Audiology Clinic Research Articles

Exploding Head Syndrome among Patients Seeking Help for Tinnitus and/or Hyperacusis at an Audiology Department in the UK: A Preliminary Study.

Exploding head syndrome (EHS) is characterized by hearing a sudden loud noise or experiencing a sense of explosion in head during the transition of sleep-wake or wake-sleep. The experience of EHS shares similarities with tinnitus, where an individual perceives a sound without any external sound source. To the authors' knowledge, the possible relationship between EHS and tinnitus has not been explored. Preliminary assessment of prevalence of EHS and its related factors among patients seeking help for tinnitus and/or hyperacusis. Retrospective cross-sectional study. A total of 148 consecutive patients who sought help for tinnitus and/or hyperacusis at an audiology clinic in the United Kingdom. The data regarding demographics, medical history, audiological measures, and self-report questionnaires were collected retrospectively from the patients' records. Audiological measures comprised of pure-tone audiometry and uncomfortable loudness levels. The self-report questionnaires which were administered as a part of standard care comprised of the Tinnitus Handicap Inventory, numeric rating scale of tinnitus loudness, annoyance, and effect on life, hyperacusis questionnaire, Insomnia Severity Index, Generalized Anxiety Disorder scale 7, and Patient Health Questionnaire (PHQ-9). To establish presence of EHS, participants were asked "Do you ever hear a sudden, loud noise, or feel a sense of explosion in your head at night?" EHS was reported by 8.1% of patients with tinnitus and/or hyperacusis (12 out of 148). The patients with and without EHS were compared, but no significant relationships were found, between the presence of EHS and age, gender, tinnitus/hyperacusis distress, symptoms of anxiety or depression, sleep difficulties, or audiological measures. The prevalence of EHS in a tinnitus and hyperacusis population is similar to that in the general population. While there does not seem to be any association with sleep or mental factors, this might be due to the limited variability in our clinical sample (i.e., most patients exhibited high level of distress regardless of EHS). Replication of the results in a larger sample with more variety of symptom severity is warranted.

The prevalence of patient-reported cognitive complaints and dementia risk factors in the audiology clinic

Background Hearing-dementia research mainly focuses on determining the causal direction of this association. Little is known about the prevalence of cognitive problems in a representative audiology patient population. Aim To examine the occurrence of self-reported cognitive complaints (SCC) and dementia risk factors (RF) in an audiology patient population. Materials and methods Patients visiting audiology clinics (n = 1100, 51% female and avg. age 61yrs) were administered an online intake tool based on the International Classification of Functioning Disability and Health. Domains extracted for analyses were memory and concentration (SCC) and loneliness, depression, sleep and vision (dementia RF) and self-reported hearing problems (SHP). Prevalence rates and associations with demographic variables and SHP were examined. Results SCC were highly prevalent, with over half of the patients reporting memory or concentration problems. Regarding dementia RF, 68% reported sleeping problems and > 50% reported sadness, anxiety or depressed mood. SHP correlated significantly with self-reported memory problems, loneliness, and vision problems. Conclusion This descriptive cohort-study suggests a high risk of cognitive issues within the audiology clinic population, indicated by the high prevalence of SCC and some dementia RF. Our findings underscore the importance of considering closer cooperation between care pathways like audiology and neurology and use of a holistic patient-centered approach.

Uncovering the effects of pandemic conditions on hearing aid experiences: a dual perspective from audiologists and hearing aid users

Purpose: This study examines the effects of the pandemic on hearing aid experiences from the perspectives of audiologists and patients, as well as communication challenges faced by both users and non-users of hearing aids. Materials and Methods: The study consisted of two phases: a longitudinal study examining the services provided by audiologists during the peak of the COVID-19 pandemic and after the first vaccination dose. The second phase involved a survey of 120 elderly individuals with hearing loss, divided into hearing aid users and non-users for assessing communication challenges. Data was collected from comprehensive audiology clinics using a series of checklists. Results: Analysis of the frequency of services related to hearing aids revealed that during the peak period, the majority of visits were for acquiring batteries and hearing aids, while fewer visits were for fitting and fine-tuning the devices. After vaccination the pattern was changed. In the second phase, significant differences were observed between the hearing aid users and non-users with regards to their ability to comprehend speech while wearing mask, communicating at a safe distance, and following TV news. Conclusions: The distribution of requested services differed during the peak period and the post-vaccination period. There was a noticeable increase in the purchase and fitting of hearing aids after vaccination. However, patients encountered difficulties due to the limited availability of tele-audiology services and delayed services from hearing aid companies. The benefits of hearing aids were impacted by the pandemic as many people did not seek adjustments for their devices.

