This is the final report of the American Academy of Audiology Task Force on the Health-Related Quality of Life (HRQoL) Benefits of Amplification in Adults. A systematic review with meta-analysis examined evidence pertaining to the use of hearing aids for improving HRQoL for adults with sensorineural hearing loss (SNHL). Relevant search strings applied to the CENTRAL, CINAHL, Cochrane Reviews, ComDisDome, EBMR, and PubMed databases identified randomized controlled trial, quasi-experimental, and nonexperimental pre-post test designed studies. Sixteen studies met a priori criteria for inclusion in this review. A random-effects meta-analysis showed differential results for generic versus disease-specific HRQoL measures for within- and between-subject designs. Although generic measures used for within-subject designs did not demonstrate HRQoL benefits from hearing aids, mean effect sizes and confidence intervals for within-subject designs and disease-specific instruments suggested that hearing aids have a small-to-medium impact on HRQoL. Further, the between-subject studies supported at least a small effect for generic measures, and when measured by disease-specific instruments, hearing aids had medium-to-large effects on adults' HRQoL. This review concludes that hearing aids improve adults' HRQoL by reducing psychological, social, and emotional effects of SNHL. Future studies should include control groups using randomized controlled trials.
This study assessed the effects of reverberation, noise, and their combination on listeners' identification of consonants and vowels in naturally produced nonsense syllables presented at different sensation levels (re: speech recognition threshold). A secondary purpose of this study was to assess listeners' identification of voicing, manner, and place of articulation for consonants at 50 dB SL in the reverberation, noise, and combined conditions. Listeners, aged 6-30 years, identified consonant-vowel-consonant-vowel (CVCV) stimuli presented at four different sensation levels (re: speech recognition threshold) of 30, 40, 50, and 60 dB SL in 4 listening conditions: (a) an optimal listening situation (no reverberation, no noise), (b) reverberation only (1.3 seconds), (c) noise only (+13 dB S/N against a multitalker babble), and (d) reverberation plus noise. Results showed that all listener groups achieved maximum consonant identification performance at 50 dB SL. Vowel identification scores were unaffected by SL. Statistical analyses revealed that children's ability to identify consonants varied according to listening condition. For example, children's consonant identification abilities reached adult-like levels of performance at about age 14 years in the reverberation-only and noise-only listening conditions. However, in the reverberation-plus-noise listening condition, children's consonant identification abilities do not mature until the late teenage years. The ability to identify vowels, on the other hand, develops much earlier. A feature analysis of the consonant data showed that for all 3 features (voicing, manner, and place), identification scores were highest in the control condition, similar for the reverberation-only and noise-only conditions, and lowest in the reverberation-plus-noise condition. Voicing was easier for listeners to identify than manner or place of articulation features in reverberation and noise. Taken together, these results suggest that the ability to identify speech in reverberation and noise reaches adult-like level of performance at different ages for different components of the speech signal.
Most of these college students should not be at great risk of hearing loss from their iPods when used conscientiously. Some concern is warranted for a small segment of these students who seemed to be most at risk because they listened to their iPods at high volume levels for long durations using earbuds, and reported that they may already have hearing loss due to their iPods.
Hearing and balance problems are prevalent among the elderly. Primary care physicians (PCPs) are important pivotal points of entry for ensuring that patients receive needed audiology services. New Medicare beneficiaries are entitled to one-time preventative examinations including hearing/balance screenings. A 35-item questionnaire was developed to assess physicians' participation in, knowledge about, and attitudes toward hearing/balance screenings and referrals for the elderly. The survey was mailed to 710 PCPs (19 undeliverable; 95 returned; response rate = 13.7%) in major metropolitan areas in the United States. Generally, these PCPs were not conducting hearing/balance screenings, aware of patient self-report screening questionnaires, or likely to screen in the future. They referred to audiologists and otolaryngologists mainly when patients complained of having hearing/balance difficulties, and they stated that these problems were important in the elderly and that the Medicare program was worthy of funding but that they had little time and were not reimbursed appropriately for screening. Therefore, PCPs could benefit from informational outreach campaigns on the prevalence of, negative HRQoL (health-related quality of life) effects from, and screening procedures for hearing/balance disorders in the elderly.
Evidence exists supporting the notion that adults with MSNHL benefit from hearing aids. This information is important and useful to audiologists, patients, and third-party payers, even considering that most of the studies in this systematic review were limited, somewhat dated, and used analog and early digital technology available when the studies were conducted. Clinical recommendations may be even stronger as future studies become available for patients fit with modern styles and high-technology hearing aids.
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