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Journal of Telemedicine and Telecare Oct 2015We conducted a systematic literature review to investigate the domain of speech-language and hearing sciences (SLHS) in telehealth. (Review)
Review
INTRODUCTION
We conducted a systematic literature review to investigate the domain of speech-language and hearing sciences (SLHS) in telehealth.
METHODS
The databases used for the literature search were Web of Knowledge, Pubmed, Scopus, Embase and Scielo. The inclusion criteria consisted of papers published up to August 2014. Papers without peer-review evaluation, and those without abstracts or available full texts were excluded.
RESULTS
A total of 103 papers were selected. The selected studies have focused primarily on hearing (32.1%), followed by speech (19.4%), language (16.5%), voice (8.7%), swallowing (5.8%), multiple areas (13.6%) and others (3.9%). The majority of the studies focused on assessment (36.9%) or intervention (36.9%). The use of telehealth in SLHS has been increasing in many countries, especially in the last 5 years. The country with the largest number of published studies was the United States of America (32.03%), followed by Australia (29.12%). The remaining studies were distributed in lower numbers among other countries.
DISCUSSION
The advancement of information and communication technologies provides more favourable conditions for providing distance care in several areas. Most of studies concluded that the telehealth procedure had advantages over the non-telehealth alternative approach (85.5%); however, 13.6% reported that it was unclear whether the telehealth procedure had advantages. Some barriers still need to be overcome, such as technology, training, regulation, acceptance and recognition of the benefits of this practice by the public and professionals. The need for speech-language pathologists and audiologists to adapt to this new health care modality is evident.
Topics: Audiology; Audiometry; Delivery of Health Care; Hearing Disorders; Humans; Language Disorders; Language Therapy; Speech Disorders; Speech Therapy; Speech-Language Pathology; Telemedicine
PubMed: 26026181
DOI: 10.1177/1357633X15583215 -
BMJ Paediatrics Open Jan 2023Early hearing detection and intervention (EHDI) measures initiated in high-income countries (HICs) were attempted in low-income and middle-income countries (L&MICs)....
BACKGROUND
Early hearing detection and intervention (EHDI) measures initiated in high-income countries (HICs) were attempted in low-income and middle-income countries (L&MICs). However, information regarding the models of EHDI, context-specific adaptations made to strategies and outcomes are not known.
AIMS
The aims of this systematic review were to identify the various models of EHDI used in Asian L&MICs in the published scientific literature and to describe their efficacy and validity.
METHODS
The studies were eligible if the programme was from Asian L&MICs, implemented for children below 6 years of age and published between 2010 and 2021. Google Scholar, PubMed, Web of Science, Scopus, EBSCOHost and EBSCO-CINAHL were used to find articles. Data were extracted from each selected article, and the risk of bias was assessed. The search results were summarised using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. For primary outcomes, narrative synthesis was used, and forest plots were generated for secondary outcomes.
RESULTS
In all, 82 studies were included, and these studies were divided into two categories: newborn and infant screening programmes and screening programmes for older children. Predominantly, a two-stage objective otoacoustic emission (Distortion Product/Transient Evoked) or automated auditory brainstem response screening, followed by a detailed auditory brainstem response to confirm the hearing loss, was used in newborn and infant screening programmes. Audiologists were the most frequent screening personnel. Screening of older children was mostly done by otolaryngologists, school instructors and nurses. They performed a single-stage pure tone audiometry screening followed by a detailed examination.
CONCLUSION
The screening tools and protocols used were similar to those used in HICs. However, no uniform protocols were followed within each country. Long-term viability of EHDI programmes was not known as there was limited information on impact outcomes such as cost-benefit.
PROSPERO REGISTRATION NUMBER
CRD42021240341.
Topics: Infant, Newborn; Infant; Humans; Child; Adolescent; Child, Preschool; Developing Countries; Hearing Loss; Asia; Otoacoustic Emissions, Spontaneous; Audiometry, Pure-Tone
PubMed: 36720503
DOI: 10.1136/bmjpo-2022-001752 -
International Forum of Allergy &... Sep 2022Cystic fibrosis (CF) is a multisystem disease that often requires otolaryngology care. Individuals with CF commonly have chronic rhinosinusitis but also present with...
BACKGROUND
Cystic fibrosis (CF) is a multisystem disease that often requires otolaryngology care. Individuals with CF commonly have chronic rhinosinusitis but also present with hearing loss and dysphonia. Given these manifestations of CF, otolaryngologists are frequently involved in the care of patients with CF; however, there is limited consensus on optimal management of sinonasal, otologic, and laryngologic symptoms.