Effectiveness of Counseling and Sound Therapies, Including Mobile Applications and Quran Therapy, in Managing Subjective Tinnitus: randomized controlled trial study

Introduction: Subjective tinnitus, the perception of sound without an external source, affects approximately 15% of the global population. Despite its non-life-threatening nature, tinnitus significantly impacts the quality of life, causing distress, sleep disturbances, anxiety, and depression. Objectives: This study assesses the effectiveness of counseling therapy combined with two sound therapy modalities; mobile applications and Quran therapy in managing tinnitus symptoms. Methods: This randomized controlled trial study involved 270 participants with subjective tinnitus, recruited from a medical center and a private audiology clinic in Sulaymaniyah, Iraq. Participants were divided into two groups: one receiving counseling therapy and sound therapy via mobile applications (ReSound Tinnitus Relief and Beltone Tinnitus Calmer), and the other receiving counseling therapy combined with Quran therapy (Quranic recitation in Maqam Al-Bayati style). Tinnitus severity and its impact on quality of life were measured using the Tinnitus Primary Function Questionnaire (TPFQ-CK) and the Tinnitus Handicap Questionnaire (THQ-CK) before and six months after the intervention. Results: Both therapy groups showed significant improvements in tinnitus severity and quality of life. The TPFQ-CK total scores decreased from 38.18 to 14.99 in the Quran therapy group and from 38.34 to 17.82 in the mobile application group. The THQ-CK total scores decreased from 43.46 to 22.99 in the Quran therapy group and from 43.74 to 25.25 in the mobile application group. Significant reductions were also observed in tinnitus annoyance and loudness levels. Conclusions: Counseling therapy combined with sound therapy, whether through mobile applications or Quranic recitation, effectively reduces tinnitus severity and improves the quality of life for individuals with subjective tinnitus. Quran therapy, leveraging spiritual and cultural practices, showed a slight edge in effectiveness over mobile applications, suggesting that culturally relevant and accessible sound therapy options can enhance tinnitus management.

Extended scope audiology clinic – a review of its outcomes and re-presentation to the ear nose and throat service

Objective To evaluate the role of Extended Scope (ES) audiologists in managing adult Ear Nose and Throat (ENT)/Otology waitlists and analyse patient re-presentation rate to the ENT service within 12 months of being discharged from the clinic. Design A retrospective cohort study assessing the efficacy of ES audiologists, measuring the discharge rate from ENT waitlists, the rate of escalation to ENT care, and the rate and reasons for any re-presentations to care. Study sample 394 adult patients. Results Of the referred patients, 95% (n = 374) were deemed suitable for ES care. Of these, 75% were discharged without further ENT intervention, 20% required escalation to ENT, and 5% were returned to the waitlist. Only one patient re-presented for care within 12 months. The inclusion of patients with CHL/MHL and vestibular symptoms marked an expansion from our previous work. The re-presentation rate was notably lower compared to other allied health ES clinics. Conclusion The ES Audiology clinic demonstrates a high discharge rate with a low incidence of patient re-presentation, highlighting the ES audiologists’ efficiency in managing non-urgent ENT cases. The study supports the continued use and expansion of ES roles to ensuring timely and quality care for patients on ENT waitlists.

Accuracy and Consistency of Confidence Limits for Monosyllable Identification Scores Derived Using Simulation, the Harrell-Davis Estimator, and Nonlinear Quantile Regression.

Audiological diagnosis and rehabilitation often involve the assessment of whether the maximum speech identification score (PBmax) is poorer than expected from the pure-tone average (PTA) threshold. This requires the estimation of the lower boundary of the PBmax values expected for a given PTA (one-tailed 95% confidence limit, CL). This study compares the accuracy and consistency of three methods for estimating the 95% CL. The 95% CL values were estimated using a simulation method, the Harrell-Davis (HD) estimator, and non-linear quantile regression (nQR); the latter two are both distribution-free methods. The first two methods require the formation of sub-groups with different PTAs. Accuracy and consistency in the estimation of the 95% CL were assessed by applying each method to many random samples of 50% of the available data and using the fitted parameters to predict the data for the remaining 50%. A total of 642 participants aged 17 to 84 years with sensorineural hearing loss were recruited from audiology clinics. Pure-tone audiograms were obtained and PBmax scores were measured using monosyllables at 40 dB above the speech recognition threshold or at the most comfortable level. For the simulation method, 6.7 to 8.2% of the PBmax values fell below the 95% CL for both ears, exceeding the target value of 5%. For the HD and nQR methods, the PBmax values fell below the estimated 95% CL for approximately 5% of the ears, indicating good accuracy. Consistency, estimated from the standard deviation of the deviations from the target value of 5%, was similar for all the methods. The nQR method is recommended because it has good accuracy and consistency, and it does not require the formation of arbitrary PTA sub-groups.

