American Journal of Audiology最新文献

Purpose: The purpose of this study was to evaluate the effect of noise exposure on otolith function measures of video ocular counter roll (vOCR), ocular vestibular evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and subjective visual vertical (SVV). Additionally, this study compared the vOCR results with other otolith function measures: cVEMP, oVEMP, and SVV.

Method: This was a cross-sectional, between-group prospective study that compared otolith function tests between noise exposure groups. Thirty-three adults between the ages of 40-60 years with no middle ear pathology, history of balance disorder, neurologic pathology, systemic diseases, or receiving ototoxic medications were included in the study. Group 1 included 17 adults (34 ears) with low-risk noise exposure, and Group 2 included 16 adults (32 ears) with high-risk noise exposure. Independent samples t tests were used to assess group mean differences for dependent variables. The independent variable was group with two levels (low risk and high risk). The dependent variables were Noise Exposure Structured Interview (NESI) score, vOCR torsion, cVEMP amplitude, oVEMP amplitude, and SVV angle. Additional analyses were completed using Pearson correlation to evaluate the relationship of vOCR to the other otolith function tests and NESI score to the otolith function tests.

Results: The results indicated significantly decreased vOCR torsion, cVEMP amplitude, and oVEMP amplitude in individuals with high-risk noise exposure compared with those in the low-risk group. Significant correlations were found for NESI scores as well as vOCR and oVEMP measures.

Conclusions: This study describes the concomitant degeneration of the auditory and vestibular systems from noise exposure affecting otolith function, as measured by audiologic testing and otolith testing. vOCR appears to be sensitive to this degeneration, indicating that vOCR could be used as a vestibular screening measure for patients with noise exposure and/or suspected utricle dysfunction.

Purpose: Cochlear implant (CI) recipients who listen with a hearing aid (HA) in the contralateral ear, known as bimodal listeners, demonstrate individual variability in speech recognition in noise. This variability may be due in part to differences in the processing delays of the CI and HA devices. This study investigated the influence of matching the processing delays of CI and HA devices on masked speech recognition for bimodal listeners.

Method: Twelve postlingually deafened adult CI recipients completed a task of masked speech recognition in two listening conditions: (a) independent default CI and HA processing delays (mismatched) and (b) with their HA-specific delay applied to the CI processing delay (matched). Speech recognition was evaluated with AzBio sentences presented in a 10-talker masker at a 0 dB SNR. The target was presented from the front loudspeaker at 0° azimuth, and the masker was co-located with the target, presented 90° toward the CI ear, or presented 90° toward the HA ear.

Results: There was a significant main effect for target-to-masker configuration, with better performance when the masker was spatially separated from the target. Better masked speech recognition was observed in the matched condition as compared to the mismatched condition.

Conclusion: Bimodal listeners may experience better masked speech recognition when the processing delay of the CI is individualized to match the processing delay of the contralateral HA.

Supplemental material: https://doi.org/10.23641/asha.27616845.

Purpose: Virtual service delivery models in audiology have become more accessible due to recent technological advancement and improved system-level uptake following COVID-19. Although current evidence identifies the benefits of virtual care to families with children who are d/Deaf or hard of hearing and supports its use in practice, this delivery model is still underutilized. This research aimed to gain consensus on an evidence-informed virtual caregiver participation framework developed from a scoping review of the communication sciences and disorders literature.

Method: A two-round modified e-Delphi study was conducted to survey 26 knowledge users from four different countries with experience in virtual audiology care, including caregivers, audiologists, researchers, and organizational leaders. The study employed Delphi techniques, building from a scoping review to synthesize existing literature informing the knowledge gap, including online surveys and team discussions. Consensus was defined numerically (75% agreement) and by comparing and interpreting text-based responses.

Results: The resulting framework grouped nine categories of caregiver participation in virtual care according to three main readiness domains: core readiness (opportunities to participate, perceived value, and willingness to participate), engagement readiness (child capacity, family-provider relationship, and role in the care process), and structural readiness (environment for participation, support, and technology).

Conclusion: This work adds novel contributions to the field, through the development of a framework for caregiver participation in virtual audiology care, that can be used to support family involvement and will guide clinical tool development and future research efforts.

Objectives: Previous research documented the values of audiology through a qualitative content analysis of documents representing traditional, best-practice hearing health care. The primary objective of this study was to validate the existing list of audiology values. Through a nationwide survey, this study aimed to elicit the values of practicing audiologists, with a specific focus on the prescription and dispensing of amplification devices, to ensure a comprehensive understanding of their priorities. Additionally, this study sought to identify any values missing from the original list and determine the rank order importance of these values, comparing this to the prioritization of values found in best-practice audiology documents. This comparison aimed to assess the alignment of recommended guidelines and real-world practices in hearing health care.

Design: An online survey was distributed to audiologists to elicit the prioritization of values from hearing health care providers. Participants were tasked with sorting and ranking 18 items, each representing a specific value in hearing health care, based on importance. Respondents were encouraged to suggest and rank the importance of additional values not included in the list. Audiologists were recruited from professional association mailing lists and direct contact. Respondent demographics were representative of U.S. audiologists. Qualitative content analysis was used to interpret values suggested by audiologists. Kendall's rank distance test was used to compare values prioritization between audiologists and best-practice audiology documents.

