International Outcome Inventory For Hearing Aids Research Articles

Deterioration of Hearing due to Hearing Aids.

In the large population with sensorineural hearing loss, one of the main reasons for insufficient adoption rate of hearing aids (HA) has been the social concern that the devices may negatively affect remaining hearing ability. To date, there have been few studies with controversial results on the issue. This study examined the long-term effects of HA on standard audiometric changes in sensorineural hearing loss. The study retrospectively analyzed patients who had newly acquired unilateral HA between 2015 and 2017 and showed consistent use for five years. Demographics; medical comorbidities; audiometric data; questionnaire results of the Hearing Handicap Inventory for the Elderly (HHIE) and International Outcome Inventory for Hearing Aids (IOI-HA); history of noise exposure and previous HA use were examined. Fifty-five patients used unilateral HA for a mean follow up period of 5.32 years. Thirty-one patients (56.4%) used HA on the right side. Audiometric data of the aided side did not show significant difference compared to the unaided side, in prefit pure-tone average of air conduction (AC) and word recognition score (WRS) (P= 0.73, 0.11, respectively), in fiveyear follow-up audiometry of AC and WRS (P=0.98, 0.07) or in the change from last to prefit audiometry of AC and WRS (P=0.58, 0.70). When comparing patients who showed 5dB or more deterioration of hearing on the aided side compared with the unaided side, 11 patients (20%) had worsened AC on the aided side and 23 (53.5%) presented with further deterioration of WRS on the aided side. There were no significant factors contributing to the difference in hearing deterioration in either group for AC or WRS. After long-term use of HA, there were no significant factors contributing to the hearing deterioration and, overall, the use of HA did not negatively affect residual hearing.

Psychometric properties of the Swedish version of the international outcome inventory – alternative interventions (IOI-AI) – ear surgery (IOI-AIop)

Objective The aims of this study were to adapt the Swedish version of the International Outcome Inventory for Hearing Aids (IOI-HA) to the International Outcome Inventory for Alternative Interventions (IOI-AI) in the context of ear surgery (IOI-AIop) and to test the psychometric properties. Design The validated Swedish questionnaire IOI-HA was adapted to the IOI-AIop by omitting the question about hearing aid use and changing the term “hearing aid” to “surgery” in the remaining items. The validity, component structure and reliability of the IOI-AIop were assessed. Study sample Subjects diagnosed with otosclerosis and undergoing stapedotomy were included in the study (n = 162). Results High mean scores were noted for all items. Ceiling effects were noted, most pronounced for the satisfaction item. Principal component analysis (PCA) yielded a two-component structure explaining 77.5% of the variance. The test-retest reliability measured by intra class correlation coefficient was >0.9, and the internal consistency coefficient measured by Cronbach’s alfa was >0.8. Conclusion The IOI-AIop showed good psychometric properties. However, ceiling effects were observed. The two-component solution was in line with previous factor analyses of the IOI-HA and the IOI-AI. The comprehensive IOI-AIop is recommended as a useful tool to evaluate patient perspectives after ear surgery.

Auditory Profile-Based Hearing Aid Fitting: Self-Reported Benefit for First-Time Hearing Aid Users.

Background: Although hearing aids (HAs) can compensate for reduced audibility, functional outcomes and benefits vary widely across individuals. As part of the Danish 'Better hEAring Rehabilitation' (BEAR) project, four distinct auditory profiles differing in terms of audiometric thresholds and supra-threshold hearing abilities were recently identified. Additionally, profile-specific HA-fitting strategies were proposed. The aim of the current study was to evaluate the self-reported benefit of these profile-based HA fittings in a group of new HA users. Methods: A total of 205 hearing-impaired older adults were recruited from two Danish university hospitals. Participants were randomly allocated to one of two treatment groups: (1) NAL-NL2 gain prescription combined with default advanced feature settings ('reference fitting') or (2) auditory profile-based fitting with tailored gain prescription and advanced feature settings ('BEAR fitting'). Two months after treatment, the participants completed the benefit version of the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12-B) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. Results: Overall, participants reported a clear benefit from HA treatment. However, no significant differences in the SSQ12-B or IOI-HA scores between the reference and BEAR fittings were found. Conclusion: First-time users experience clear benefits from HA treatment. Auditory profile-based HA fitting warrants further investigation.

Quality of Life Among Adults With Hearing Loss Who Were Prescribed Hearing Aids in Aseer Province, Saudi Arabia: A Cross-Sectional Tertiary Center-Based Study.