Barriers to Meeting National Early Hearing Detection and Intervention Guidelines in a Diverse Patient Cohort.

To determine our audiology clinics status in meeting the Joint Committee on Infant Hearing recommended 1-3-6 benchmarks for identification and intervention for congenital sensorineural hearing loss and identify those factors contributing to delay in identification and intervention. This is a retrospective case series. Children with sensorineural hearing loss who underwent auditory brainstem response (ABR) testing, hearing aid evaluation, or cochlear implant mapping at our tertiary pediatric medical center between January 2018 and December 2021 were included. Simple and multiple linear regression analyses were used to identify social, demographic, and health factors associated with primary outcomes, defined as age at hearing loss identification, age at intervention (here defined as amplification start), and interval between identification and intervention. Of 132 patients included, mean age was 2.4 years, 48% were male, and 51% were Hispanic. There was significant association between each Hispanic ethnicity (p = 0.005, p = 0.04, respectively), insurance type (p = 0.02, p = 0.001, respectively), and later age at identification and intervention. In multivariable analyses, Hispanic ethnicity was significantly associated with both delays in identification and intervention (p = 0.03 and p = 0.03, respectively), and public insurance was associated with delays in intervention (p = 0.01). In addition, the total number of ABRs was significantly associated with both older age of identification and intervention (p < 0.001, p < 0.001, respectively). Mediator analysis demonstrated that the effect of ethnicity on age at identification is mediated by the total number of ABRs performed. A significant association between total number of ABRs and age at identification and intervention for children with hearing loss exists. Hispanic ethnicity was associated with delays in meeting milestones, further mediated by the number of ABRs, providing a potential avenue for intervention in addressing this disparity.

Screen-H Website Audiometry as a Diagnostic Tool for Hearing Screening in Patients with Hearing Loss

Background Hearing loss, affecting 16.8% of Indonesians, impacts quality of life and daily activities. Limited access to hearing loss evaluation and treatment, due to demographic and socioeconomic conditions, particularly in remote areas, hinders early detection and intervention. Website audiometry Screen-H, accessible on mobile phones, tablets, and computers, offers a fast, painless, and non-invasive solution. Purpose This study aimed to assess the agreement between Screen-H and gold standard pure-tone audiometry. Methods In this analytical observational study with a cross-sectional design, participants over 10 years old with hearing loss were consecutively sampled at the Audiology Clinic of Otorhinolaryngology-Head and Neck Surgery, Dr. Hasan Sadikin General Hospital, Bandung. The sensitivity and specificity of Screen-H® were evaluated, and the Kappa score measured agreement with pure-tone audiometry. Results We included 321 patients, comprising 150 women (47%) and 171 men (53%). Screen-H® showed 82.8% sensitivity and 94.1% specificity in the right ear, and 80.8% sensitivity and 93.1% specificity in the left ear. Conclusion The high specificity and sensitivity of Screen-H, combined with its speed, ease of use, non-invasiveness, and cost-effectiveness, make it an effective screening tool for hearing loss in environments with noise levels ≤ 40 dB HL, starting from 35 dB HL stimuli.

