Comparative assessment of the effectiveness of hearing assessment protocols in identifying SNHL in elderly and senile people

Introduction. The article discusses methods of screening for hearing impairments in patients of the older age group in the frame-work of primary health care.Aim of the study. Conduct a comparative analysis of the effectiveness of different hearing assessment protocols in primary health care.Materials and methods. Сlinical and demographic data were collected in 585 elderly and senile patients (mean age 76.43 ± 9.83), tonal threshold audiometry was performed in the frequency range from 250 Hz to 12000 Hz, hearing was studied using the web application “Automated primary hearing assessment” (patent No. 2019664671) and analyzed the self-assessment of hearing with the HHIE questionnaire.Results. Most of the patients were elderly people (57.44%) with a high percentage of concomitant diseases (up to 89.23%). When interviewing a geriatrician about a complaint of hearing loss, a sensitivity of 91.5% and a specificity of 82.2% for detecting mild hearing loss, a sensitivity of 95.5% and a specificity of 71.8% for screening for moderate to severe hearing loss were obtained. When assessing the total score of the HHIE questionnaire (>17 points) and moderate hearing loss, the sensitivity was 84.7% and the specificity was 88.7%. The sensitivity index of the web application «Automated primary hearing assessment» for detecting moderate hearing impairment was 90.6% for the left ear and 88.5% for the right ear, and specificity – 88.5% for the left ear and 97.5% for the right ear.Discussion. Raising awareness of hearing problems through the introduction of feasible methods of assessing hearing function should lead to an increase in the number of older adults receiving adequate hearing rehabilitation.Conclusions. The authors conclude that it is important to take preliminary account of data on the sensitivity and specificity of assessment protocols for detecting hearing impairments of varying severity at the stage of examination of an older patient by a geriatrician and an otorhinolaryngologist.

Differences in Auditory Perception Between Young and Older Adults When Controlling for Differences in Hearing Loss and Cognition

This study was designed to examine age effects on various auditory perceptual skills using a large group of listeners (155 adults, 121 aged 60–88 years and 34 aged 18–30 years), while controlling for the factors of hearing loss and working memory (WM). All subjects completed 3 measures of WM, 7 psychoacoustic tasks (24 conditions) and a hearing assessment. Psychophysical measures were selected to tap phenomena thought to be mediated by higher-level auditory function and included modulation detection, modulation detection interference, informational masking (IM), masking level difference (MLD), anisochrony detection, harmonic mistuning, and stream segregation. Principal-components analysis (PCA) was applied to each psychoacoustic test. For 6 of the 7 tasks, a single component represented performance across the multiple stimulus conditions well, whereas the modulation-detection interference (MDI) task required two components to do so. The effect of age was analyzed using a general linear model applied to each psychoacoustic component. Once hearing loss and WM were accounted for as covariates in the analyses, estimated marginal mean thresholds were lower for older adults on tasks based on temporal processing. When evaluated separately, hearing loss led to poorer performance on roughly 1/2 the tasks and declines in WM accounted for poorer performance on 6 of the 8 psychoacoustic components. These results make clear the need to interpret age-group differences in performance on psychoacoustic tasks in light of cognitive declines commonly associated with aging, and point to hearing loss and cognitive declines as negatively influencing auditory perceptual skills.

Adapting Audiology Procedures During the Pandemic: Validity and Efficacy of Testing Outside a Sound Booth

Purpose: This investigation aims to provide outcomes from a clinical perspective on the validity and efficacy of a wireless automated audiometer system that could be used in multiple settings when a sound booth is not accessible. Testing was conducted in a clinical setting under modified protocols meeting safety precautions during the COVID-19 pandemic. Method: Four doctoral students in audiology served as examiners. Participants were 69 adults between the ages of 20 and 69 years, with normal hearing (≤ 25 dB HL; n = 110 ears) or hearing loss (> 25 dB HL; n = 25 ears). Two versions of a pure-tone air-conduction threshold test following a modified Hughson-Westlake approach were performed and compared at 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz (a) in a sound-treated test booth using standard manual audiometry and (b) in a quiet, nonsound-treated clinical room (sound booth free) using automated KUDUwave audiometry. Participants were asked to complete a five-item feedback questionnaire, and examiners were interviewed to report on their experience. Results: Clinical validity to within ±10 dB of standard audiometry was demonstrated for 94.5% of the total thresholds ( n = 937) measured with the sound booth–free approach. Less accuracy (73.3%) was observed using a ±5 dB comparison. When comparing the mean thresholds, there were significant differences ( p < .01) between the mean thresholds at most frequencies, with mean sound booth thresholds being higher than the sound booth–free mean thresholds. A strong threshold correlation (.91–.98) was found between the methods across frequencies. Participant and examiner feedback supported the efficacy of the sound booth–free technology. Conclusions: Findings support sound booth–free, automated software-controlled audiometry with active noise monitoring as a valid and efficient procedure for pure-tone hearing threshold assessment. This method offers an effective alternative when circumstances require more transportable hearing assessment technology or do not allow for standard manual audiometry in a sound booth.

Prepulse inhibition predicts subjective hearing in rats

Auditory studies in animals benefit from quick and accurate audiometry. The auditory brainstem response (ABR) and prepulse inhibition (PPI) have been widely used for hearing assessment in animals, but how well these assessments predict subjective audiometry still remains unclear. Human studies suggest that subjective audiometry is consistent with the ABR-based audiogram, not with the PPI-based audiogram, likely due to top-down processing in the cortex that inhibits PPI. Here, we challenged this view in Wistar rats, as rodents exhibit less complexity of cortical activities and thereby less influence of the cerebral cortex on PPI compared to humans. To test our hypothesis, we investigated whether subjective audiometry correlates with ABR- or PPI-based audiograms across the range of audible frequencies in Wistar rats. The subjective audiogram was obtained through pure-tone audiometry based on operant conditioning. Our results demonstrated that both the ABR-based and PPI-based audiograms significantly correlated to the subjective audiogram. We also found that ASR strength was information-rich, and adequate interpolation of this data offered accurate audiometry. Thus, unlike in humans, PPI could be used to predict subjective audibility in rats.

Experienced hearing aid users’ perspectives of assessment and communication within audiology: A qualitative study using digital methods

ObjectiveTo explore experienced hearing aid users’ perspectives of audiological assessments and the patient-audiologist communication dynamic during clinical interactions.DesignA qualitative study was implemented incorporating both an online focus group and online semi-structured interviews. Sessions were audio-recorded and transcribed verbatim. Iterative-inductive thematic analysis was carried out to identify themes related to assessment and communication within audiology practice.Study samplesSeven experienced hearing aid users took part in an online focus group and 14 adults participated in semi-structured interviews (age range: 22 - 86 years; 9 males, 11 females).ResultsThemes related to assessment included the unaided and aided testing procedure and relating tests to real world hearing difficulties. Themes related to communication included the importance of communication strategies, explanation of test results and patient centred care in audiology.ConclusionTo ensure that hearing aid services meet the needs of the service users, we should explore user perspectives and proactively adapt service delivery. This approach should be ongoing, in response to advances in hearing aid technology. Within audiology, experienced hearing aid users’ value 1) comprehensive, relatable hearing assessment, 2) clear, concise, deaf aware patient-audiologist communication, 3) accessible services and 4) a personalised approach to recommend suitable technology and address patient specific aspects of hearing loss.