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JAMA Otolaryngology-- Head & Neck... Jun 2023Hearing loss is a highly prevalent condition, with numerous debilitating consequences when left untreated. However, less than 20% of US adults with hearing loss use... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Hearing loss is a highly prevalent condition, with numerous debilitating consequences when left untreated. However, less than 20% of US adults with hearing loss use hearing aids. Over-the-counter (OTC) hearing aids became available in October 2022 to improve access and affordability. However, clinical effectiveness studies of available OTC hearing aids using the existing devices in the market are limited.
OBJECTIVE
To compare the clinical effectiveness of a self-fitting OTC hearing aid with remote support and a hearing aid fitted using audiologist-fitted best practices.
DESIGN, SETTING, AND PARTICIPANTS
This randomized clinical effectiveness trial was conducted between April 14 and August 29, 2022. Sixty-eight adults with self-perceived mild to moderate hearing loss were recruited and randomly assigned to either the self-fitting or the audiologist-fitted group. Following bilateral hearing aid fitting, participants first completed a 2-week, take-home field trial without any support. Access to fine-tuning for both groups was only available after the 2-week trial. Support and adjustment were provided remotely for the self-fitting group per request and by the audiologist for the audiologist-fitted group. Participants were then reassessed after an additional 4-week take-home trial.
INTERVENTIONS
A commercially available self-fitting OTC hearing aid was provided to participants in the self-fitting group who were expected to set up the hearing aids using the commercially supplied instructional material and accompanying smartphone application. In the audiologist-fitted group, audiologists fitted the same hearing aid according to the National Acoustics Laboratories nonlinear version 2 algorithm for prescriptive gain target using real-ear verification with hearing aid use instruction.
MAIN OUTCOMES AND MEASURES
The primary outcome measure was self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary measures included the International Outcome Inventory for Hearing Aids (IOI-HA) and speech recognition in noise measured using an abbreviated speech-in-noise test and a digits-in-noise test. All measures were completed at baseline and at 2 intervals following hearing aid fitting (2 and 6 weeks).
RESULTS
Sixty-four participants were included in the analytic sample (33 men [51.6%]; mean [SD] age, 63.6 [14.1] years), with equal numbers of participants (nā=ā32) randomized into each group. The groups did not differ significantly in age (effect size r = -0.2 [95% CI, -0.3 to 0.2]) or 4-frequency pure-tone average (effect size r = 0.2 [95% CI, -0.1 to 0.4]). After the 2-week field trial, the self-fitting group had an initial advantage compared with the audiologist-fitted group on the self-reported APHAB (Cohen d = -0.5 [95% CI, -1.0 to 0]) and IOI-HA (effect size r = 0.3 [95% CI, 0.0-0.5]) but not speech recognition in noise. At the end of the 6-week trial, no meaningful differences were evident between the groups on any outcome measures.
CONCLUSION AND RELEVANCE
In this randomized clinical effectiveness trial, self-fitting OTC hearing aids with remote support yielded outcomes at 6 weeks post fitting comparable to those of hearing aids fitted using audiologist best practices. These findings suggest that self-fitting OTC hearing aids may provide an effective intervention for mild to moderate hearing loss.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05337748.
Topics: Male; Adult; Humans; Middle Aged; Hearing Aids; Audiologists; Hearing Loss; Treatment Outcome; Self Report; Deafness; Hearing Loss, Sensorineural; Speech Perception
PubMed: 37052929
DOI: 10.1001/jamaoto.2023.0376 -
Seminars in Hearing Feb 2022Healthcare policy decisions that affect the day-to-day work of an audiologist and his/her ability to best serve our patients occur every day. It is imperative that every... (Review)
Review
Healthcare policy decisions that affect the day-to-day work of an audiologist and his/her ability to best serve our patients occur every day. It is imperative that every professional participate in advocacy efforts; however, many audiologists are unfamiliar with current advocacy initiatives, how to participate, or how critical one phone call, email, or meeting could be in the legislative process.
PubMed: 35719748
DOI: 10.1055/s-0042-1743121 -
International Journal of... 2016The Spring 2016 issue of the International Journal of Telerehabilitation (IJT) presents original and innovative work in three diverse sections: usability, intervention,...
The Spring 2016 issue of the International Journal of Telerehabilitation (IJT) presents original and innovative work in three diverse sections: usability, intervention, and pedagogy, followed by a book review on teleaudiology. The contributors to this issue are notably multi-disciplinary and include an audiologist, computer scientists, engineers, an epidemiologist, occupational therapists, a rehabilitation counselor, a physician (physical medicine and rehabilitation), and speechlanguage pathologists. The common thread linking the Journal's authors and their manuscripts, is excellence in telerehabilitation related innovation.
