Differences in Force Levels, Word Recognition in Quiet, Sentence Reception Threshold in Noise, and Subjective Outcomes for a Bone-Anchored Hearing Device Programmed Using Manufacturer First-Fit, Aided Sound-Field Thresholds and Programmed to DSL-BCD Using a Skull Simulator

2021 ◽  
Vol 32 (07) ◽  
pp. 395-404
Author(s):  
Adam Voss ◽  
Alison Brockmeyer ◽  
Michael Valente ◽  
John Pumford ◽  
Cameron C. Wick ◽  
...  
Keyword(s):  
Word Recognition ◽  
Best Practice ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Sound Field ◽  
Double Blind ◽  
Best Practice Guidelines ◽  
Data Collection And Analysis ◽  
Hearing Devices ◽  
Subjective Outcomes

Abstract Background Best practice guidelines for verifying fittings of bone-anchored hearing devices (BAHD) recommend using aided sound-field thresholds (ASFT), but express caution regarding the variables impacting obtaining valid and reliable ASFTs.1 Recently, a skull simulator was introduced to facilitate programming BAHD devices in force level (FL) to desired sensation level-bone conduction devices (skull simulator/DSL-BCD)2 3 targets in a hearing aid analyzer. Currently, no evidence is available reporting if differences in measured FL using the manufacturer first-fit (FF) and word recognition in quiet, sentence reception threshold in noise, and subjective outcomes are present for a BAHD programmed using ASFT versus programmed using skull simulator/DSL-BCD targets. Purpose The aim of this study was to examine if significant differences were present in FL using the FF and word recognition in quiet at 50 and 65 decibel of sound pressure level (dB SPL), sentence reception threshold in noise and subjective outcomes using the abbreviated profile of hearing aid benefit (APHAB), and speech, spatial, and qualities of hearing (SSQ) between a BAHD fit using ASFT or skull simulator/DSL-BCD targets. Research Design A double-blind randomized crossover design with 15 adults having unilateral sensorineural hearing loss. All participants were successful users of the Cochlear America Baha 5. Data Collection and Analysis Baha Power 5 devices were fit using FF, ASFT, and skull simulator/DSL-BCD targets. Order of the three fitting strategies was randomly assigned and counter-balanced. Results No significant differences were found for a BAHD device programmed using ASFT versus skull simulator/DSL-BCD targets for consonant-nucleus-consonant words in quiet at 50 or 65 dB SPL, sentence reception threshold in noise, the APHAB or SSQ. There were, however, significant differences, at primarily 500 to 2,000 Hz in measured FLs between the FF, ASFT, and skull simulator/DSL-BCD targets at 50 and 65 dB SPL. Conclusions There were no significant differences in subject performance with two speech measures and subjective responses to two questionnaires for BAHD fittings using ASFT versus using skull simulator/DSL-BCD targets. Differences in FL between the three fitting strategies were present primarily at 500 to 2,000 Hz. Limitations of the study are highlighted along with situations where the skull simulator can play a significantly beneficial role when fitting BAHD devices.

scholarly journals Differences in Word and Phoneme Recognition in Quiet, Sentence Recognition in Noise, and Subjective Outcomes between Manufacturer First-Fit and Hearing Aids Programmed to NAL-NL2 Using Real-Ear Measures

2018 ◽  
Vol 29 (08) ◽  
pp. 706-721 ◽  
Author(s):  
Michael Valente ◽  
Kristi Oeding ◽  
Alison Brockmeyer ◽  
Steven Smith ◽  
Dorina Kallogjeri
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Monosyllabic Word ◽  
Phoneme Recognition ◽  
Double Blind ◽  
Sentence Recognition ◽  
Subjective Outcomes ◽  
Fitting Hearing Aids

