COSI (Client Orientated Scale of Improvement): a procedure created to help determine the most important hearing problems perceived by the patient. Goals can be generated which can be used to determine if the hearing aids are beneficial to the patient. The goals can be systematically analyzed and tracked within the software (Figure ). 

Figure : COSI Screen

Step 1: Determining the Targets of Accommodation:

The patient will have personal objectives, which he/she will like to see improvement with the hearing aids. It is important to discuss these objectives with the patient and summarize them into a short phrase or sentence. Obtain at least three fitting objectives from the patient and rank them in order of priority: most important to least important (Most important = 1, Least important = 2, 3, 4, etc.). The fitting objective with the highest priority will be assigned the most weight.

Step 2: Changes compared to the unaided Condition:

Directly after the fitting enter in the changes experienced by the patient in comparison to the unaided condition. Have the patient determine if his/her personal objectives have become worse, unchanged, slightly better, better, or much better with the hearing aids.

Step 3: Final Evaluation (after the first Acclimatisation):

After the first acclimatization, most likely after a series of follow-up appointments, re-assess how the hearing aids have allowed the patient to meet his/her personal objectives. Have the patient rate if the hearing aids have made listening worse, unchanged, slightly better, better, or much better.

The Analysis sub-tab, within the COSI tab, will show a graphic display of the results.

Figure : COSI Evaluation screen

Two graphics are available within the COSI Analysis tab: progress in comparison to the unaided condition and progress at the final evaluation.