METHODS
The Cystic Fibrosis Foundation convened a multidisciplinary team of otolaryngologists, pulmonologists, audiologists, pharmacists, a social worker, a nurse coordinator, a respiratory therapist, two adults with CF, and a caregiver of a child with CF to develop consensus recommendations. Workgroups developed draft recommendation statements based on a systematic literature review, and a ≥80% consensus was required for acceptance of each recommendation statement.
RESULTS
The committee voted on 25 statements. Eleven statements were adopted recommending a treatment or intervention, while five statements were formulated recommending against a specific treatment or intervention. The committee recommended eight statements as an option for select patients in certain circumstances, and one statement did not reach consensus.
CONCLUSION
These multidisciplinary consensus recommendations will help providers navigate decisions related to otolaryngology consultation, medical and surgical management of CF-CRS, hearing, and voice in individuals with CF. A collaborative and multidisciplinary approach is advocated to best care for our patients with CF. Future clinical research is needed utilizing standardized, validated outcomes with comprehensive reporting of patient outcome, effects of modulator therapies, and genetic characteristics to help continue to advance care, decrease morbidity, and improve the quality of life for individuals with CF.
Topics: Adult; Child; Consensus; Cystic Fibrosis; Humans; Otolaryngology; Quality of Life; Sinusitis
PubMed: 35089650
DOI: 10.1002/alr.22974 -
Disability and Rehabilitation.... Feb 2021Systematic evaluation and meta-analysis of the effects of digital noise reduction (DNR) algorithms on speech intelligibility, sound quality and listening effort in adult... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Systematic evaluation and meta-analysis of the effects of digital noise reduction (DNR) algorithms on speech intelligibility, sound quality and listening effort in adult populations.
DESIGN
Systematic review and meta-analysis.
STUDY SAMPLE
Six databases were searched for experimental studies published from 2000 to 2017 in English using the following search terms: "hearing aid" and "noise reduction". A total of 264 unique hits were obtained; out of which, 16 studies were included.
RESULTS
The population effect was estimated for speech intelligibility and other subjective measures. From six studies, the population effect estimated for speech intelligibility measures was small ( = 0.28) with zero population variance. Sample size variance accounted for all the effect size variations found across studies. The population effect for subjective measures was medium ( = 0.46 ± 0.10) as calculated from seven studies.
CONCLUSIONS
Based on a criterion of moderate evidence, this meta-analysis did not reveal a consistent improvement in speech intelligibility with DNR in adult population. The subjective outcome measures (e.g., acceptable noise level and sound quality judgment) showed a moderate positive effect of DNR.Implications for RehabilitationThe findings of the study will provide useful clinical information in follow up visits in audiologic rehabilitation.The meta-analysis of DNR informs clinicians to create realistic expectations in hearing aid users.This paper summarizes the available data on different outcome measures such as speech intelligibility, listening effort and sound quality.The results of this meta-analysis will help clinical audiologists in devising hearing aid orientation and counseling.
Topics: Hearing Aids; Hearing Loss; Humans; Noise; Prosthesis Design; Speech Intelligibility
PubMed: 31502900
DOI: 10.1080/17483107.2019.1642394 -
JAMA Otolaryngology-- Head & Neck... Jul 2020Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in...
IMPORTANCE
Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss.
OBJECTIVE
To develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure.
DESIGN, SETTING, AND PARTICIPANTS
This qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience.
MAIN OUTCOMES AND MEASURES
A set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life.
RESULTS
The literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health.
CONCLUSIONS AND RELEVANCE
The association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.
Topics: Academic Success; Auditory Threshold; Communication Aids for Disabled; Focus Groups; Hearing Loss; Humans; Interpersonal Relations; Interviews as Topic; Leisure Activities; Music; Qualitative Research; Quality of Life; Sound Localization; Speech Perception; Tinnitus
PubMed: 32407468
DOI: 10.1001/jamaoto.2020.0674 -
FP Essentials Oct 2022A comprehensive geriatric assessment (CGA) is a systematic, multidisciplinary evaluation of older adult patients with the goal of identifying and managing geriatric...
A comprehensive geriatric assessment (CGA) is a systematic, multidisciplinary evaluation of older adult patients with the goal of identifying and managing geriatric conditions and syndromes. It focuses on various medical, social, and environmental issues. A CGA ideally is performed as an in-person outpatient visit, either in a clinical setting or the home of the patient. The physician, family members and/or caregivers, and a social worker are key contributors. Involvement of family members or caregivers particularly is important if cognitive issues or mood disorders are of concern. Physical therapists, occupational therapists, nurses, speech-language pathologists, dietitians, audiologists, and pharmacists also can provide additional expertise. Many questionnaires and assessment tools are available to simplify data gathering, including assessments of functional status, frailty, mobility, fall risk, nutritional status, polypharmacy, and cognition. These assessments can be completed by patients, family members, or caregivers with assistance from members of the medical team. CGAs should be guided by the Geriatric 5M's framework: mind, mobility, medications, multicomplexity, and matters most. A systematic review of these elements can help identify areas of need and requirements for support for older adult patients.