AbstractThe American Speech-Language-Hearing Association (ASHA) and American Academy of Audiology (AAA) have created Best Practice Guidelines for fitting hearing aids to adult patients. These guidelines recommend using real-ear measures (REM) to verify that measured output/gain of hearing aid(s) match a validated prescriptive target. Unfortunately, approximately 70–80% of audiologists do not routinely use REM when fitting hearing aids, instead relying on a manufacturer default “first-fit” setting. This is problematic because numerous studies report significant differences in REM between manufacturer first-fit and the same hearing aids using a REM or programmed-fit. These studies reported decreased prescribed gain/output in the higher frequencies for the first-fit compared with the programmed fit, which are important for recognizing speech. Currently, there is little research in peer-reviewed journals reporting if differences between hearing aids fitted using a manufacturer first-fit versus a programmed-fit result in significant differences in speech recognition in quiet, noise, and subjective outcomes.To examine if significant differences were present in monosyllabic word and phoneme recognition (consonant-nucleus-consonant; CNC) in quiet, sentence recognition in noise (Hearing in Noise Test; HINT), and subjective outcomes using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities of Hearing (SSQ) questionnaires between hearing aids fit using one manufacturer’s first-fit and the same hearing aids with a programmed-fit using REM to National Acoustic Laboratories Nonlinear Version 2 (NAL-NL2) prescriptive target.A double-blind randomized crossover design was used. Throughout the study, one investigator performed all REM whereas a second investigator measured speech recognition in quiet, noise, and scored subjective outcome measures.Twenty-four adults with bilateral normal sloping to moderately severe sensorineural hearing loss with no prior experience with amplification.The hearing aids were fit using the proprietary manufacturer default first-fit and a programmed-fit to NAL-NL2 using real-ear insertion gain measures. The order of the two fittings was randomly assigned and counterbalanced. Participants acclimatized to each setting for four weeks and returned for assessment of performance via the revised CNC word lists, HINT, APHAB, and SSQ for the respective fitting.(1) A significant median advantage of 15% (p < 0.001; 95% CI: 9.7–24.3%) for words and 7.7% (p < 0.001; 95% CI: 5.9–10.9%) for phonemes for the programmed-fit compared with first-fit at 50 dB sound pressure level (SPL) and 4% (p < 0.01; 95% CI: 1.7–6.3%) for words at 65 dB SPL; (2) No significant differences for the HINT reception threshold for sentences (RTS); (3) A significant median advantage of 4.2% [p < 0.04; 95% confidence interval (CI): −0.6–13.2%] for the programmed-fit compared with the first-fit for the background noise subscale problem score for the APHAB; (4) No significant differences on the SSQ.Improved word and phoneme recognition for soft and words for average speech in quiet were reported for the programmed-fit. Seventy-nine percent of the participants preferred the programmed-fitting versus first-fit. Hearing aids, therefore, should be verified and programmed using REM to a prescriptive target versus no verification using a first-fit.

scholarly journals Review of Bone Conduction Hearing Devices

2021 ◽  
Vol 11 (2) ◽  
pp. 207-219
Author(s):  
Susan E. Ellsperman ◽  
Emily M. Nairn ◽  
Emily Z. Stucken
Keyword(s):  
Hearing Aid ◽  
Bone Conduction ◽  
Sound Transmission ◽  
Ear Canal ◽  
Hearing Devices ◽  
Bone Conduction Hearing ◽  
Single Sided Deafness

Bone conduction is an efficient pathway of sound transmission which can be harnessed to provide hearing amplification. Bone conduction hearing devices may be indicated when ear canal pathology precludes the use of a conventional hearing aid, as well as in cases of single-sided deafness. Several different technologies exist which transmit sound via bone conduction. Here, we will review the physiology of bone conduction, the indications for bone conduction amplification, and the specifics of currently available devices.

Can audiometric results predict qualitative hearing improvements in bone-anchored hearing aid recipients?

2013 ◽  
Vol 128 (1) ◽  
pp. 35-42
Author(s):  
M L McNeil ◽  
M Gulliver ◽  
D P Morris ◽  
F M Makki ◽  
M Bance
Keyword(s):  
Pure Tone ◽  
Hearing Aid ◽  
Subjective Evaluation ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sound Field ◽  
Hearing Aid Fitting ◽  
Pure Tone Average ◽  
Hearing Handicap ◽  
Bone Anchored Hearing Aid

