Hearing loss is one of the most common chronic disabilities in older adults, yet reported rates of users' satisfaction with hearing aids are low. Some believe that physicians can provide patients who are pursuing a hearing aid fitting an impartial opinion that will improve hearing aid satisfaction.OBJECTIVE To determine whether a physician consultation increased or decreased patients' satisfaction with hearing aids compared with patients undergoing hearing aid fitting with a dispensing audiologist alone.DESIGN, SETTING, AND PARTICIPANTS This multicenter, parallel-group, standard regimen-controlled, randomized clinical trial was conducted in offices of audiologists, family physicians, and a hospital-based neurotologist in Vancouver, British Columbia, Canada, and recruited participants from July 2016 to December 2020 with a 3-month postintervention follow-up. The final data analysis was conducted on March 25, 2022. Adult first-time hearing aid users with averaged sensorineural hearing losses of more than 25 dB were prospectively allocated by random number generation to control and intervention groups. Participants were excluded from analysis if they did not attend follow-up or complete the study questionnaire.INTERVENTIONS Control participants were followed up solely by their dispensing audiologist. The intervention group attended a single structured visit with a physician in addition to their audiologist's determined follow-up. MAIN OUTCOMES AND MEASURESPrimary outcome: hearing aid satisfaction 3 months postfitting as measured by the Satisfaction with Amplification in Daily Life (SADL) questionnaire. Secondary outcome: number of returned hearing aids. Prerecruitment null hypothesis: no intergroup difference in postfitting hearing aid satisfaction. Intergroup difference in mean SADL questionnaire scores analyzed by effect size and the Student t test and proportion of returned hearing aids by the Fischer exact test. RESULTS A total of 133 participants (mean [SD] age, 70.9 [8.5] years; 64 women [48.1%]) were recruited. Of these, 51 randomized to the control group (mean [SD] age, 71.7 [8.3] years; 28 women [54.9%]) and 42 to the physician intervention (mean [SD] age, 69.9 [7.6] years; 17 women [40.5%]) had results that were analyzed. There was no clinically meaningful intergroup difference in participants' SADL scores (control: mean [SD] score, 5.33 [0.72]; physician consultation: mean [SD] score, 5.35 [0.61]), the mean difference of 0.02 (95% CI, -0.25 to 0.29), or returned hearing aids (control, 1; physician consultation, 0). CONCLUSIONS AND RELEVANCEThe results of this randomized clinical trial suggest that a physician consultation that is focused on hearing change does not alter a patient's satisfaction with hearing aids 3 months postfitting.
Previous studies reported to this Society regarding our repeated evoked potentials (REPs) protocol for auditory brainstem responses (ABRs) have used a click rate of approximately 11 per s. Revisions in the REPs/ABR protocol requiring collection of as many as 16 waveforms in a single session encourage test streamlining, such as increasing click rate. The ABR literature suggests that while click rates of 30/s and above may affect 11/s-based absolute ABR parameters such as peak latency and peak amplitude, fewer changes will be seen with rates lower than 30/s. There are no data on the effect of click rate on ABR peak stability, the dependent variable targeted by the REPs procedure. Eight young adults with normal hearing (four women and four men) were tested in a within-subjects five-session design. Each session involved collection of 4 left ear, 4 right ear, and 8 binaural ABR waveforms; in sessions 1 and 5 a click rate of 11.1 per s was used; for sessions 2, 3, and 4, responses were evoked at click rates of 22.2, 33.3, and 44.4 per s, respectively. Results indicate that click rates faster than 30/s do create the most changes in 11/s-based peak latency and amplitude, though the effects for all increases are differentially distributed by peak, ear condition, and individual subject. Changes in click rate also have marked effects on ABR stability, both latency and amplitude, with details highly specific to individuals. In general, however, changes in stability as a function of click rate occur in the context of replication of the overall shape of the ‘‘stability profile’’ for each subject, providing further evidence of the ‘‘fingerprint’’ nature of this means of characterizing individual auditory brainstems.
The speech-perception abilities of 15 prelingual deaf children, using the Nucleus 21-channel cochlear implant, were examined with a new audiovisual speech-feature test for young children. The test stimuli include the letters "b, d, c, p, t, v, z" and pictures of "me," "knee," and "key." Preliminary test retest data suggest good reliability for a 60-item test. Performance is significantly correlated with a closed-set picture test for young children. A feature analysis indicated that the voicing and envelope features were understood moderately well when presented by audition, and the place feature was understood well when presented by vision. [Work supported by NIH.] 4:45 7PPI4. Speech and hearing applications of LabVIEW ©. B. Espinoza-Varas, Chongjoon Shim, and Theodore H. Venema (Dept. Commun. Disord., Univ. Oklahoma Health Sci. Ctr., Oklahoma City, OK 73190) A system for research, teaching, and clinical applications in speech and heating is described. The system utilizes LabVIEW © software, National Instruments © expansion boards (D/A converter, DIO and DMA boards), and a Macintosh © IIFX computer. LabVIEW is an integratedpackage for data acquisition, digital signal processing, instrument and process control, data analysis and graphics. The package: (a) employs an icon-based language that does not require writing of code; (b) contains a comprehensive library of modular, pre-programed functions (e.g., A/D conversion, digital filtering, FFT analysis, etc.) callable by displaying icons to the screen; (c) links modules with a graphical "wiring" utility; and (d) is intuitively simple to use. The system is being used for signal generation, control of psychoacoustic and speechperception experiments, data analysis, and signal processing. A package of heating-science laboratory demonstrations has been implemented also.
Measures of listeners’ ability to attend to each of four possible discrimination cues were obtained. The stimuli comprised pairs (T1,T2) of 1500-Hz, 80-ms, 66-dB SL tones separated by a 80-ms silent interval [Espinoza-Varas, J. Acoust. Soc. Am. 74, 1687–1694 (1983)]. In a three-interval, 2AFC task, listeners discriminated a ‘‘standard’’ pair (interval 1) from a ‘‘comparison’’ pair (interval 2 or 3) containing increments in the duration (ΔT) or in the frequency (ΔF) of either T1 or T2. Each of the four possible increments was controlled by an adaptive track targeting 71-percent-correct thresholds (Levitt, 1971). Separate adaptive tracks were used for each increment, but all four tracks were interleaved randomly within a block of trials. That is, only one kind of increment occurred on a given trial, but all four increments alternated randomly within a block of trials. Each adaptive track terminated after 10 reversals, and thresholds were defined as the average increment value of the last five reversals. A block of trials terminated when the ten-reversals criterion was reached with all four cues. The slope of the adaptive tracks and the thresholds reached after ten reversals provided measures of attention distribution. [Work supported by OCAST Grant No. HSO-005 and Presbyterian Health Foundation.]
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