A Follow-Up Study of Children Diagnosed with Delayed Speech and Language

Objective: The aim of our study was to examine the current health status of children with normal peripheral hearing who were referred to the audiology clinic with complaints of speech and language delay in early childhood.&#x0D; Methods: The data of a retrospective file review in which the information of 105 children with normal hearing ages 12-60 months referred to the Audiology Clinic with complaints of speech and language delay were used in the study. After the initial diagnosis of delayed speech and language (approximately two years), their medical condition was assessed through semi-structured telephone interviews. The obtained data are presented with descriptive statistics.&#x0D; Results: Out of 105 children, 54 (51.4%) were diagnosed with other additional diagnoses including; autism spectrum disorder:21 (20%), general developmental delay: 13 (12.3%), attention deficit and hyperactivity disorder: 9 (8.5%), epilepsy: 4 (3.8%).7 (6.6%) of children followed from endocrine, neurology, genetics, cardiology, nephrology and ophthalmology departments. 51 children (48.57%) have achieved the average level of speech and language development with interventions such as speech and language therapy and/or social support in the following period, and they do not currently have any medical follow-up. &#x0D; Conclusion: The results indicated that cases where children who apply with the complaint of speech and language delay may have additional diagnoses in the future, or they can achieve the average level of speech and language development with specialist interventions. Long-term follow-up of this delay is important in terms of providing effective communication skills and the probability of being a diagnostic marker.

Perceptions of Hearing Health Care: A Qualitative Analysis of Satisfied and Dissatisfied Online Reviews.

The aim of this study was to examine the hearing health care experience of satisfied and dissatisfied consumers as reported on Google reviews. Using qualitative thematic analysis, open-text responses from Google regarding hearing health care clinics across 40 U.S. cities were examined. During the original search, 13,168 reviews were identified. Purposive sampling led to a total of 8,420 five-star reviews and 321 one-star reviews. The sample consisted of 500 five-star (satisfied) and 234 one-star (dissatisfied) reviews, describing experiences with audiology clinics, excluding reviews related to ear, nose, and throat services; other medical specialties; and those not relevant to hearing health care. Satisfied and dissatisfied consumer reviews yielded nuanced dimensions of the hearing health care consumer experience, which were grouped into distinct domains, themes, and subthemes. Six and seven domains were identified from the satisfied and dissatisfied reviews, encompassing 23 and 26 themes, respectively. The overall experience domain revealed emotions ranging from contentment and gratitude to dissatisfaction and waning loyalty. The clinical outcomes domain highlights the pivotal contribution of well-being and hearing outcomes to the consumer experience, while the standard of care domain underscores shared expectations for punctuality, person-centered care, and efficient communication. Facility quality, professional competence, and inclusive care were also highlighted across positive and negative reviews. Findings indicate dimensions of satisfied and dissatisfied hearing health care consumer experiences, identifying areas for potential service refinement. These consumer experiences inform person-centric service delivery in hearing health care.

Self-administered, internet-enabled, modified rhyme test (MRT) for evaluating consonant confusion in remote subjects

A self-administered MRT has been developed for persons unable to attend on-site for testing. Subjects remotely log on to a website and are instructed to use their own computer and headphones or earphones/earbuds and seek a quiet location without distractions for the test. After inputting personal identification, the software produces the maximum and minimum intensity sounds that will be heard to allow the subject to adjust the audio gain to a comfortable listening level. The subject is then instructed not to re-adjust the audio gain during the MRT. Each trial is initiated by the subject and consists of the forced choice of one of six rhyming words, which is embedded in a carrier sentence. The pre-recorded speech in a single test, consisting of 25 trials, is replayed at a pre-selected, fixed speech signal-to-noise ratio. The internet-enabled MRT has been validated for subjects with believed normal hearing (N = 18) by comparison with a conventional MRT in our audiology clinic in which subjects' hearing thresholds were determined, and stimuli were presented at a prescribed sensation level (N = 7). Results were also compatible with word scores obtained on-site without audiological controls when subjects wore high-fidelity headphones (N = 6). [Work supported by NIOSH and the Alpha Foundation.]

Prevalence and Risk Factors of Hearing Loss at Bugando Medical Centre Mwanza Tanzania

Hearing enable us to communicate and interact all over the world. When hearing is reduced or not there at all then is a major problem. In Africa more so in the Sub Sahara, this problem is on the rise due to the activities that are been carried out. There is no clinical data that is available from our national and zonal referral hospital, this study is a stepping stone for more studies. The outcome will show the burden of the people with reduced or has no ability to hear, distribution of hearing loss and the contributing factors. The engagement was conducted in a tertiary hospital serving more than five regions of the country. It`s a descriptive cross-sectional study. The study spanned from July 2020 to December 2020 with the total number of patients visited the otorhinolaryngology and audiology clinic being 6,234 the ones hearing loss 526. The study found prevalence of 8.4% for reduce/inability to hear. Females found to be more by 1.3%. Sensorineural hearing was the leading (51%), followed by conductive hearing (41%). The group most affected by sensorineural hearing were 40-59 (53.7%). On conductive hearing, the leading group being affected were 3-39 years (46.6%). In the distribution of sensorineural hearing the leading one was mild hearing in the age group of 3-39 (63%), followed by moderate hearing at 25.5%. The contributory factors were inflammation, such as allergic rhinitis (38%), otitis (34%), and wax (9.5). These factors contributed to about 60% of hearing loss. A group of young adults have been found to have mild hearing (63%); this shows that in a few years, the majority of the young group will have severe hearing problems, hence decreasing the manpower of our economy. Public knowledge about ear care should be offered to people, and this should be done by the media and the health sector as a whole

