Online-administered hearing handicap inventory: evaluation of reliability and item-order effects

To evaluate an online version of the 25-item Hearing Handicap Inventory (HHI) in terms of reliability and potential effects of item order. Participants completed a Danish translation of the HHI online. Two different item orders were compared: (1) the conventional order and (2) an experimental order where items were presented in blocks starting with the 10-item Hearing Handicap Inventory Screener (HHI-S). Internal consistency and test-retest reliability were also examined. Bland-Altman limits of agreement were calculated for different degrees of hearing-related well-being (“auditory wellness”). Participants aged 50 and above with a wide range of hearing abilities (N = 194). No effects of item order were found. The HHI and HHI-S both showed excellent internal consistency and good test-retest reliability. Bland-Altman limits of agreement broadened as auditory wellness worsened. HHI scores appear unaffected by the item order. The HHI-S can be extracted from the full HHI without changing the results. The test-retest reliability of the HHI varies with auditory wellness.