Assessment and Treatment of Tinnitus Patients Using a "Masking Approach"

2002 ◽  
Vol 13 (10) ◽  
pp. 545-558 ◽  
Author(s):  
Martin A. Schechter ◽  
James A. Henry
Keyword(s):  
Hearing Aids ◽  
Historical Review ◽  
Evaluation Process ◽  
Direct Patient Care ◽  
Tinnitus Questionnaire ◽  
Care Experience ◽  
Treatment Services ◽  
Assessment And Treatment ◽  
Retraining Therapy ◽  
Tinnitus Masking

Audiology clinics are increasingly being asked to provide tinnitus treatment services to patients who are severely distressed by tinnitus. It is unclear what levels of tinnitus care are available at different audiology clinics across the nation. Some clinics have staff who are experienced with the tinnitus masking technique or with tinnitus retraining therapy (TRT), whereas other clinics may limit their care to the provision of hearing aids. This article is an attempt to provide some basic information for those clinicians who would like to provide at least a minimum level of care for their tinnitus patients using the tinnitus masking approach. The most important requirement is a commitment by the clinician to assemble some basic resources and to structure the clinical schedule so that adequate time is available for historical review, evaluation, trial and selection of devices, and tinnitus counseling. A minimum set of measurements is recommended for inclusion in the tinnitus evaluation process. This informal review summarizes a variety of clinical observations culled from years of direct patient care experience. A tinnitus questionnaire is provided to help clinicians review potentially relevant issues.

Clinical Guide for Audiologic Tinnitus Management II

2005 ◽  
Vol 14 (1) ◽  
pp. 49-70 ◽  
Author(s):  
James A. Henry ◽  
Tara L. Zaugg ◽  
Martin A. Schechter
Keyword(s):  
Treatment Outcomes ◽  
Hearing Aids ◽  
Treatment Method ◽  
Mp3 Players ◽  
Retraining Therapy ◽  
Clinically Significant ◽  
Uniform Manner ◽  
Procedural Components ◽  
Tinnitus Masking ◽  
Assessment Procedures

Purpose: This article is the second of 2 that address the need for basic procedures that can be used commonly by audiologists to manage patients with clinically significant tinnitus, as well as hyperacusis. The method described is termed audiologic tinnitus management (ATM). Method: ATM was developed specifically for use by audiologists. Although certain procedural components were adapted from the methods of tinnitus masking and tinnitus retraining therapy, ATM is uniquely and specifically defined. A detailed description of the ATM assessment procedures is provided in the companion article (J. A. Henry, T. L. Zaugg, & M. A. Schechter, 2005). The present article describes a specific clinical protocol for providing treatment with ATM. Results: The treatment method described for ATM includes structured informational counseling and an individualized program of sound enhancement that can include the use of hearing aids, ear-level noise generators, combination instruments (noise generator and hearing aid combined), personal listening devices (wearable CD, tape, and MP3 players), and augmentative sound devices (e.g., tabletop sound generators). Ongoing treatment appointments involve primarily the structured counseling, evaluation, and adjustment of the use of sound devices, and assessment of treatment outcomes. The informational counseling protocol and an interview form for determining treatment outcomes are each described in step-by-step detail for direct clinical application. Conclusion: This article can serve as a practical clinical guide for audiologists to provide treatment for tinnitus in a uniform manner.

Clinical Guide for Audiologic Tinnitus Management I

2005 ◽  
Vol 14 (1) ◽  
pp. 21-48 ◽  
Author(s):  
James A. Henry ◽  
Tara L. Zaugg ◽  
Martin A. Schechter
Keyword(s):  
Hearing Aids ◽  
Clinical Management ◽  
Management Strategies ◽  
Research Experience ◽  
Assessment Protocol ◽  
Mp3 Players ◽  
Retraining Therapy ◽  
Perceptual Characteristics ◽  
Tinnitus Masking ◽  
Audiologic Evaluation

