactions between mothers and children using a non-invasive and portable neuroimaging technique called functional near infrared spectroscopy.



Are people with high schizotopy scores poor at auditory prediction?

Project lead: Joseph Sollini

Funder: Nottingham Research Fellowship

The purpose of this study is to investigate the relationship between schizotypal personality traits and auditory prediction. To do so, we use an auditory prediction task (Sollini et al. 2021) along with a questionnaire based assesment of schizotopy (Mason & Claridge, 2006).



Socioemotional Well-being As An Individual Factor In The Assessment And Amelioration Of Hearing Loss

Project lead: Jack Holman

Funder: Medical Research Foundation

Developing understanding and reliable measurement of individual socioemotional well-being differences for adults with hearing loss, with the aim of facilitating better assessment of individual needs and better outcomes.
The socioemotional consequences of hearing loss (and hearing-aid treatment) may play out differently for different people, dependent on their circumstances, personality, and daily activities. In this project we will help to identify individual differences in socioemotional well-being and the best way of measuring them. We will identify if existing measures can accurately and effectively measure the key components, and whether additional interventions could improve socioemotional well-being outcomes for those who need it. This project is the first step in developing understanding and interventions to increase the happiness and comfort of each person with hearing loss based on their individual needs.


Development and evaluation of a digital intervention: Internet Self-Help, Understanding and Support for Hyperacusis (iSHUSH) 

Project lead: Kathryn Fackrell

Funder: NIHR Post-Doctoral Fellowship

The development and evaluation of a digital intervention for hyperacusis which incorporates adults living with hyperacusis and healthcare professionals experiences, challenges and views of hyperacusis, theory and evidence. 
The digital intervention aims to provide educational and self-help components to support adults experiencing hyperacusis. A advisory group for the project has been established to help guide the development and evaluation. To ensure acceptability, usability and feasibility of the intervention, interviews, surveys and piloting are being conducted throughout with the intended users (e.g., adults living with hyperacusis and healthcare professionals). 


Emotional responses in daily-life listening situations for people with hearing loss, and emotional adaptation after a first hearing-aid fitting

Project leads: Graham Naylor and Jack Holman

Funder: Hearing Industry Research Consortium

We aim to better understanding of the specific causes of positive and negative emotional reactions to hearing-dependent situations and hearing devices.
Using research techniques such as semi-structured interviewing and smartphone based ecological momentary assessment we hope to pave the way for improved clinical assessment and counselling; provide narratives for efforts to promote the uptake of hearing help; identify situations which are especially likely to trigger negative emotions, enabling better targeting of interventions and setting of expectations; identify novel risk factors for the discontinuation of hearing aid use, and thereby inspire work to address those risks.


Developing a questionnaire measure for use with children with hearing loss: YBHRQL-Y

Project leads: Sarah Somerset and Adam Pedley

Funder: NIHR

Developing, validating and scoring an adapted version of the YBHRQL, used in adults with severe and profound hearing loss.  Putting severe and profoundly deaf children at the heart of questionnaire development.  
We have taken an existing measure the York Binaural Hearing Related Quality of Life System (YBHRQL) and adapted the pre-existing domains for use with young people aged 8 to 16 years with a severe or profound hearing loss.  we have used the qualitative pre-test interview approach to put the young people at the heart of our questionnaire adaptation.  A questionnaire can only be as good as the questions it asks.  For these questions to be good they must be both relatable to those completing them and reliable.  We have adapted the existing measure with young people as co-experts.  We are now in the process of validation and scoring.  By developing our questionnaire in this way we have designed it to be a patient reported outcome measure (PROM) which means a health utility value can be calculated from it's score.  This in turn can then be used for health economic calculations of quality and costs associated with care participants receive.  This has been designed to be used in the wider BEARS trial.


Understanding and alleviating hearing disability: A cognitive-behavioural model of miscommunication in everyday conversation

Project lead: Graham Naylor

Funders: Medical Research Council

This programme develops a comprehensive account of how, in everyday conversation, the perceptual impairments due to hearing loss can trigger activity limitations and participation restrictions
Difficulty engaging in conversation is the most often-reported problem of hearing loss, but currently treatment with hearing aids does not adequately fix this. There is a clear and unmet need for understanding why and how older adults with hearing loss experience problems in conversation. With such understanding, better treatments will become possible, improving the social participation of people with hearing loss. In this programme we will develop an in-depth explanation of how miscommunications happen in everyday conversation, and how people behave in response to them.


Incorporating active strategies in speech testing to predict communication performance

Project lead: Tim Beechey

Funder: Medical Research Foundation

This project investigates how the inclusion of active communication behaviours in hearing testing may affect measures of hearing impairment and device benefit and improve predictions of individual rehabilitation outcomes.
Conversation is central to humans’ capacity to communicate, maintain relationships, and fulfil requirements of daily living. A person’s capacity for successful spoken conversation relies on both hearing sensitivity and the use of active communication strategies, such as asking for repetitions or moving closer to a talker. This project incorporates active communication strategies into controlled assessment of speech comprehension to quantify the benefit of these strategies and the extent to which taking account of these strategies can improve the prediction of the impact of hearing impairment and amplification on speech understanding.


Effectiveness and safety of different ear wax removal methods

Project leads: Derek Hoare, Magdalena Sereda

Funder: NIHR Nottingham BRC 

Assessing the currently available online information regarding microsuction and irrigation as wax removal methods and patient perspectives of these two methods.  

A build-up of earwax in the ear canal can cause hearing loss and discomfort and may contribute to infections. Irrigation and microsuction are two earwax removal methods available in the UK. The two methods differ in availability, contraindications, and cost. However, there is a lack of evidence comparing clinical and cost-effectiveness of these techniques.

In preparation for the future clinical trials, we are analysing the content and quality of the earwax removal websites and patients' experiences with each method shared within online forums. We are looking at preference for one method, pre- and post-treatment, outcomes and contraindications and complications.



Development of an attentional hearing outcome for group conversations

Project leads: William M Whitmer

Funder: WS Audiology

We are developing an outcome to evaluate the selective and distributive attentional mechanisms associated with conversational listening.
Within group conversation, we often need to not only focus on one but monitor multiple talkers at once. That is, we need to engage both selective and distributed attention to not restrict our ability to participate fully. Further, for active engagement in a conversation, the ability to recall words is secondary to the ability to follow the gist of the ongoing conversation(s). To measure the benefits of technology in group conversations, as well as better quantify our conversational capacity, we will develop an outcome based on the Just-Follow Conversation task that can capture the selective and distributed listening required of group conversation.


Hearing Sciences

Mental Health & Clinical Neuroscience
School of Medicine
University of Nottingham
Medical School, QMC
Nottingham, NG7 2UH

telephone: University Park +44 (0) 115 74 86900
Ropewalk House +44 (0) 115 82 32600
Glasgow +44 (0) 141 242 9665