Results: After filtering out incomplete or disqualifying responses, data from 289 audiologists across 46 states were analyzed. Additional values suggested by respondents aligned with existing values from best-practice documents; thus, no new values were added as a result of this study. A ranked list of values based on mean order of importance was elicited from U.S.-based audiologists. There was substantial agreement between survey results and the rank order of values found in best-practice audiology documents. A demographic subgroup analysis revealed a broad agreement among audiologists in the rank order of values.

Conclusions: This study validated a comprehensive list of values in audiology and identified the rank order of values among a nationally representative sample of audiologists. The findings provide a foundation for future investigations into how these values influence decision-making processes for individuals with hearing difficulty. Addressing values conflicts as potential barriers to hearing health care usage can lead to solutions aligned with values of specific populations, ultimately improving the adoption and effectiveness of hearing health care interventions.

Supplemental material: https://doi.org/10.23641/asha.27478149.

Purpose: Hearing loss (HL) is a leading cause of disability worldwide, but its health-related costs have been incompletely studied. Our objective was to examine the association between HL and direct health care costs and identify subgroups in which costs associated with HL are especially high.

Method: This was a retrospective population-based cohort study of adults treated in a universal health care system between April 2008 and March 2019. HL was identified using administrative health data. We estimate health care costs in 2023 Canadian dollars, including costs for hospitalization, provider claims, ambulatory care visits, prescription medications, and long-term care (LTC).

Results: Of 4,424,632 participants, 146,644 (3.3%) had HL. Participants with HL were older (Mdn = 55 years [interquartile range: 43-68] vs. 35 years [24-50]) and had more comorbidities (1 [0-2] vs. 0 [0-1]) at baseline than participants without, whereas the likelihood of female sex, rural residence, and material deprivation were similar between groups with and without HL. Over median follow-up of 11.0 years, total age-sex adjusted annual health costs and each of its component costs were significantly higher in participants with HL compared to those without (annual total costs: $6,871, 95% confidence interval [CI] [$6,778, $6,962] vs. $4,716, 95% CI [$4,729, $4,763]). After full adjustment (a maximum of 29 comorbidities), annual costs remained significantly higher in participants with HL overall and for certain subcomponents (provider claims, ambulatory visits, and medications), whereas adjusted costs of hospitalization and LTC were lower among people with HL. The magnitude of the incremental costs among participants with HL was most pronounced for younger participants, men, or those with less comorbidity. Total projected annual direct health costs for Alberta residents with HL were $1.01 billion in 2023, of which $125 million (95% CI [$116, $135 million]) was attributable to HL specifically.

Conclusions: Compared to those without HL, health costs were markedly higher among participants with HL, partially due to a higher burden of comorbidity. The relatively high population attributable costs of HL suggest that better prevention, recognition, and management of this condition could yield substantial economic benefits.

Supplemental material: https://doi.org/10.23641/asha.27353439.

Purpose: The purpose of the present study was to develop and evaluate an in-person hearing aid training program designed for health care workers and personal care aides (PCAs) who care for older adults.

Method: Participants were 18 health care workers and PCAs whose clients were older adults. This was a randomized controlled study in which half of the participants were assigned to the experimental group (n = 9) and the other half to a control group (n = 9). The experimental group was administered a hearing aid training program that was developed in this study for health care workers and PCAs. Participants in the control group were trained on a task similar in complexity and administration time to the hearing aid training program. The Practical Hearing Aid Skills Test-Revised Version 2 (PHAST-Rv2) was administered before and immediately after training. A 2 × 2 mixed analysis of variance (ANOVA) was used to compare the pre- and post-training scores between and within the experimental and control groups. Descriptive statistics were used to examine the differences between pre- and post-training scores on each of the administered PHAST-Rv2 tasks. In addition, participants were asked about their experience helping clients with their hearing aids.

Results: Mean pre- and post-training PHAST-Rv2 scores for the experimental group were 59.50% and 95.84%, respectively, and 57.66% and 59.96%, respectively, for the control group. Results from a 2 × 2 mixed ANOVA with time point (pre- and post-training) as the within-subject variable and group (experimental and control) as the between-subject variable demonstrated that hearing aid training significantly improved PHAST-Rv2 scores for the experimental group. Post-training, the tasks that the experimental group improved on the most were brushing the microphone port, cleaning the dome, placing the hearing aids in the charger, and inserting the hearing aid into the model ear. No demographic variables were significantly correlated with the participants' improvement on the PHAST-Rv2 post-training score.

Conclusion: A hearing aid training program designed specifically for health care workers was shown to be an efficient and effective way to improve how well health care workers can care for and operate a hearing aid.

Purpose: This study aims to evaluate the effect of auditory neuropathy spectrum disorder (ANSD) on postoperative auditory perception and listening difficulties in pediatric cochlear implant (CI) recipients.