Purpose: This article is the first of 2 that present basic guidelines for audiologists to provide clinical management of tinnitus. The method, termed audiologic tinnitus management (ATM), was developed to incorporate management strategies that can be implemented most efficiently by audiologists. Method: Development of ATM has been drawn from the clinical and research experience of the authors and numerous audiologists. Certain elements of ATM are adapted from the methods of tinnitus masking and tinnitus retraining therapy. Procedures are described in the present article for performing the intake assessment, while the companion article (J. A. Henry, T. L. Zaugg, & M. A. Schechter, 2005) describes treatment methodology. Results: Development of ATM has resulted in defined procedures to conduct a basic tinnitus assessment that includes written questionnaires, an intake interview, audiologic evaluation, and a psychoacoustic assessment of tinnitus perceptual characteristics. If patients report a sound tolerance problem (hyperacusis), loudness discomfort levels are measured at audiometric frequencies. There are special procedures for selecting hearing aids, ear-level noise generators, combination devices (noise generator and hearing aid combined), and personal listening devices (i.e., portable radios and tape, CD, and MP3 players). Conclusions: This article explains each of these assessment components in detail. Adoption of the ATM assessment protocol by audiologists can contribute to the establishment of uniform procedures for the clinical management of tinnitus patients.

Comparison of Tinnitus Masking and Tinnitus Retraining Therapy

2002 ◽  
Vol 13 (10) ◽  
pp. 559-581 ◽  
Author(s):  
James A. Henry ◽  
Martin A. Schechter ◽  
Stephen M. Nagler ◽  
Stephen A. Fausti
Keyword(s):  
Clinical Application ◽  
Basic Component ◽  
Tinnitus Retraining Therapy ◽  
Basic Approach ◽  
Sound Therapy ◽  
The World ◽  
Considerable Confusion ◽  
International Attention ◽  
Retraining Therapy ◽  
Tinnitus Masking

Two methods for treating tinnitus are compared. Tinnitus masking has been used for over 25 years, and although this method is used in clinics around the world, there are many misconceptions regarding the proper protocol for its clinical application. Tinnitus retraining therapy has been used clinically for over 12 years and has received considerable international attention. Although these methods are distinctive in their basic approach to tinnitus management, certain aspects of treatment appear similar. These aspects of treatment have created considerable confusion and controversy, especially regarding the use of "sound therapy" as a basic component of treatment. It is the objective of this article to clarify the major differences that exist between these two forms of treatment.

Partnership in Post-Adoption Services Evaluating the First Year of a Complementary Contract

1997 ◽  
Vol 21 (3) ◽  
pp. 50-56 ◽  
Author(s):  
Alan Burnell ◽  
Adrian Briggs
Keyword(s):  
Social Services ◽  
Comprehensive Assessment ◽  
First Year ◽  
Service Users ◽  
Adoptive Families ◽  
Treatment Services ◽  
Assessment And Treatment ◽  
One Year ◽  
Families With Children ◽  
Consultation Services

In the autumn 1995 edition of Adoption & Fostering, Alan Burnell and Adrian Briggs described the origins and objectives of a novel complementary contract between East Sussex Social Services and the Post-Adoption Centre (PAC), aimed at providing post-adoption counselling and consultation services to all those involved in adoption in the county. The same authors now evaluate the operation of the contract, one year on. After filling in some background they assess its achievements so far, with particular regard to the extra support to service users and staff, and reducing the risk of disruption. The article concludes that the first year of the contract has demonstrated the need for comprehensive assessment and treatment services for adoptive families with children experiencing attachment difficulties.