PubMed: 27563385
DOI: 10.5195/ijt.2016.6197 -
Frontiers in Surgery 2022To present recommendations for the coordinated evaluation and management of the hearing and reconstructive needs of patients with microtia and aural atresia. (Review)
Review
OBJECTIVES
To present recommendations for the coordinated evaluation and management of the hearing and reconstructive needs of patients with microtia and aural atresia.
METHODS
A national working group of 9 experts on microtia and atresia evaluated a working document on the evaluation and treatment of patients. Treatment options for auricular reconstruction and hearing habilitation were reviewed and integrated into a coordinated care timeline.
RESULTS
Recommendations were created for children with microtia and atresia, including diagnostic considerations, surgical and non-surgical options for hearing management and auricular reconstruction, and the treatment timeline for each option. These recommendations are based on the collective opinion of the group and are intended for otolaryngologists, audiologists, plastic surgeons, anaplastologists, and any provider caring for a patient with microtia and ear canal atresia. Close communication between atresia/hearing reconstruction surgeon and microtia repair surgeon is strongly recommended.
PubMed: 36636584
DOI: 10.3389/fsurg.2022.944223 -
Seminars in Hearing May 2022This article explores the clinical applications of Audiology Practice Standards Organization (APSO) Standards 2 and 13, both of which keep us fully focused on the... (Review)
Review
This article explores the clinical applications of Audiology Practice Standards Organization (APSO) Standards 2 and 13, both of which keep us fully focused on the patient-as-person. The topics within Standard 2 include audiologists' interpersonal communication skills, specifically clarity (ensuring patient comprehension) and empathy (understanding the patient's experiences). Standard 2 also addresses the topic of health literacy, which has been recently expanded to consider not only the degree to which individuals are able to find, understand, and use information and services to inform health-related decisions but also how organizations equitably support those necessary skills. The characteristics and benefits of services provided in patient- and family-centered care contexts are also described. Standard 13 addresses audiologists' support toward overall successful adjustment as defined by the patient, including both technical and personal adjustment to amplification, nontechnical communication issues, and rehabilitation support using readily available technologies. A new assessment protocol that includes goal setting and intervention is described, as well as a patient-centered intervention strategy involving discussion of personally meaningful photographs. Both standards provide a necessary balance to our technology-reliant profession.
PubMed: 35903078
DOI: 10.1055/s-0042-1748834 -
Seminars in Hearing May 2019The need for monitoring hearing and auditory function during drug therapy and other treatments that have the potential to cause hearing loss is well documented. Besides... (Review)
Review
The need for monitoring hearing and auditory function during drug therapy and other treatments that have the potential to cause hearing loss is well documented. Besides the main purpose of ototoxic monitoring, which is to provide feedback to the attending physician about the effects the treatment is having on the auditory system, it is also helpful in setting expectations for the patient and his/her family about the communication issues that may result from the drug therapy. This article will review tests available to an audiologist, both subjective and objective, that can be used to effectively monitor hearing levels and auditory function during treatment. Published guidelines and various ototoxic monitoring protocols are reviewed regarding tests administered, what constitutes a significant change in test results and how these findings are reported, and the impact significant changes may have on the course of treatment. Test protocols from different institutions are compared for both similarities and contrasts. Effective scheduling and test location are key to a successful monitoring program. Finally, the need to streamline ototoxic monitoring of hearing and auditory function to reduce test time and make it less stressful and tiresome on the patient will be considered.
PubMed: 31036990
DOI: 10.1055/s-0039-1684042 -
Seminars in Hearing May 2019The purpose of this article is to provide a brief introduction and review regarding basic principles of pharmacology, including terminology and colloquialisms, as well... (Review)
Review
The purpose of this article is to provide a brief introduction and review regarding basic principles of pharmacology, including terminology and colloquialisms, as well as pharmacokinetic and pharmacodynamic principles of ototoxic agents. As an audiology practitioner, it is more important than ever to have a working knowledge regarding the known and proposed mechanisms of action for drugs and chemicals with known ototoxicity potential. Additionally, this article provides a discussion regarding the biochemistry behind distribution, which is a major step in determining ototoxic potential of known and potential ototoxins.
PubMed: 31036986
DOI: 10.1055/s-0039-1684038 -
Seminars in Hearing Feb 2020In the field of audiology, change is inevitable: changes in technologies with hearing devices, changes in consumer knowledge, and changes in consumer-driven solutions.... (Review)
Review
In the field of audiology, change is inevitable: changes in technologies with hearing devices, changes in consumer knowledge, and changes in consumer-driven solutions. With these changes, the audiologist must adapt to meet the needs of the consumer. There are potential predictors that the audiologist could use to determine who is more likely to pursue and use amplification; by using these data, the audiologists may increase their productivity and increase patient satisfaction. The goal of this article is to investigate the MarkeTrak 10 (MT10) data to determine the trends in adoption and use of hearing aids as well as examine predictive factors that can be used to determine hearing aid adoption.
PubMed: 32047345
DOI: 10.1055/s-0040-1701242