AbstractIntroduction:Patients receiving a bone-anchored hearing aid have well-documented improvements in their quality of life and audiometric performance. However, the relationship between audiometric measurements and subjective improvement is not well understood.Methods:Adult patients enrolled in the Nova Scotia bone-anchored hearing aid programme were identified. The pure tone average for fitting the sound-field threshold, as well as the better and worse hearing ear bone conduction and air conduction levels, were collected pre-operatively. Recipients were asked to complete the Speech, Spatial and Qualities of Hearing questionnaire; their partners were asked to complete a pre- and post-bone anchored hearing aid fitting Hearing Handicap Inventory for Adults questionnaire.Results:Forty-eight patients who completed and returned the Speech, Spatial and Qualities of Hearing questionnaire had partners who completed the Hearing Handicap Inventory for Adults questionnaire. The results from the Speech, Spatial and Qualities of Hearing questionnaire correlated with the sound-field hearing threshold post-bone-anchored hearing aid fitting and the pure tone average of the better hearing ear bone conduction (total Speech, Spatial and Qualities of Hearing Scale to the pre-operative better hearing ear air curve (r = 0.3); worse hearing ear air curve (r = 0.27); post-operative, bone-anchored hearing aid-aided sound-field thresholds (r = 0.35)). An improvement in sound-field threshold correlated only with spatial abilities. In the Hearing Handicap Inventory for Adults questionnaire, there was no correlation between the subjective evaluation of each patient and their partner.Conclusion:The subjective impressions of hearing aid recipients with regards to speech reception and the spatial qualities of hearing correlate well with pre-operative audiometric results. However, the overall magnitude of sound-field improvement predicts an improvement of spatial perception, but not other aspects of hearing, resulting in hearing aid recipients having strongly disparate subjective impressions when compared to those of their partners.

scholarly journals Management of Residual Hearing with Cartilage Conduction Hearing Aid after Lateral Temporal Bone Resection: Our Institutional Experience

2021 ◽  
Vol 11 (2) ◽  
pp. 263-274
Author(s):  
Noritaka Komune ◽  
Yoshie Higashino ◽  
Kazuha Ishikawa ◽  
Tomoko Tabuki ◽  
Shogo Masuda ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Surgical Techniques ◽  
Sound Field ◽  
Bone Resection ◽  
Temporal Bone Surgery ◽  
Temporal Bone Resection ◽  
Lateral Temporal Bone Resection ◽  
Hearing Compensation

Background: There is no guideline for hearing compensation after temporal bone resection. This study aimed to retrospectively analyze surgical cases with reconstruction for hearing preservation after temporal bone malignancy resection and propose a new alternative to compensate for hearing loss. Methods: We retrospectively reviewed the medical records of 30 patients who underwent lateral temporal bone surgery for temporal bone malignancy at our institution and examined their hearing abilities after surgery. Result: The hearing outcomes of patients with an external auditory meatus reconstruction varied widely. The mean postoperative air–bone gap at 0.5, 1, 2, and 4 kHz ranged from 22.5 dB to 71.25 dB. On the other hand, the average difference between the aided sound field thresholds with cartilage conduction hearing aid and bone conduction thresholds at 0.5, 1, 2, and 4 kHz ranged from −3.75 to 41.25. More closely located auricular cartilage and temporal bone resulted in smaller differences between the aided sound field and bone conduction thresholds. Conclusions: There is still room for improvement of surgical techniques for reconstruction of the auditory meatus to preserve hearing after temporal bone resection. The cartilage conduction hearing aid may provide non-invasive postoperative hearing compensation after lateral temporal bone resection.

scholarly journals Lineups

Psychology ◽  
2021 ◽  
Author(s):  
Margaret Bull Kovera ◽  
Jacqueline Katzman
Keyword(s):  
Best Practice ◽  
Video Recording ◽  
Correct Identification ◽  
Policy Recommendations ◽  
Double Blind ◽  
Best Practice Guidelines ◽  
Police Investigations ◽  
Additional Section ◽  
Lineup Procedures ◽  
Mistaken Identification

Lineups are conducted in the course of police investigations when a crime has been witnessed by one or more people. A lineup typically consists of a person whom the police believe committed the crime (i.e., the suspect) and some number of people who are known to be innocent of the crime (i.e., fillers). When the police have developed a suspect, they show witnesses a lineup to test whether they will claim that the suspect is the person who committed the crime (i.e., the perpetrator). If so, the witness is said to have made a positive identification of the suspect. What is not clear, at least in real-world investigations, is whether that identification is correct, because sometimes suspects are guilty and sometimes they are innocent. Since the late 1970s, psychologists have conducted experiments to find lineup procedures that decrease the likelihood that witnesses will mistakenly identify innocent suspects. These experiments are typically conducted in laboratory settings in which researchers expose participants to a simulated crime, often on videotape. After the participant-witnesses have viewed the crime, they are asked to attempt an identification from a lineup. In the laboratory, researchers can vary whether the perpetrator appears in that lineup. When the perpetrator is present in the lineup (i.e., a target-present lineup), the witness can identify the suspect (a correct identification), identify a filler, or say that the perpetrator is not there (an incorrect rejection of the lineup). When the perpetrator is not present (i.e., a target-absent lineup), the witness can make a mistaken identification of the suspect, identify a filler, or correctly reject the lineup. Using this method, researchers have identified lineup procedures that decrease mistaken identifications, which are the leading cause of wrongful convictions among those who have been exonerated by DNA tests conducted after trial. This article contains sections describing comprehensive General Overviews of research on lineups, research demonstrating that Live Lineups Are Equivalent to Photo Lineups, and Policy Recommendations and Best Practice Guidelines. The remaining sections describe many of these policy recommendations, including how Lineups Are Superior to Showups, having an Evidence-Based Suspicion for placing a suspect in a lineup, unbiased Lineup Composition, Double-Blind Administration, proper Lineup Instructions, collecting witnesses’ Confidence Statements in the accuracy of their identification immediately after the initial identification, Video Recording Identification Procedures, and avoiding Repeated Lineups. An additional section addresses special issues that need to be considered when Conducting Lineups with Children.