Understanding Patient Utilization Patterns of Cochlear Implant Processors.

To evaluate the extent of benefit the second processor provides and to better understand utilization patterns regarding cochlear implant (CI) sound processors. Institutional contracts determine the external CI sound processor hardware that a patient is eligible for. Despite the high prevalence of CI worldwide, there is a paucity in the literature regarding patient preferences and how patients utilize provided external hardware. A close-ended, multiple-choice survey was mailed to all patients over the age of 18 years who underwent CI between 2016 to 2020 at a tertiary academic medical center. Patients who received their CI hardware prior to 2018 were provided 2 processors, whereas those who received their hardware in 2018 or later were provided 1 processor. A total of 100/263 surveys were returned for a response rate of 38.0%. Of the cohort with 1 processor, 31.3% experienced a period without a functioning processor and access to sound compared to 5.6% of the cohort with 2 processors (P = -.003). Of the cohort with 2 processors, 24.3% noted that they often or always utilize their second processor. When asked how important having a second processor was, 62.9% of the 2-processor group responded that it was very important (P = .001). The most common reason for utilizing the second processor was a damaged primary processor. Patients who received 2 processors had a significantly lower number of postoperative audiology clinic visits for device troubleshooting (P < .001). Patients who have 2 CI external processors identify this as being very important to them and experience significantly less time without access to sound due to lack of a functioning processor. As institutional contracts often dictate whether a patient will receive 1 or 2 sound processors with their CI hardware, it is important to understand patient preferences and utilization patterns in order to guide patient-centric policies.

Development of the Children's English and Spanish Speech Recognition Test: Psychometric Properties, Feasibility, Reliability, and Normative Data.

The Children's English and Spanish Speech Recognition (ChEgSS) test is a computer-based tool for assessing closed-set word recognition in English and in Spanish, with a masker that is either speech-shaped noise or competing speech. The present study was conducted to (1) characterize the psychometric properties of the ChEgSS test, (2) evaluate feasibility and reliability for a large cohort of Spanish/English bilingual children with normal hearing, and (3) establish normative data. Three experiments were conducted to evaluate speech perception in children (4-17 years) and adults (19-40 years) with normal hearing using the ChEgSS test. In Experiment 1, data were collected from Spanish/English bilingual and English monolingual adults at multiple, fixed signal-to-noise ratios. Psychometric functions were fitted to the word-level data to characterize variability across target words in each language and in each masker condition. In Experiment 2, Spanish/English bilingual adults were tested using an adaptive tracking procedure to evaluate the influence of different target-word normalization approaches on the reliability of estimates of masked-speech recognition thresholds corresponding to 70.7% correct word recognition and to determine the optimal number of reversals needed to obtain reliable estimates. In Experiment 3, Spanish/English bilingual and English monolingual children completed speech perception testing using the ChEgSS test to (1) characterize feasibility across age and language group, (2) evaluate test-retest reliability, and (3) establish normative data. Experiments 1 and 2 yielded data that are essential for stimulus normalization, optimizing threshold estimation procedures, and interpreting threshold data across test language and masker type. Findings obtained from Spanish/English bilingual and English monolingual children with normal hearing in Experiment 3 support feasibility and demonstrate reliability for use with children as young as 4 years of age. Equivalent results for testing in English and Spanish were observed for Spanish/English bilingual children, contingent on adequate proficiency in the target language. Regression-based threshold norms were established for Spanish/English bilingual and English monolingual children between 4 and 17 years of age. The present findings indicate the ChEgSS test is appropriate for testing a wide age range of children with normal hearing in either Spanish, English, or both languages. The ChEgSS test is currently being evaluated in a large cohort of patients with hearing loss at pediatric audiology clinics across the United States. Results will be compared with normative data established in the present study and with established clinical measures used to evaluate English- and Spanish-speaking children. Questionnaire data from parents and clinician feedback will be used to further improve test procedures.

