Currently viewing Vol. 1 • Issue 5 • 2014

The Robyn Cox I Know

Those of us who grew to know Robyn Cox during the sporadic IHAFF meetings held over some 20 years learned that she has a wonderful sense of humour and a talent for writing,1 but most of all she is an extraordinarily careful thinker. At the most recent meeting we were discussing an answer which most of us assumed was correct, when, after a long pause, Robyn − having done a careful search through her memory bank − said “I don't know of any evidence in favour of that.” None of the rest of us could either when we thought about it.

Some years ago, Robyn almost single-handedly, using nothing but the force of her passion and personality, talked the IHAFF group into a series of meta-analyses, where each pair agreed to take a question, find as many published papers on the general topic as they could find, throw out all of those that did not directly address the question, and summarize, typically in a table, the remaining pertinent evidence. For example, Gail Gudmundsen and I agreed to take the question “Is there any evidence that speech tests taken before hearing aid fitting were predictive of success with the hearing aid?” After reviewing some 300 articles and book chapters that held promise, we eliminated 220 on the basis of their abstracts, and reviewed the remaining 80 papers in depth. Only five directly addressed our question, and only one of those found a significant correlation between a pre-fitting speech (in noise) test and the satisfaction with the hearing aid. (Even there, the correlation − between pre-fitting QuickSIN scores, and later satisfaction − was somewhat ambiguous because there was also a correlation between QuickSIN scores and age.) I think each of us was grateful to Robyn for teaching us what a meta analysis is, and convincing us it wouldn't hurt us to do one, but most felt once in a lifetime was enough for that much work.

After one of her presentations at a convention, someone asked a question from the floor and, when Robyn seemed to have gone into a confused trance, the questioner kept trying to reword the question simply enough so Robyn could understand it. Robyn finally said, somewhat annoyed: “I understood your question the first time. Please be quiet while I think of the best way to answer it.” Her resulting answer was, as usual, eloquent, direct, and thoughtful. As often as not, however, it was Robyn who asked the difficult question when someone made a claim for which she didn't think there was any evidence. Robyn practiced “evidence-based practice” before it was popular, and served as the conscience for all of us.

Robyn has a finely honed ability to recognize important questions that have not been answered (or have been answered incorrectly). Her research to answer those questions is legendary. In many cases, a new tool was needed; she and her colleagues devised a whole serious of speech tests and hearing aid benefit and satisfaction measures that have become standards in our field. She even found that the single most important factor in hearing aid satisfaction was not found on any of the traditional measures, but in the psychological health of the hearing aid purchaser. The importance of the thinking of Robyn and her colleagues is indicated by some 5,000 citations of their papers. The “Abbreviated Profile of Hearing Aid Benefit (APHAB)” paper alone earned 605 citations (so far).

Finally, Robyn helped us laugh at ourselves, as she sometimes laughed at herself: Either way, her laugh is contagious. It has been an honour and pleasure to be considered one of her colleagues.

Footnote

1Regarding writing and humor, Robyn was one of the admitted co-authors of the famous IHAFF Serenade composed on a raft floating down the Snake River during the 1994 Jackson Hole Rendezvous

Sung to the tune of: Ghost Riders in the Sky as sung originally by the Sons of the Pioneers

I sat down at my sound proof booth and did the Contour Test
The damn dots came up on the screen and picked the aid that's best
The input/output function chose the aid that's great
I jumped into the sky and did a figure eight (not a FIG6 not a FIG6,not a FIG6)
APHAB-EE-EYE-AYE, APHAB-EE-EYE-OOO. IHAFFER's in the know!

The aid came in the morning mail, I checked the ANSI spec.
It did not meet the target goals, but I said, what the heck!
I tweeked, I twied, I twied, I tweeked until VIOLA sang!
The patient wrote a check to me and then the cash bell rang!
APHAB-EE-EYE-AYE, APHAB-EE-EYE-OOO. IHAFFER's in the know!

The patient came back in two weeks, I ran the Contour Test.
She picked the numbers that I knew were the very best.
She never said that any sound was painful or too loud.
As an audiologist, I knew that I was proud!
APHAB-EE-EYE-AYE, APHAB-EE-EYE-OOO. IHAFFER's in the know!

After six month's accommodation, she came back to complain.
She said that even at the top, the volume had no range.
I said: "My dearest patient, just shove it in your ear!
I don't remember telling you, the aid would help you hear!

About the author

Mead Killon, PhD

Mead C. Killion, PhD, ScD (hon), is the chief technology officer at Etymotic Research, Inc., and adjunct professor of audiology at Northwestern University.