Introduction Hearing loss affects people of all ages, and it may become a burden for patients as well as for those around them. It leads to social isolation and impacts the quality of life (QOL). Many studies aim to investigate the outcome of hearing aids as an intervention to treat hearing loss. Our study's objective is to assess the QOL in participants and investigate the possible factors that have an impact on the outcomes of hearing aid use. Methods The study adopted a cross-sectional design and was carried out in the Armed Forces Hospital South Region, a tertiary care center in Aseer Province, Saudi Arabia. Participants were patients who presented to the ENT clinic with a complaint of hearing loss from 2017 to 2019and who were prescribed hearing aids as their treatment. The study uses the World Health Organization Quality of Life BREF (WHOQOL-BREF) questionnaire and the International Outcome Inventory for Hearing Aids (IOI-HA) to measure the QOL and its determinants in patients using hearing aids. Results A total of 210 patients were included in the study. Sensorineural hearing loss (SNHL) was found in 72.2%, and 20% of patients were found to have bilateral hearing loss. Moderate or severe hearing loss was found in 80% of the patients in the worst hearing ear. The overall QOL among the participants was satisfactory, with the highest domain score being the social relationship domain (85.9%). The QOL was significantly higher in participants who were in an intimate relationship (P =0.02). A positive correlation was found between the IOI-HA scores and the WHOQOL-BREF scores in general health (R = 0.14, P =0.034), psychological health (R = 0.16, P = 0.018), and the overall QOL score (R = 0.15, P = 0.035). Conclusion Hearing aids are a cost-effective intervention that improves QOL and prevents associated comorbidities. Compliance and adherence to hearing aids improve the QOL for patients, as well as for their spouses. Patients suffering from hearing loss while also in an intimate relationship had better QOL scores. A correlation was found in outcomes between the IOI-HA scores and the WHOQOL-BREF scores in general health, psychological health, and overall health.

Factors Associated With Hearing Aid Outcomes Including Social Networks, Self-Reported Mental Health, and Service Delivery Models.

This study aims to identify and describe factors that influence hearing aid outcomes including social networks, self-reported mental health, and service delivery models. A prospective cross-sectional online survey was sent to hearing aid users recruited through an online platform (http://www.hearingtracker.com) between October and November 2021. The survey contained questions on patient demographics, audiological variables, general health and social factors, and self-reported hearing aid outcomes using the International Outcome Inventory for Hearing Aids (IOI-HA). Regression models evaluated potential contributing factors of hearing aid outcomes on the IOI-HA. Three hundred ninety-eight hearing aid users completed the survey with an average age of 66.6 (SD = 13.0) years, of which 59.3% were male. Positive contributing factors of hearing aid outcomes (IOI-HA total score) were social network of people with hearing loss with hearing aids (p < .010; Exp[B] = 0.03, 95% CI [0.01, 0.1]), self-reported mental health (p < .05; Exp[B] = 0.6, 95% CI [0.01, 1.2]), work situation (p < .001; Exp[B] = 1.9, 95% CI [0.7, 2.8]), quality of life (p < .005; Exp[B] = 1.2, 95% CI [0.3, 1.1]), and self-reported hearing difficulty (p < .02; Exp[B] = 0.8, 95% CI [0.2, 1.5]). Negative contributing factors of hearing aid outcomes included social networks of people with hearing loss without hearing aids (p < .001; Exp[B] = -0.1, 95% CI [-0.2, -0.2]) and service delivery model of private or university clinic compared to big-box retailers (p < .001; Exp[B] = -1.6, 95% CI [-2.7, -0.7]). Novel factors including social network of persons with hearing loss who use hearing aids, self-reported mental health, service delivery model, and work situation are significant contributors to hearing aid outcomes. These newly identified factors can inform public hearing health promotion and individualized audiological care to optimize hearing aid outcomes. https://doi.org/10.23641/asha.24060486.

Impact of hearing aid technology level at first-fit on self-reported outcomes in patients with presbycusis: a randomized controlled trial.

To provide clinical guidance in hearing aid prescription for older adults with presbycusis, we investigated differences in self-reported hearing abilities and hearing aid effectiveness for premium or basic hearing aid users. Secondly, as an explorative analysis, we investigated if differences in gain prescription verified with real-ear measurements explain differences in self-reported outcomes. The study was designed as a randomized controlled trial in which the patients were blinded towards the purpose of the study. In total, 190 first-time hearing aid users (>60years of age) with symmetric bilateral presbycusis were fitted with either a premium or basic hearing aid. The randomization was stratified on age, sex, and word recognition score. Two outcome questionnaires were distributed: the International Outcome Inventory for Hearing Aids (IOI-HA) and the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-12). In addition, insertion gains were calculated from real-ear measurements at first-fit for all fitted hearing aids. Premium hearing aid users reported 0.7 (95%CI: 0.2; 1.1) scale points higher total SSQ-12 score per item and 0.8 (95%CI: 0.2; 1.4) scale points higher speech score per item, as well as 0.6 (95%CI: 0.2; 1.1) scale points higher qualities score compared to basic-feature hearing aid users. No significant differences in reported hearing aid effectiveness were found using the IOI-HA. Differences in the prescribed gain at 1 and 2kHz were observed between premium and basic hearing aids within each company. Premium-feature devices yielded slightly better self-reported hearing abilities than basic-feature devices, but a statistically significant difference was only found in three out of seven outcome variables, and the effect was small. The generalizability of the study is limited to community-dwelling older adults with presbycusis. Thus, further research is needed for understanding the potential effects of hearing aid technology for other populations. Hearing care providers should continue to insist on research to support the choice of more costly premium technologies when prescribing hearing aids for older adults with presbycusis. Clinical Trial Registration: https://register.clinicaltrials.gov/, identifier NCT04539847.