Method: The Children's Auditory Perception Test (CAPT) assesses auditory perception skills, and the Children's Home Inventory of Listening Difficulties (CHILD) Scale evaluates daily listening difficulties. The study involved pediatric CI recipients (n = 40) aged between 5 and 7 years, with and without diagnosis of ANSD. The research ensured homogeneity across various factors, including chronological age, age at diagnosis, age at initial implantation, bilateral simultaneous surgery, etiologies of hearing loss, and family education level.

Results: The findings have demonstrated that children without ANSD exhibited better performance in integrating visual-auditory stimuli and overall listening performance, distant sound source scores, and noisy environment scores (respectively p = .047, p = .001, p = .028, and p = .010). Additionally, children with better speech perception also have a better ability to integrate audiovisual stimuli (p = .005, r = .438).

Conclusions: There are significant differences in postoperative listening skills and auditory perceptions between children with and without an ANSD who have CIs. Accordingly, children without an ANSD perform better.

Purpose: The purpose of this study was to examine the psychometric properties of the Swedish short form of the Speech, Spatial and Qualities of Hearing Scale (SSQ12) and investigate whether the paper-and-pen and online formats could be used interchangeably.

Method: Individuals with and without hearing problems were invited to participate in this study. The participants (N = 125) were randomized into four groups: paper-paper, online-online, paper-online, and online-paper. All participants completed the Swedish SSQ12 twice.

Results: Principal components analysis revealed one component. Statistical analysis revealed good psychometric properties. Administration formats were compared using repeated-measures analysis of variance, which revealed no statistically significant differences.

Conclusions: The results indicate that the Swedish SSQ12 is possible to use in paper-and-pen and online formats interchangeably. The questionnaire has potential to be used by Swedish audiologists seeking to understand the individual experience of hearing loss or to evaluate hearing rehabilitation. To further understand the possible differences and to broaden the use and understanding of the SSQ12, future studies should aim to determine the minimal clinically important difference for the SSQ12.

Purpose: In 2021, the Veterans Health Administration (VHA) and Department of Defense (DOD) Tinnitus Working Group conducted a survey of DOD and VHA clinicians to evaluate clinical services provided for tinnitus.

Method: The online survey included a mix of multiple-choice and open-ended questions. Respondents included VHA and DOD health care providers in audiology, otolaryngology, mental health, and primary care, as well as DOD hearing conservation technicians. Quantitative and qualitative methods were used to analyze the data.

Results: A total of 669 providers responded to this combined survey. Results indicated that compared to DOD and VHA providers in other fields, audiologists tended to be more confident and more aware of their role in tinnitus management. In terms of confidence and scope of practice, DOD mental health care providers were the group least familiar with tinnitus care. Other results explored herein include barriers to tinnitus care, facilitators for progressive tinnitus management programs, interventions and patient materials offered, new patient materials wanted, and respondents' preferred information sources and training methods.

Conclusion: Survey results indicated that more directed education and support are needed to increase DOD and VHA clinicians' awareness of the need for tinnitus services and their roles in providing that care.

Supplemental material: https://doi.org/10.23641/asha.27229215.

Purpose: U.S. Army Soldiers undergo annual audiometric surveillance to facilitate prevention of auditory injury. Soldiers are screened for bothersome tinnitus and subsequently referred for a clinical audiological evaluation as warranted. Presumably, most Soldiers seen in the clinic for bothersome tinnitus receive a tinnitus diagnosis. The incidence of self-reported bothersome tinnitus at the time of annual audiometric surveillance and subsequent diagnosis of tinnitus in the medical record has not been examined to date. This study estimated the incidence of tinnitus diagnosis in a population of Soldiers who reported new onset bothersome tinnitus and explored trends associated with tinnitus diagnosis to refine hearing health education.

Method: A subset of hearing conservation records retrieved for a previous study were selected based on change in self-reporting of bothersome tinnitus. Corresponding medical records were retrieved for this sample of Active Duty (AD) Soldiers. The data were retrospectively examined, and analyses were conducted to identify statistically significant differences between Soldiers with and Soldiers without a tinnitus diagnosis. In addition, trend patterns of bothersome tinnitus and significant threshold shift (STS) were examined.

Results: Of the sample of 730,350 AD Soldiers, 16.7% self-reported new onset bothersome tinnitus and 7.1% of those recorded as having bothersome tinnitus had a diagnosis of tinnitus in their medical record. Soldiers with a tinnitus diagnosis were older and had higher pure-tone averages than Soldiers without a tinnitus diagnosis. Counterintuitively, overall trend percentages of bothersome tinnitus increased per calendar year, while the percentages of STS decreased throughout the study period.

Conclusions: The rate of tinnitus diagnosis in the medical record is vastly lower than the prevalence of bothersome tinnitus recorded in the annual surveillance system. Steps should be taken to screen, refer, and diagnose tinnitus more consistently. Based on the outcome of the study analysis, we recommend that screening for bothersome tinnitus more closely follows procedure recommendations from the Department of Veterans Affairs and Department of Defense (VA/DOD) Tinnitus Working Group, which may reduce the rate at which Soldiers report bothersome tinnitus.