International Journal of Audiology最新文献

Objective: To assess the feasibility of a newly developed PC-based Korean digits-in-noise (K-DiN) test for categorising the degree of hearing loss in participants with normal hearing and various degrees of hearing loss.

Design: The results of the Korean matrix sentence test (K-matrix) were compared with the corresponding K-DiN test results. Correlation analysis examined the relationships between the K-DiN speech reception thresholds (SRTs), age, pure-tone average (PTA), and K-Matrix SRTs. Receiver operating characteristic curves were constructed to evaluate the discriminatory ability of K-DiN across different degrees of hearing loss.

Study sample: K-DiN testing was conducted on 73 individuals with normal hearing and 166 individuals with hearing loss. Subsequently, 93 individuals were subjected to the K-Matrix.

Results: The K-DiN SRTs exhibited significant correlations with the PTA thresholds and K-Matrix SRTs. For detecting mild hearing loss, the K-DiN test demonstrated 90% sensitivity and 98% specificity with a -4 dB signal-to-noise ratio cut-off, accompanied by an area under the curve (AUC) of 0.98. Furthermore, the more severe the hearing loss, the lower the AUC value.

Conclusions: The findings from this study highlight the K-DiN test's excellent discriminative ability for differentiating normal hearing from hearing loss and for categorising individuals into distinct hearing-loss groups.

Objective: Co-design interventions with GPs to increase referrals from general medical practice to hearing care.

Design: In phase one of this intervention design study, three focus groups informed by the Theoretical Domains Framework (TDF) were conducted to explore perceived barriers and enablers to audiology referral for Australian GPs. In phase two, interventions aimed at addressing barriers and strengthening enablers were co-designed by GPs and the research team during three workshops.

Study sample: Twenty GPs in Victoria, Australia, participated in three focus groups and one co-design workshop.

Results: Key barriers to referral were a lack of knowledge of costs/funding; low trust in audiologists, a reliance on patients raising hearing concerns, negative beliefs about hearing rehabilitation, and competing clinical priorities. Key enablers were good relationships and communication between GPs and local audiologists, awareness of the impacts and co-morbidities of hearing loss and the social impacts of interventions, and having specified ages for comprehensive health checks (including hearing). Two interventions were proposed: a digital software prompt to encourage GPs to refer suitable older patients, and an online resource package including a digital referral form.

Conclusions: We identified high-priority barriers and enablers to be addressed by theory-informed interventions in clinical practice.

Objective: Measuring vestibular rehabilitation progress with questionnaires can be difficult in time-limited clinical settings. We developed and tested a new brief tool: Client Oriented Scale of Improvement for Dizziness and Imbalance (COSIDI), based on validated client-oriented scales for hearing aids (COSI) and for tinnitus (COSIT), and on wider evidence for involving patients in specifying the goals for rehabilitation.

Design: We developed the COSIDI with patient and clinician feedback and validated it through comparison with Dizziness Handicap Inventory (DHI) and Vestibular Rehabilitation Benefit Questionnaire (VRBQ) during normal clinical appointments.

Study sample: 91 outpatients in three clinical settings in Cardiff, Swansea and Southampton.

Results: COSIDI improvement scores showed comparable effect size with DHI and VRBQ (Cohen's d = 1.1 vs 1.2 and 0.64) and correlated highly with the existing measures (r = 0.73). Clinicians found COSIDI to be useful and appropriate for rehabilitation measurement, due to its patient-focus, brevity and support for goal-setting.

Conclusions: COSIDI is a valid tool for assessing vestibular rehabilitation, used alone or as complementary to other tools, which clinicians indicated provide useful prompts for patients to consider.

Objectives: Two methods, paired comparisons and ratings, were investigated when comparing two hearing-aid programs in live group conversations.

Design: Two conversation scenarios were staged in an ordinary office setting. During the conversations, the participants either switched between two hearing-aid programs or used a fixed program. After each conversation, they rated hearing-aid function, ease to hear and speak, and the flow of the conversation.