scholarly journals FAIR + FIT: Guiding Principles and Functional Metrics for Linked Open Data (LOD) KOS Products

2020 ◽  
Vol 5 (1) ◽  
pp. 93-118
Author(s):  
Marcia Lei Zeng ◽  
Julaine Clunis
Keyword(s):  
Best Practice ◽  
Semantic Analysis ◽  
Open Data ◽  
International Standards ◽  
Best Practice Guidelines ◽  
Data Collection And Analysis ◽  
Sample Data ◽  
Fair Principles ◽  
Guiding Principles ◽  
User Friendly

AbstractPurposeTo develop a set of metrics and identify criteria for assessing the functionality of LOD KOS products while providing common guiding principles that can be used by LOD KOS producers and users to maximize the functions and usages of LOD KOS products.Design/methodology/approachData collection and analysis were conducted at three time periods in 2015–16, 2017 and 2019. The sample data used in the comprehensive data analysis comprises all datasets tagged as types of KOS in the Datahub and extracted through their respective SPARQL endpoints. A comparative study of the LOD KOS collected from terminology services Linked Open Vocabularies (LOV) and BioPortal was also performed.FindingsThe study proposes a set of Functional, Impactful and Transformable (FIT) metrics for LOD KOS as value vocabularies. The FAIR principles, with additional recommendations, are presented for LOD KOS as open data.Research limitationsThe metrics need to be further tested and aligned with the best practices and international standards of both open data and various types of KOS.Practical implicationsAssessment performed with FAIR and FIT metrics support the creation and delivery of user-friendly, discoverable and interoperable LOD KOS datasets which can be used for innovative applications, act as a knowledge base, become a foundation of semantic analysis and entity extractions and enhance research in science and the humanities.Originality/valueOur research provides best practice guidelines for LOD KOS as value vocabularies.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Modified Earpieces and CROS for High Frequency Hearing Losses

1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Field ◽  
Intensity Level ◽  
Test Results ◽  
High Frequency Hearing Loss ◽  
Increased Sensitivity ◽  
Difficult Cases

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.

Opioid crisis in primary care? An audit of high-dose opioid prescribing at Bangholm GP Practice

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711581
Author(s):  
Charlotte Greene ◽  
Alice Pearson
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Practice Guidelines ◽  
Best Practice ◽  
Evidence Base ◽  
High Dose ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Best Practice Guidelines

BackgroundOpioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018.AimAn audit at Bangholm GP Practice to understand the scale of high-strength opioid prescribing. The aim of the audit was to find out if indications, length of prescription, discussion, and documentation at initial consultation and review process were consistent with best-practice guidelines.MethodA search on Scottish Therapeutics Utility for patients prescribed an average daily dose of opioid equivalent ≥50 mg morphine between 1 July 2019 and 1 October 2019, excluding methadone, cancer pain, or palliative prescriptions. The Faculty of Pain Medicine’s best-practice guidelines were used.ResultsDemographics: 60 patients (37 females), average age 62, 28% registered with repeat opioid prescription, 38% comorbid depression. Length of prescription: average 6 years, 57% >5 years, 22% >10 years. Opioid: 52% tramadol, 23% on two opioids. Indications: back pain (42%), osteoarthritis (12%), fibromyalgia (10%). Initial consultation: 7% agreed outcomes, 35% follow-up documented. Review: 56% 4-week, 70% past year.ConclusionOpioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.

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