Prescription of binaural hearing aids in the United Kingdom: a knowledge, attitude and practice (KAP) study

2002 ◽  
Vol 116 (S28) ◽  
pp. 2-6 ◽  
Author(s):  
Sunil N. Dutt ◽  
Ann-Louise McDermott ◽  
Richard M. Irving ◽  
Ivor Donaldson ◽  
Ahmes L. Pahor ◽  
...  
Keyword(s):  
United Kingdom ◽  
Hearing Aids ◽  
Otitis Media With Effusion ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Unilateral Deafness ◽  
Attitudes And Practices ◽  
The United Kingdom ◽  
Paediatric Age ◽  
Tinnitus Masking

The purpose of this questionnaire study was to evaluate the existing knowledge of binaural hearing and the attitudes and practices of prescribing bilateral hearing aids amongst otolaryngologists in the United Kingdom. Of the 950 questionnaires sent to the current members of the British Association of Otolaryngologists and Head and Neck Surgeons (BAO-HNS), there were 591 respondents (62 per cent). The true response rate with completed questionnaires was 59 per cent. Eighty-one per cent of the respondents were aware of the importance of binaural hearing and had a positive attitude towards binaural fitting. The practice of bilateral hearing aid prescriptions was found to be poor amongst all grades on the NHS (less than 10 per cent of all hearing aid prescriptions). This practice in the private sector was variable, dependent largely on patient preference and affordability. The practice of binaural prescription was higher for patients in the paediatric age group than amongst adults. Two common indications for hearing aid prescriptions for unilateral deafness were otitis media with effusion in children (23 per cent of respondents) and for tinnitus masking in adults (12 per cent of respondents). Many otolaryngologists believed that there was not enough evidence to support bilateral bone-anchored hearing aid implantation and bilateral cochlear implantation. Ninety-four per cent of the respondents believed that binaural hearing was as important as binocular vision.

Referral Criteria for Assessment and Treatment: In an Ambulatory Dysphagia Clinic

2012 ◽  
Vol 73 (4) ◽  
pp. 189-194
Author(s):  
Klara Lorinczi ◽  
Vanessa Denheyer ◽  
Amanda Pickard ◽  
Alice Lee ◽  
Diana R. Mager
Keyword(s):  
Health Care ◽  
Retrospective Chart Review ◽  
Wait Times ◽  
Health Care Teams ◽  
Treatment Services ◽  
Referral Criteria ◽  
Assessment And Treatment ◽  
Timely Access ◽  
Interdisciplinary Health Care Teams ◽  
Interdisciplinary Health Care

Dysphagia is highly prevalent in patients with chronic neurological disorders and can increase the risk for comorbidities such as aspiration pneumonia and malnutrition. Treatment includes timely access to interdisciplinary health care teams with specialized skills in dysphagia management. A retrospective chart review (n=99 of 125 charts screened) was conducted to evaluate the effectiveness of referral criteria to identify and triage patients with suspected dysphagia to an ambulatory dysphagia clinic. Variables collected included demographic information (age), anthropometric information (body mass index [BMI], each patient’s sex), reason for referral, primary medical diagnosis, symptomatology (e.g., pneumonia, chest congestion), nutrition and swallowing interventions, clinic wait times, missed/cancelled appointments, and referring health care professional. The mean age and mean BMI ± standard deviation of patients reviewed were 68.7 years ± 18.4 years and 25.2 kg/m2 ± 6.7 kg/m2, respectively. Average clinic wait times were 158 days (13 to 368 days) for routine and 52 days (0 to 344 days) for urgent assessments (p<0.001). The most common reason(s) for referral was/were related to dysphagia (n=83), surgery (n=50), and/or gastrointestinal symptomatology (n=28); 80% to 90% of patients received varying diagnostic and treatment services for dysphagia. Development of effective referral criteria is critical to ensure that clients with dysphagia receive timely diagnostic, treatment, and nutrition interventions by interdisciplinary health care teams specializing in dysphagia.

Is P&T Ready to Add Rapid Cycle Analytics to Formulary?