Study sample: Experienced hearing-aid users (n = 27) with moderate hearing loss who were fitted with binaural hearing aids with two directionality programs.

Results: The methods showed consistent results: the program preferred in paired comparisons also received the highest function ratings when used as a fixed program. On a population level, the paired comparisons method was slightly more effective in finding differences between the programs. On an individual level, only the paired comparisons method revealed a difference between the hearing-aid programs. Conversation flow ratings were generally high for both methods.

Conclusions: Both psychophysical methods worked well for evaluating hearing-aid settings during live group conversations, and the results of the two methods generally agreed. The paired comparison method was slightly more effective in finding differences between the two hearing-aid settings. Ratings of conversation flow were generally high for both methods.

Objective: This study investigated the relationship between audiovisual (AV) integration and acoustic change complex (ACC) responses in cochlear implant (CI) users.

Design: A cross-sectional design was employed. AV integration was assessed with the McGurk paradigm under auditory-only, visual-only, congruent (e.g., auditory /ba/-visual /ba/), and incongruent (e.g., auditory /ba/-visual /ga/) AV conditions. ACC responses were recorded using the /ui/ stimulus. Group comparisons and correlations between AV performance and ACC latencies were analysed.

Study sample: The study included 25 normal-hearing (NH) adults and 50 CI users (prelingual and postlingual) matched for age and cortical maturation.

Results: NH participants outperformed CI users in auditory-only, congruent, and incongruent AV conditions (p < .05), while visual-only performance was similar (p > .05). CI users showed greater reliance on visual cues and fewer fusion responses under incongruent conditions. ACC latencies were consistently shorter in NH than in CI groups (p < .05). Correlations between ACC latencies and AV performance were observed only in the prelingual CI group, where shorter latencies reflected higher auditory-only accuracy.

Conclusions: CI users exhibited limitations in AV integration and prolonged ACC latencies. Moreover, ACC measures mainly reflect auditory discrimination capacity rather than direct multisensory integration, providing complementary insights into the neural mechanisms underlying speech perception in CI users.

Objective: Age-related hearing loss may induce negative views of ageing, which can predict decreased physical, cognitive, and mental health over time. How hearing loss influences views of ageing, and whether its potential impact is solely negative, remains largely unexplored. This study explored how older adults with hearing loss perceive their ageing experience, using the Awareness of Age-Related Change (AARC) framework.

Design: Semi-structured interviews were analysed using deductive thematic analysis guided by the five AARC domains.

Study sample: Fifteen older adults (mean age = 70.8, 60% male) with objectively assessed mild-to-severe age-related hearing loss (mean pure tone average = 38.6 dBHL).

Results: Participants described a wide range of ageing experiences across 17 codes, spanning all five AARC domain and cross-domain themes. While loss-related ageing experiences such as social withdrawal were common, we also identified novel gain-related experiences, including adopting advocacy roles for peers and enhanced feelings of control and stability through proactive hearing management. Two overarching themes shaped experiences across all domains: knowledge-informed adaptation and social comparison.

Conclusions: Our findings highlight the multifaceted nature of ageing with hearing loss. Applying the AARC framework provides novel insights into psychosocial adaptation, with implications for person-centred interventions that support healthy ageing among people experiencing hearing loss.

Objective: Listening in a conversation has numerous demands not addressed by traditional speech-intelligibility tests. We here examine the utility of an alternative way to assess conversational listening, the just-follow conversation (JFC) test, namely its reproducibility and sensitivity to stimulus changes, as well as what it can tell us about conversational demands.

Design: Participants repeatedly adjusted the overall level of one monologue, one dialogue and two simultaneous monologues in the front hemifield until they could just follow the speech. Speech was presented in surrounding fixed-level café and same-spectrum noise backgrounds.

Study sample: Fifty-four adults, including 27 bilateral hearing-aid (HA) users, participated. HA users adjusted aided and unaided in separate blocks; non-users repeated each condition to evaluate reproducibility.

