Cartilage Conduction Hearing Aid Fitting in Clinical Practice

Author(s):  
Tadashi Nishimura ◽  
Hiroshi Hosoi ◽  
Tomoko Sugiuchi ◽  
Nozomu Matsumoto ◽  
Takanori Nishiyama ◽  
...  

Abstract Background Cartilage conduction hearing aids (CCHAs) were newly devised and spread fast in Japan since their launch in 2017. However, little knowledge is available for this new device. Purpose The aim of this study was to establish the knowledge of CCHAs and suggest their indication. Research Design Correlational study. Study Sample A total 256 patients were registered. Data Collection and Analysis The fitting of CCHAs was surveyed in nine institutions. The outcomes were assessed by audiometric tests. The patients were classified into seven groups, depending on the ear conditions. The clinical characteristics, assessment results, and purchase rates were compared among the groups. The assessment results of CCHAs were also compared with those of previously used hearing aids. Results Most patients who used CCHAs were classified into the bilateral closed (aural atresia or severe stenosis) ear (n = 65) or unilateral closed ear (n = 124) groups. The patients in these groups achieved good benefits that resulted in a high purchase rate. The bilateral continuous otorrhea group also supported a high purchase rate, although the benefits of CCHAs were not always excellent. In contrast, the purchase rate was poor in the patients who could use air conduction hearing aids (ACHAs) without absolute problems. As for using a CCHA as a contralateral routing of signals hearing aid, the benefits depended on the patients. Conclusions CCHAs are considered as a great option not only to the patients with closed ears but also to those who had difficulties in ACHAs usage.

Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  

Abstract Background Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. Purpose To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. Research Design An observational study. Study Sample Thirty-nine older adults with hearing loss. Data Collection and Analysis The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. Results For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029–0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28–0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. Conclusion The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.


2020 ◽  
Vol 31 (05) ◽  
pp. 354-362
Author(s):  
Paula Folkeard ◽  
Marlene Bagatto ◽  
Susan Scollie

Abstract Background Hearing aid prescriptive methods are a commonly recommended component of evidence-based preferred practice guidelines and are often implemented in the hearing aid programming software. Previous studies evaluating hearing aid manufacturers' software-derived fittings to prescriptions have shown significant deviations from targets. However, few such studies examined the accuracy of software-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription. Purpose The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSL v5.0 prescription, across a range of hearing aid brands, audiograms, and test levels. Research Design This study is a prospective chart review with simulated cases. Data Collection and Analysis A set of software-derived fittings were created for a six-month-old test case, across audiograms ranging from mild to profound. The aided output from each fitting was verified in the test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviations from target across frequencies 250-6000 Hz were calculated, together with the root-mean-square error (RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passages at 55- and 65-dB SPL were compared with published norms. Study Sample Thirteen behind-the-ear style hearing aids from eight manufacturers were tested. Results The amount of deviation per frequency was dependent on the test level and degree of hearing loss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ± 5 dB of the target for most frequencies. RMSE results revealed more than 84% of those hearing aid fittings for the mild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearing losses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiograms fell within the normative range for DSL pediatric fittings, although they fell within the lower portion of the distribution. For more severe losses, SII values for some hearing aids fell below the normative range. Conclusions In this study, use of the software-derived manufacturers' fittings based on the DSL v5.0 pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target, particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based on verification of hearing aid output would be required to optimize the fit to target, maximize aided SII, and ensure appropriate audibility across all degrees of hearing loss.


1998 ◽  
Vol 124 (3) ◽  
pp. 271 ◽  
Author(s):  
Emmanuel A. M. Mylanus ◽  
Kitty C. T. M. van der Pouw ◽  
Ad F. M. Snik ◽  
Cor W. R. J. Cremers

1996 ◽  
Vol 110 (4) ◽  
pp. 362-365
Author(s):  
K. J. Munro ◽  
D. Cafarelli Dees

AbstractThis case describes an apparent improvement in hearing sensitivity in a young girl over a period of 12 months, after she was fitted with binaural hearing-aids. Discrepancies between objective and subjective test results are highlighted. Even if the underlying reason for the conflicting test results was due to poor listening skills or test error, this child behaved like a hearing-impaired child and her performance improved after hearing-aid use. The case also illustrates the application of earphone testing from six months of age. The importance of closely monitoring all children who are fitted with hearing-aids is highlighted.