Topics: Aged; Caregivers; Geriatric Assessment; Humans; Nucleotidyltransferases; Polypharmacy
PubMed: 36201650
DOI: No ID Found -
BMC Pediatrics Aug 2022An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic...
BACKGROUND
An effective newborn hearing screening programme has low referral rate and low loss to follow-up (LTFU) rate after referral from initial screening. This systematic review identified studies evaluating the effect of protocol and programme factors on these two outcomes, including the screening method used and the infant group.
METHODS
Five databases were searched (latest: April 2021). Included studies reported original data from newborn hearing screening and described the target outcomes against a protocol or programme level factor. Studies were excluded if results were only available for one risk condition, for each ear, or for < 100 infants, or if methodological bias was observed. Included studies were evaluated for quality across three domains: sample, screening and outcome, using modified criteria from the Ottawa-Newcastle and QUADAS-2 scales. Findings from the included studies were synthesised in tables, figures and text.
RESULTS
Fifty-eight studies reported on referral rate, 8 on LTFU rate, and 35 on both. Only 15 studies defined LTFU. Substantial diversity in referral and LTFU rate was observed across studies. Twelve of fourteen studies that evaluated screening method showed lower referral rates with aABR compared to TEOAE for well babies (WB). Rescreening before hospital discharge and screening after 3 days of age reduced referral rates. Studies investigating LTFU reported lower rates for programmes that had audiologist involvement, did not require fees for step 2, were embedded in a larger regional or national programme, and scheduled follow-up in a location accessible to the families. In programmes with low overall LTFU, higher LTFU was observed for infants from the NICU compared to WB.
CONCLUSION
Although poor reporting and exclusion of non-English articles may limit the generalisability from this review, key influential factors for referral and LTFU rates were identified. Including aABR in WB screening can effectively reduce referral rates, but it is not the only solution. The reported referral and LTFU rates vary largely across studies, implying the contribution of several parameters identified in this review and the context in which the programme is performed. Extra attention should be paid to infants with higher risk for hearing impairment to ensure their return to follow-up.
Topics: Evoked Potentials, Auditory, Brain Stem; Follow-Up Studies; Hearing Tests; Humans; Infant; Infant, Newborn; Neonatal Screening; Otoacoustic Emissions, Spontaneous; Referral and Consultation
PubMed: 35932008
DOI: 10.1186/s12887-022-03218-0 -
Sao Paulo Medical Journal = Revista... 2022Tocilizumab is an anti-human interleukin 6 receptor monoclonal antibody that has been used to treat coronavirus disease 2019 (COVID-19). However, there is no consensus... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tocilizumab is an anti-human interleukin 6 receptor monoclonal antibody that has been used to treat coronavirus disease 2019 (COVID-19). However, there is no consensus on its efficacy for the treatment of COVID-19.
OBJECTIVE
To evaluate the effectiveness and safety of tocilizumab for treating COVID-19.
DESIGN AND SETTING
Systematic Review of randomized controlled trials (RCTs), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
METHODS
We searched MEDLINE via PubMed, EMBASE, CENTRAL, and IBECS for RCTs published up to March 2021. Two authors selected studies and assessed the risk of bias and the certainty of the evidence following Cochrane Recommendations.
RESULTS
Eight RCTs with 6,139 participants were included. We were not able to find differences between using tocilizumab compared to standard care on mortality in hospitalized patients with COVID-19 (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.84 to 1.13; 8 trials; 5,950 participants; low-certainty evidence). However, hospitalized patients under tocilizumab plus standard care treatment seemed to present a significantly lower risk of needing mechanical ventilation (risk ratio = 0.78; 95% CI 0.64-0.94 moderate-certainty of evidence).
CONCLUSIONS
To date, the best evidence available shows no difference between using tocilizumab plus standard care compared to standard care alone for reducing mortality in patients with COVID-19. However, as a finding with a practical implication, the use of tocilizumab in association to standard care probably reduces the risk of progressing to mechanical ventilation in those patients.
REGISTRATION
osf.io/qe4fs.
Topics: Humans; Brazil; COVID-19; COVID-19 Drug Treatment; Randomized Controlled Trials as Topic; Antiviral Agents; Treatment Outcome
PubMed: 36102463
DOI: 10.1590/1516-3180.2022.0170.R1.01072022 -
Journal of Speech, Language, and... Jan 2024The contributions from the central auditory and cognitive systems play a major role in communication. Understanding the relationship between auditory and cognitive...