2020 ◽  
pp. 001857872091834
Author(s):  
Diana Altshuler ◽  
Kenny Yu ◽  
John Papadopoulos ◽  
Arash Dabestani
Keyword(s):  
Real World ◽  
Average Length ◽  
Evaluation Process ◽  
Direct Patient Care ◽  
Pharmacy Staff ◽  
Efficient Manner ◽  
Data Set ◽  
Novel Approach ◽  
Minimum Criteria ◽  
Point Of Reference

Purpose: The intent of this article is to evaluate a novel approach, using rapid cycle analytics and real world evidence, to optimize and improve the medication evaluation process to help the formulary decision making process, while reducing time for clinicians. Summary: The Pharmacy and Therapeutics (P&T) Committee within each health system is responsible for evaluating medication requests for formulary addition. Members of the pharmacy staff prepare the drug monograph or a medication use evaluation (MUE) and allocate precious clinical resources to review patient charts to assess efficacy and value. We explored a novel approach to evaluate the value of our intravenous acetaminophen (IV APAP) formulary admittance. This new methodology, called rapid cycle analytics, can assist hospitals in meeting and/or exceeding the minimum criteria of formulary maintenance as defined by the Joint Commission Standards. In this particular study, we assessed the effectiveness of IV APAP in total hip arthroplasty (THA) and total knee arthroplasty (TKA) procedures. We assessed the correlation to same-stay opioid utilization, average length of inpatient stay and post anesthesia care unit (PACU) time. Conclusion: We were able to explore and improve our organization’s approach in evaluating medications by partnering with an external analytics expert to help organize and normalize our data in a more robust, yet time efficient manner. Additionally, we were able to use a significantly larger external data set as a point of reference. Being able to perform this detailed analytical exercise for thousands of encounters internally and using a data warehouse of over 130 million patients as a point of reference in a short time has improved the depth of our assessment, as well as reducing valuable clinical resources allocated to MUEs to allow for more direct patient care. This clinically real-world and data-rich analytics model is the necessary foundation for using Artificial or Augmented Intelligence (AI) to make real-time formulary and drug selection decisions

Clinical trial to compare tinnitus masking and tinnitus retraining therapy

2006 ◽  
Vol 126 (sup556) ◽  
pp. 64-69 ◽  
Author(s):  
J.A. Henry ◽  
M.A. Schechter ◽  
T.L. Zaugg ◽  
S. Griest ◽  
P.J. Jastreboff ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Tinnitus Retraining Therapy ◽  
Retraining Therapy ◽  
Tinnitus Masking

scholarly journals The evaluation of treatment services and systems for substance use disorders

2003 ◽  
Vol 25 (3) ◽  
pp. 393-411 ◽  
Author(s):  
Brian Rush
Keyword(s):  
Substance Use ◽  
Program Evaluation ◽  
Substance Use Disorders ◽  
Planning Process ◽  
Research Training ◽  
Single Case ◽  
Evaluation Process ◽  
Outcome Evaluation ◽  
Treatment Service ◽  
Treatment Services

Scientific research and program evaluation have not played a major role in shaping the development of treatment services and systems in most countries. This has led to disparities in the development, management and monitoring of national treatment systems. In the evaluation of treatment for substance use disorders, the evaluation practitioner will usually be working at one of five levels: single case, treatment activity, treatment service, treatment agency or treatment system. One of the major barriers to undertaking internal program evaluation is the belief that it is a complicated research process best left to those with specific research training. Program managers and staff can plan and initiate an evaluation process for their program if they have access to research expertise when needed for certain parts of the process. There are seven main components of an evaluation process that can be planned and implemented: need assessment; evaluation planning, process evaluation, cost analysis, client satisfaction evaluation, outcome evaluation and economic evaluation. However, evaluation is more than the techniques and technology required to implement these types of activities. It also involves the routine questioning of current practice even if the feedback may be less positive than anticipated. A healthy culture for evaluation is one in which feedback loops are woven into the fabric of the treatment service or system. There are many barriers to evaluation in substance abuse services but these barriers can be overcome with careful planning and commitment to the delivery of evidence-based services.

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