Effectiveness of an Over-the-Counter Self-fitting Hearing Aid Compared With an Audiologist-Fitted Hearing Aid

Hearing loss is a highly prevalent condition, with numerous debilitating consequences when left untreated. However, less than 20% of US adults with hearing loss use hearing aids. Over-the-counter (OTC) hearing aids became available in October 2022 to improve access and affordability. However, clinical effectiveness studies of available OTC hearing aids using the existing devices in the market are limited. To compare the clinical effectiveness of a self-fitting OTC hearing aid with remote support and a hearing aid fitted using audiologist-fitted best practices. This randomized clinical effectiveness trial was conducted between April 14 and August 29, 2022. Sixty-eight adults with self-perceived mild to moderate hearing loss were recruited and randomly assigned to either the self-fitting or the audiologist-fitted group. Following bilateral hearing aid fitting, participants first completed a 2-week, take-home field trial without any support. Access to fine-tuning for both groups was only available after the 2-week trial. Support and adjustment were provided remotely for the self-fitting group per request and by the audiologist for the audiologist-fitted group. Participants were then reassessed after an additional 4-week take-home trial. A commercially available self-fitting OTC hearing aid was provided to participants in the self-fitting group who were expected to set up the hearing aids using the commercially supplied instructional material and accompanying smartphone application. In the audiologist-fitted group, audiologists fitted the same hearing aid according to the National Acoustics Laboratories nonlinear version 2 algorithm for prescriptive gain target using real-ear verification with hearing aid use instruction. The primary outcome measure was self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary measures included the International Outcome Inventory for Hearing Aids (IOI-HA) and speech recognition in noise measured using an abbreviated speech-in-noise test and a digits-in-noise test. All measures were completed at baseline and at 2 intervals following hearing aid fitting (2 and 6 weeks). Sixty-four participants were included in the analytic sample (33 men [51.6%]; mean [SD] age, 63.6 [14.1] years), with equal numbers of participants (n = 32) randomized into each group. The groups did not differ significantly in age (effect size r = -0.2 [95% CI, -0.3 to 0.2]) or 4-frequency pure-tone average (effect size r = 0.2 [95% CI, -0.1 to 0.4]). After the 2-week field trial, the self-fitting group had an initial advantage compared with the audiologist-fitted group on the self-reported APHAB (Cohen d = -0.5 [95% CI, -1.0 to 0]) and IOI-HA (effect size r = 0.3 [95% CI, 0.0-0.5]) but not speech recognition in noise. At the end of the 6-week trial, no meaningful differences were evident between the groups on any outcome measures. In this randomized clinical effectiveness trial, self-fitting OTC hearing aids with remote support yielded outcomes at 6 weeks post fitting comparable to those of hearing aids fitted using audiologist best practices. These findings suggest that self-fitting OTC hearing aids may provide an effective intervention for mild to moderate hearing loss. ClinicalTrials.gov Identifier: NCT05337748.

Predictable Factors of People with Asymmetrical Hearing Loss Wearing a Hearing Aid in the Worse Ear Only.

In patients with bilateral asymmetrical hearing loss (AHL), where only one hearing aid is available, it is difficult to decide which ear to amplify. The aim of this study was to evaluate the outcomes of hearing aid use for AHL patients fitted with a hearing aid in their worse ear only. One-hundred-two adults with asymmetrical-mixed or sensorineural hearing loss were retrospectively included. AHL was classified into three subgroups: unilateral hearing loss (UHL) and AHL type 1 (AHL1) and type 2 (AHL2). The main outcome measures were (1) the time spent wearing a hearing aid, (2) the hearing in a noise test (HINT), (3) the sound localization test and (4) the Korean version of the International Outcome Inventory for Hearing Aids (IOI-HA). The 1 kHz-hearing threshold of the better ear was significantly better in the successful users than in the intermittent users for UHL. Younger age was associated with significantly better outcomes than older for AHL1 and AHL2. Among the etiologies of AHL, sudden hearing loss was associated with significantly better outcomes of hearing aid use for AHL, UHL and AHL1 patients. In this study, the success rate and usage rates were 43.1% and 67.6% in AHL patients wearing a hearing aid in the worse ear. This study identified the hearing threshold of 1 kHz from the better ear, age and etiology of sudden hearing loss as audiometric and non-audiometric factors that affected the outcomes of hearing aid use.