PURPOSE
The contributions from the central auditory and cognitive systems play a major role in communication. Understanding the relationship between auditory and cognitive abilities has implications for auditory rehabilitation for clinical patients. The purpose of this systematic review is to address the question, "In adults, what is the relationship between central auditory processing abilities and cognitive abilities?"
METHOD
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to identify, screen, and determine eligibility for articles that addressed the research question of interest. Medical librarians and subject matter experts assisted in search strategy, keyword review, and structuring the systematic review process. To be included, articles needed to have an auditory measure (either behavioral or electrophysiologic), a cognitive measure that assessed individual ability, and the measures needed to be compared to one another.
RESULTS
Following two rounds of identification and screening, 126 articles were included for full analysis. Central auditory processing (CAP) measures were grouped into categories (behavioral: speech in noise, altered speech, temporal processing, binaural processing; electrophysiologic: mismatch negativity, P50, N200, P200, and P300). The most common CAP measures were sentence recognition in speech-shaped noise and the P300. Cognitive abilities were grouped into constructs, and the most common construct was working memory. The findings were mixed, encompassing both significant and nonsignificant relationships; therefore, the results do not conclusively establish a direct link between CAP and cognitive abilities. Nonetheless, several consistent relationships emerged across different domains. Distorted or noisy speech was related to working memory or processing speed. Auditory temporal order tasks showed significant relationships with working memory, fluid intelligence, or multidomain cognitive measures. For electrophysiology, relationships were observed between some cortical evoked potentials and working memory or executive/inhibitory processes. Significant results were consistent with the hypothesis that assessments of CAP and cognitive processing would be positively correlated.
CONCLUSIONS
Results from this systematic review summarize relationships between CAP and cognitive processing, but also underscore the complexity of these constructs, the importance of study design, and the need to select an appropriate measure. The relationship between auditory and cognitive abilities is complex but can provide informative context when creating clinical management plans. This review supports a need to develop guidelines and training for audiologists who wish to consider individual central auditory and cognitive abilities in patient care.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.24855174.
Topics: Adult; Humans; Cognition; Auditory Perception; Memory, Short-Term; Noise; Speech; Speech Perception
PubMed: 38147487
DOI: 10.1044/2023_JSLHR-22-00716 -
The International Tinnitus Journal Mar 2021Prevalence of tinnitus range from 7.1% to 14.6% (National Center for Health Statistics, 2016), but the mechanisms responsible for the development of this abnormal...
INTRODUCTION
Prevalence of tinnitus range from 7.1% to 14.6% (National Center for Health Statistics, 2016), but the mechanisms responsible for the development of this abnormal sensory state remain poorly understood.
OBJECTIVES
To determine the evidence for different etiologies and pathophysiology of tinnitus identified by clinical diagnostic tests in the adult population.
STUDY DESIGN
Systematic literature review.
METHODS
Review of data base using PRISMA guidelines: Google Scholar, Medline, Springer Link, Pubmed. In addition, manual reference search of identified papers. Randomized controlled trials, case control study, prospective cohort studies, and retrospective reviews of consecutive patients in which clear data were reported with respect to etiology and pathophysiology of tinnitus.
RESULTS
Sixty seven articles met the inclusion criteria. The papers searched recent studies from 2004 to 2018 for different etiologies such as noise exposure, age, ototoxic drugs, hearing loss among patients with tinnitus. Multiple pathophysiology were identified, including inner ear pathology, auditory nerve synchronisation, central nervous system anomalies and limbic and autonomous nervous system problems. The group of papers evaluated tinnitus patients with specific diagnostic tests such as pure tone audiometry, Immitance audiometry, otoacoustic emission, Auditory brainstem response and diagnostic imaging of fMRI, MRI and PET study.
CONCLUSIONS
The results indicate a high level of heterogeneity between the studies for all the assessed areas. These results support the need for greater stratification of the tinnitus population and the importance of a standardized Puretone audiometry with extended high frequency, OAE, ABR and diagnostic imaging (fMRI, MRI & PET) method to make comparisons between studies possible. Diagnostic imaging is an important useful method for identification of intracranial pathology that can present with tinnitus as a primary symptom. Establishment of a direct causal link between tinnitus and these etiologies and pathophysiology remains elusive.
Topics: Adult; Audiometry, Pure-Tone; Case-Control Studies; Humans; Prospective Studies; Retrospective Studies; Tinnitus
PubMed: 34410084
DOI: 10.5935/0946-5448.20210015