2009 ◽  
Vol 20 (06) ◽  
pp. 374-380 ◽  
Author(s):  
Sherri L. Smith ◽  
Colleen M. Noe ◽  
Genevieve C. Alexander

Background: The International Outcome Inventory for Hearing Aids (IOI-HA) was developed as a global hearing aid outcome measure targeting seven outcome domains. The published norms were based on a private-pay sample who were fitted with analog hearing aids. Purpose: The purpose of this study was to evaluate the psychometric properties of the IOI-HA and to establish normative data in a veteran sample. Research Design: Survey. Study Sample: The participants were 131 male veterans (mean age of 74.3 years, SD = 7.4) who were issued hearing aids with digital signal processing (DSP). Intervention: Hearing aids with DSP that were fitted bilaterally between 2005 and 2007. Data Collection and Analysis: Veterans were mailed two copies of the IOI-HA. The participants were instructed to complete the first copy of the questionnaire immediately and the second copy in two weeks. The completed questionnaires were mailed to the laboratory. The psychometric properties of the questionnaire were evaluated. As suggested by Cox and colleagues, the participants were divided into two categories based on their unaided subjective hearing difficulty. The two categories were (1) those with less hearing difficulty (none-to-moderate category) and (2) those who report more hearing difficulty (moderately severe+ category). The norms from the current veteran sample then were compared to the original, published sample. For each hearing difficulty category, the critical difference values were calculated for each item and for the total score. Results: A factor analysis showed that the IOI-HA in the veteran sample had the identical subscale structure as reported in the original sample. For the total scale, the internal consistency was good (Chronbach's α = 0.83), and the test–retest reliability was high (λ = 0.94). Group and individual norms were developed for both hearing difficulty categories in the veteran sample. For each IOI-HA item, the critical difference scores were <1.0. This finding suggests that for any item on the IOI-HA, there is a 95 percent chance that an observed change of one response unit between two test sessions reflects a true change in outcome for a given domain. Conclusions: The results of this study confirmed that the psychometric properties of the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.


2014 ◽  
Vol 25 (09) ◽  
pp. 893-903 ◽  
Author(s):  
Erik P. Rauterkus ◽  
Catherine V. Palmer

Background: The hearing aid effect is the term used to describe the assignment of negative attributes to individuals using hearing aids. The effect was first empirically identified in 1977 when it was reported that adults rating young children with and without hearing aids assigned negative attributes to the children depicted with hearing aids. Investigations in the 1980s and 1990s reported mixed results related to the extent of the hearing aid effect but continued to identify, on average, some negative attributes assigned to individuals wearing hearing aids. Purpose: The specific aim of this research was to investigate whether the hearing aid effect has diminished in the past several decades by replicating the methods of previous studies for testing the hearing aid effect while using updated devices. Research Design: Five device configurations were rated across eight attributes. Results for each attribute were considered separately. Study Sample: A total of 24 adults judged pictures of young men wearing various ear level technologies across 8 attributes on a 7-point Likert scale. Five young men between ages 15 and 17 yr were photographed wearing each of five device configurations including (1) a standard-sized behind-the-ear (BTE) hearing aid coupled to an earmold with #13 tubing, (2) a mini-BTE hearing aid with a slim tube open-fit configuration, (3) a completely-in-the-canal hearing aid that could not be seen because of its location in the ear canal, (4) an earbud, and (5) a Bluetooth receiver. Data Collection and Analysis: The 24 raters saw pictures of each of the 5 young men with each wearing one of the 5 devices so that devices and young men were never judged twice by the same observer. All judgments of each device, regardless of the young man modeling the device, were combined in the data analysis. The effect of device types on judgments was tested using a one-way between-participant analysis of variance. Results: There was a significant difference on the judgment of age and trustworthiness level among the five devices. However, our post hoc analysis revealed that only two significant effects were present. People wearing a completely-in-the-canal aid (nothing visible in the ear) were rated significantly older than people wearing an earbud, and people wearing the standard-size BTE with earmold were rated significantly more trustworthy than people who wore the Bluetooth device. Conclusions: It was hypothesized that the hearing aid effect would be diminished in 2013 compared with data reported in the past. This proved to be the case, as no hearing aid condition was rated as more negative than any of the non–hearing aid device conditions. In fact, models wearing the standard-size BTE with earmold were rated as more trustworthy than models wearing the Bluetooth device. The standard-sized BTE with earmold condition is the configuration that can be directly compared with previous research because similar devices were used in those studies. These results indicate that the hearing aid effect has diminished, if not completely disappeared, in the 21st century.


2019 ◽  
Vol 62 (11) ◽  
pp. 4150-4164 ◽  
Author(s):  
Inge de Ronde-Brons ◽  
Wim Soede ◽  
Wouter Dreschler

Purpose The aim of the study was to evaluate the application of a modified version of the Amsterdam Inventory for Auditory Disabilities and Handicap to inventory self-reported hearing difficulties pre and post hearing aid fitting in 6 dimensions: detection, speech in silence, speech in noise, localization, discrimination, and noise tolerance. Method Questionnaires pre and post hearing aid fitting were collected during regular practice of hearing aid provision. Data of 740 subjects are presented; 337 already used hearing aids, and 403 were new users. Results Group-averaged scores improved due to hearing aid fitting for all 6 dimensions. Based on a criterion previously defined for the Amsterdam Inventory for Auditory Disabilities and Handicap questionnaire, 66% of subjects had a significant individual improvement in sum score. Experienced users showed lower improvement in scores, whereas their aided prescores were, on average, not better than the (unaided) score of 1st users. Conclusions The questionnaire can be applied as a structured approach to inventory hearing problems in 6 dimensions prior to hearing aid fitting and to systematically evaluate the effects of hearing aid fitting after a trial period. The data presented here can serve as normative data for comparison of individual subjects in clinical practice.