ENHANCE: a comparative prospective longitudinal study of cognitive outcomes after 3 years of hearing aid use in older adults.

With an aging population, the prevalence of hearing loss and dementia are increasing rapidly. Hearing loss is currently considered the largest potentially modifiable risk factor for dementia. The effect of hearing interventions on cognitive function should therefore be investigated, as if effective, these may be successfully implemented to modify cognitive outcomes for older adults with hearing loss. This prospective longitudinal observational cohort study compared outcomes of a convenience sample of prospectively recruited first-time hearing aid users without dementia from an audiology center with those of community-living older adults participating in a large prospective longitudinal cohort study with/without hearing loss and/or hearing aids. All participants were assessed at baseline, 18 months, and 36 months using the same measures. Participants were 160 audiology clinic patients (48.8% female patient; mean age 73.5 years) with mild-severe hearing loss, fitted with hearing aids at baseline, and 102 participants of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging (AIBL) (55.9% female patient; mean age 74.5 years). 18- and 36-month outcomes of subsets of the first participants to reach these points and complete the cognition assessment to date are compared. Primary comparative analysis showed cognitive stability for the hearing aid group while the AIBL group declined on working memory, visual attention, and psychomotor function. There was a non-significant trend for decline in visual learning for the AIBL group versus no decline for the hearing aid group. The hearing aid group showed significant decline on only 1 subtest and at a significantly slower rate than for the AIBL participants (p < 0.05). When education effects on cognitive trajectory were controlled, the HA group still performed significantly better on visual attention and psychomotor function (lower educated participants only) compared to the AIBL group but not on working memory or visual learning. Physical activity had no effect on cognitive performance trajectory. Hearing aid users demonstrated significantly better cognitive performance to 3 years post-fitting, suggesting that hearing intervention may delay cognitive decline/dementia onset in older adults. Further studies using appropriate measures of cognition, hearing, and device use, with longer follow-up, are required.

Cochlear implant referral patterns in the UK suggest a postcode lottery with inequitable access for older adults; results of a pilot audit in five Audiology sites

Objective To use a standardised reporting tool to identify potential eligible candidates for cochlear implant (CI) referral and quantify the proportion of adults who had a CI referral discussion after presenting with an audiogram within United Kingdom (UK) audiometric criteria. Design Retrospective multicentre 6-month audit of Audiology clinic databases. Study sample A total of 810 adults from five geographically diverse UK Audiology sites. Results Data were collected in late 2019 after UK CI audiometric candidacy criteria changed; one site collected only 3 months of data. The proportion of potential eligible adults (based only on audiometry) considered for CI referral was 64% (521 out of 810) and varied by site (from 50% to 83%). About 24% of patients (123 out of 521) declined CI referral; this also varied across sites (12–45%). The median age of patients where CI referral was not considered was 80 years – significantly higher than the group where CI referral was considered (73 years). Conclusions CI referral is dependent on where adults live, and how old they are. Older adults are significantly less likely to be considered for CI referral by Audiologists. Audiology clinics need more support to empower staff to talk to patients about CI referral.

The Use of Electronic Health Records for Behavioral Phenotyping of School-Age Children With Unilateral Hearing Loss: A Methodological Approach.

This methodological study describes a technique for extracting information from de-identified electronic health records (EHRs) to identify occurrences of permanent unilateral hearing loss (UHL) and associated educational comorbidities. This was an exploratory methodological study utilizing approximately 3.3 million de-identified medical records. Structured and unstructured data were extracted using both automated and manual methods. When both methods were available, positive and negative predictive values were calculated to evaluate the utility of using automated methods. We defined a cohort of 471 records that met our criteria of school-age children with permanent UHL and no additional significant disabilities/diagnoses. Fifty-one percent of the children reflected in this cohort had indicators of adverse educational progress, defined as documentation of receiving educational services, speech-language therapy, and/or parental/teacher concern, with 12% of records reflecting overlapping services/concerns. Negative predictive values were generally high and positive predictive values were generally low, suggesting automated searches are useful for excluding factors of interest, but not finding them. This study demonstrates the feasibility of using EHRs in examining UHL in school-age children. By restricting our cohort to individuals who were seen in audiology clinic, we were able to capture variables such as educational difficulty that are not routinely ascertained in medical contexts. The proportion of children in this cohort demonstrating a marker of adverse educational progress is consistent with numerous prior observational studies, thus providing validity to this ascertainment approach. We describe challenges encountered in creating this cohort and detail our hybrid approach to ascertaining key variables accurately.