Results: JFCs were greater for dialogues than monologues, but not greater for two simultaneous monologues than dialogues. Individual JFCs correlated with self-reported speech understanding as well as pure-tone threshold averages. Aiding did not have a significant effect on results. Measures of reproducibility were comparable to more traditional speech-intelligibility tests.

Conclusion: The current results show that the JFC test is a relatively quick, repeatable measure that invokes both subjective and objective components of speech understanding, but it may be of limited use in evaluating amplification.

Objective: to measure the maximum stable gain (MSG, the feedback limit) and its variability in users with two percutaneous power bone conduction devices (BCDs), to determine an MSG-based fitting range, and to measure the available aided dynamic range.

Design: The MSG was determined with the BCD attached to a participant's head. The BCD output was measured on a skull simulator. A fitting range was derived using the speech intelligibility index.

Study sample: 42 adult BCD users.

Results: The average and range of the MSG was 13.3 ± 3.2 dB for device 1 and 16.1 ± 5.90 dB for device 2. The fitting range is 35-40 dB HL for a good understanding of soft speech and 45-50 dB HL for moderate-to-sufficient understanding of speech at a normal level in at least 50% of the cases with this hearing loss. The output for common speech levels is not limited by the maximum force output, except at low frequencies.

Conclusions: For users of a percutaneous power BCD, the maximum applicable gain is limited by feedback and is smaller than the full-on gain. Consequently, BCDs enable sufficient speech intelligibility only for mild-to-moderate sensorineural hearing loss. The aided dynamic range is adequate for hearing thresholds within this fitting range.

Objective: To introduce the Phoneme Discriminability Level (PDL) and compare its ability to predict scores on the Situated Phoneme (SiP) test with those of a phoneme-level version of the Speech Intelligibility Index (SIIP) and the original Speech Intelligibility Index (SII).

Design: SII, SIIP, and PDL values were calculated for 24,444 SiP-test trials and used to train and evaluate logistic regression models. Models were trained on half of the study sample and statistically evaluated on the other half.

Study sample: Seventy-four adult native speakers of Swedish (mean age = 62 years), with hearing ranging from normal to severe loss. All had symmetric hearing without conductive components.

Results: Models based on PDL and SIIP showed similar overall predictive power, and both outperformed the SII-based model. SIIP and SII were better at predicting average session scores, whereas PDL was better at predicting scores for individual test words. Adding random intercepts for test words improved the predictive accuracy of the SIIP and PDL models, but only at the level of individual words, not whole sessions.

Conclusions: All investigated models are useful for predicting SiP-test scores. SIIP and PDL appear suitable for optimising SiP-test settings and estimating critical differences.

Objective: To survey public attitudes about self-administered home-based hearing tests and fit-at-home hearing aids.

Design: Online survey enquiring about willingness to try the above. Explanatory variables included sex, age, and education.

Study sample: A representative sample of 2135 UK adults.

Results: Only 13% of respondents were unwilling to undertake a home-based hearing test. Perceived benefits of home-based testing were associated with convenience and ease, and its use as a precursor to a formal hearing test. Main concerns were associated with accuracy and reliability. Regarding hearing aid fitting pathways, 71%, 63% and 79% were willing to try a pre-programmed, self-programmed or audiologist-fit hearing aid, respectively. Respondents' preferred pathways were 37% fit-at-home (26% and 11% for pre-programmed and self-programmed, respectively) and 53% for audiologist-fit (10% responded "Don't Know"). Adults >65 years were less willing to complete and/or trust a home-based hearing test, and less willing to try fit-at-home hearing aids.

Conclusion: Most adults reported a willingness to conduct home-based hearing tests and to try fit-at-home hearing aids. These pathways have the potential to shift care closer to home and provide innovative sustainable pathways for a proportion of the public. Their effectiveness combined with user preference has yet to be evaluated.