2014 ◽  
Vol 25 (07) ◽  
pp. 644-655 ◽  
Author(s):  
Carly Meyer ◽  
Louise Hickson ◽  
Asad Khan ◽  
David Walker

Background: Between 68.1–89.5% of clients report that they are satisfied with their hearing aids. Two variables that are thought to contribute to dissatisfaction with hearing aids are product performance, and a mismatch between performance and client prefitting expectations about hearing-aid performance (i.e., disconfirmation). A focus on variables related to satisfaction is relevant to improving hearing rehabilitation services. Purpose: The aim of this study was to determine if measures of hearing-aid performance and disconfirmation, specifically related to hearing ability and hearing-aid problems, were associated with overall hearing-aid satisfaction among a sample of hearing-aid users. Research Design: A retrospective research design was employed. Study Sample: A total of 123 individuals participated in the study (57% male; mean age: 72 yr). All participants owned hearing aids. Data Collection and Analysis: A personal details questionnaire and the Profile of Hearing Aid Consumer Satisfaction questionnaire (Wong et al, 2009) were completed by participants, 3–12 mo after they obtained hearing aids. Overall hearing-aid satisfaction was a dichotomized variable (satisfaction vs. dissatisfaction); therefore, logistic regression modeling was applied to the data to determine which variables were associated with overall hearing-aid satisfaction. Results: Sixty-one percent of the sample reported that they were satisfied with their hearing aids. Hearing-aid satisfaction was associated with the ability to hear with hearing aids and better-than-expected performance in this same area; fewer hearing-aid problems; and fewer problems with hearing-aid manipulation, hearing-aid appearance, and wearer discomfort than were anticipated before hearing-aid fitting. Conclusions: It is recommended that to improve hearing-aid satisfaction, clinicians should ensure optimal hearing-aid benefit in the listening situations that the person with hearing impairment most wants to hear better; reduce the likelihood of hearing-aid problems occurring; and promote positive disconfirmation (performance exceeds expectations) with respect to both hearing ability and hearing-aid performance through the education of clients about the likely benefits of hearing aids in a variety of listening environments, and the potential problems they could face with hearing-aid manipulation and wearer discomfort.


CoDAS ◽  
2015 ◽  
Vol 27 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Mirna Rossi Barbosa ◽  
Daniel de Sousa Medeiros ◽  
Luiza Augusta Rosa Rossi-Barbosa ◽  
Antônio Prates Caldeira

PURPOSE: To analyze the self-reported outcomes after hearing aid fitting among individuals in the northern region of Minas Gerais and associated factors. METHODS: A cross-sectional and analytical study with a random sample of adults and elderly attending the public health care service was conducted in the northern region of Minas Gerais (86 municipalities), Brazil. Study's participants answered International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires. Data were analyzed descriptively and analytically with Poisson regression analysis. RESULTS: We interviewed 272 adults and 112 individuals reported not using their hearing aids regularly. The mean of IOI-HA global score was lower than expected. The individual's relationship with their hearing aid (Factor 1) was worse than the individual's relationship with their environment (Factor 2). Lower global scores were statistically associated with no work. CONCLUSIONS: The observed scores for the study's population are lower than those recorded in other studies. The results suggest that there are limitations in the fitting and follow-up of individuals who received hearing aids.


2017 ◽  
Vol 28 (06) ◽  
pp. 506-521 ◽  
Author(s):  
Stella L. Ng ◽  
Shanon Phelan ◽  
MaryAnn Leonard ◽  
Jason Galster

Background: Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients’ needs, and attentive to society’s influence. Purpose: The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. “Connected” refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. Research Design: The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. Study Sample: The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. Data Collection and Analysis: The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. Results: The clinician case highlighted clinicians’ heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed patients’ perceptions of themselves as technologically competent or incompetent, and descriptions of how they learned to use the new technology. Between cases, the study found a difference in the response to how the connected hearing aid changed the clinician–patient relationship. While clinicians valued the increased time they spent “getting to know” their patients, patients experienced some frustration specific to the additional troubleshooting related to Bluetooth connectivity. Across cases, there was a resounding theme of “normalization” of hearing aids via their integration with a “normal” technology (mobile phones) and general lack of concern about privacy in relation to the smartphone application and its tracking and geotagging features. Both audiologists and patients credited the connected hearing aids with increased opportunities to participate more fully in everyday life. Conclusions: The introduction of smartphone-connected hearing aids influenced the identities and candidate profiles of hearing aid users, and the nature of time spent in clinical interactions, in important and interesting ways. The influence of connected hearing aids on patient experience and audiology practice calls for continued research and clinical consideration, with implications for clinical decision-making regarding hearing aid candidacy. Further study should look critically at normalization and possible unintended stigmatizing effects of making hearing aids increasingly discreet.


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