Instruments for evaluating the parental emotional status and ecological support systems among parents who considered cochlear implantation for their children with hearing loss: A scoping review.

Parents of children diagnosed with severe-to-profound sensorineural hearing loss may experience a range of emotions owing to a lack of knowledge and experience in dealing with such children. However, most audiology clinics only attend to children with deaf and hard of hearing (DHH) and not their parents. Thus, parents' emotional and support needs are frequently excluded from the intervention sessions, making their own needs invisible. This study aimed to identify academic and clinical instruments used for assessing parental emotional status (PES) and ecological support systems (ESS) in early intervention and determine the factors affecting PES and ESS among parents of DHH children undergoing cochlear implantation. This scoping review followed the rigorous methodological framework; searched Medline (via OVID and EMBSCO), Scopus, and Web of Science; and selected studies relevant to validated instruments used to evaluate the PES and ESS among parents of DHH children below 6 years old. Before selecting and reviewing relevant articles, two reviewers independently assessed article titles and abstracts from the data sources. Two reviewers verified half of the first reviewer's extracted data. Overall, 3060 articles were retrieved from the database search, and 139 were selected for full-text review following title and abstract reviews. Ultimately, this study included 22 articles. Among them, 23 and 12 validated instruments, most of which are generic measures, were used for assessing PES and ESS, respectively. Three condition-specific instruments were identified and designed to be administered following cochlear implantation surgery. This study revealed that healthcare professionals who interact with parents of DHH children lack the necessary instruments, particularly for parents of children undergoing cochlear implantation surgery. Therefore, it is necessary to develop condition-specific instruments for parents who consider cochlear implantation for their children.

Effects of remote ear-nose-and-throat specialist assessment screening on self-reported hearing aid benefit and satisfaction

Objective To explore the impact of remote versus in-person ear-nose-and-throat (ENT) specialist screening before hearing treatment on self-reported hearing aid (HA) benefit and satisfaction among adult first-time HA users. Design Participants were randomised to either remote or in-person ENT assessment before treatment initiation. Hearing ability, hearing quality, and treatment satisfaction were assessed pre- and post-HA treatment using the SSQ12, IOI-HA, and selected items from the 2021 Danish national Patient-Reported Experience Measures. Average daily HA usage was also recorded. Study sample 751 adult potential first-time HA users with self-reported hearing impairment were included; 501 participants were remotely assessed in private or public audiological clinics, and 250 control group participants were assessed in-person by private ENT specialists. Of the 658 participants who completed the entire trial, 454 received HAs. Results No significant post-treatment HA benefit differences were found between groups. Remotely assessed HA recipients in private clinics expressed slightly higher staff and waiting time satisfaction. Participants with normal hearing and mild/moderate hearing loss reported higher pre-treatment hearing ability and quality. No significant difference in average daily HA usage was observed between groups. Conclusions Findings suggest that remote screening does not compromise patient-reported HA benefit and satisfaction when compared to in-person screening.

Comparison of Traditional Impression and 3D Ear Scanning Techniques, Earmold Comfort, and Audiology Clinical Implications: A Pilot Study.

This study investigated clinical aspects of the traditional ear impression and 3D ear scanning techniques. Adult earmold-users and non-users participated in this study. The earmold-users also participated in the earmold comfort comparison study by wearing earmolds from both techniques, one set a week according to a randomized sequence. Multiple clinical aspects of both techniques according to the participants and audiology professionals were recorded. Results revealed a preference for the 3D-scanning technique, which was perceived as more comfortable although both techniques were perceived as safe. Although the earmolds might have issues from both techniques, there was no significant difference in the perception of earmolds. Experience with the specific technique can affect the responses from the professionals. Compared to the traditional technique, 3D-scans had higher fixed but less variable costs and procedure times. A special clinical case was included and indicated that 3D-scans could be an option for specific patients. This study led to a better understanding of the two techniques clinically. With increasing involvement of new technology and more young professionals joining the profession of audiology, 3D ear scanning could be a viable consideration for audiology practices.