Fitting a Hearing Aid on the Better Ear, Worse Ear, or Both: Associations of Hearing-aid Fitting Laterality with Outcomes in a Large Sample of US Veterans.

Longitudinal electronic health records from a large sample of new hearing-aid (HA) recipients in the US Veterans Affairs healthcare system were used to evaluate associations of fitting laterality with long-term HA use persistence as measured by battery order records, as well as with short-term HA use and satisfaction as assessed using the International Outcome Inventory for Hearing Aids (IOI-HA), completed within 180 days of HA fitting. The large size of our dataset allowed us to address two aspects of fitting laterality that have not received much attention, namely the degree of hearing asymmetry and the question of which ear to fit if fitting unilaterally. The key findings were that long-term HA use persistence was considerably lower for unilateral fittings for symmetric hearing loss (HL) and for unilateral worse-ear fittings for asymmetric HL, as compared to bilateral and unilateral better-ear fittings. In contrast, no differences across laterality categories were observed for short-term self-reported HA usage. Total IOI-HA score was poorer for unilateral fittings of symmetric HL and for unilateral better-ear fittings compared to bilateral for asymmetric HL. We thus conclude that bilateral fittings yield the best short- and long-term outcomes, and while unilateral and bilateral fittings can result in similar outcomes on some measures, we did not identify any HL configuration for which a bilateral fitting would lead to poorer outcomes. However, if a single HA is to be fitted, then our results indicate that a better-ear fitting has a higher probability of long-term HA use persistence than a worse-ear fitting.

Predicting Aided Outcome With Aided Word Recognition Scores Measured With Linear Amplification at Above-conversational Levels.

Many hearing aid (HA) users receive limited benefit from amplification, especially when trying to understand speech in noise, and they often report hearing-related residual activity limitations. Current HA fitting strategies are typically based on pure-tone hearing thresholds only, even though suprathreshold factors have been linked to aided outcomes. Furthermore, clinical measures of speech perception such as word recognition scores (WRSs) are performed without frequency-specific amplification, likely resulting in suboptimal speech audibility and thus inaccurate estimates of suprathreshold hearing abilities. Corresponding measures with frequency-specific amplification ("aided") would likely improve such estimates and enable more accurate aided outcome prediction. Here, we investigated potential links between either unaided WRSs or aided WRSs measured at several above-conversational levels and two established HA outcome measures: The Hearing-In-Noise Test (HINT) and the International Outcome Inventory for Hearing Aids (IOI-HA). Thirty-seven older individuals with bilateral hearing impairments participated. Two conditions were tested: unaided and aided, with all stimuli presented over headphones. In the unaided condition, the most comfortable level (MCL) for the presented speech stimuli, WRS at MCL+10 dB as well as uncomfortable levels (UCLs) for narrowband noise stimuli were measured. In the aided condition, all stimuli were individually amplified according to the "National Acoustic Laboratories-Revised, Profound" fitting rule. Aided WRSs were then measured using an Interacoustics Affinity system at three above-conversational levels, allowing for the maximum aided WRS as well as the presence of "rollover" in the performance-intensity function to be estimated. Multivariate data analyses were performed to examine the relations between the HINT (measured using a simulated HA with the NAL-RP amplification) or IOI-HA scores (for the participants' own HAs) and various potential predictors (age, pure-tone average hearing loss, unaided WRS, aided WRS, rollover presence [ROp], and UCL). Aided WRSs predicted the HINT scores better than any other predictor and were also the only significant predictor of the IOI-HA scores. In addition, UCL and ROp in the aided WRSs were significant predictors of the HINT scores and competed for variance in the statistical models. Neither age nor pure-tone average hearing loss could predict the two aided outcomes. Aided WRSs can predict HA outcome more effectively than unaided WRSs, age or pure-tone audiometry and could be relatively easily implemented in clinical settings. More research is necessary to better understand the relations between ROp, UCL and speech recognition at above-conversational levels.

Characteristics of sound localization in children with unilateral microtia and atresia and predictors of localization improvement when using a bone conduction device.

This study aimed to determine the characteristics of sound localization in children with unilateral microtia and atresia (UMA) and the influence of a non-surgical bone conduction device (BCD). Hearing benefits were evaluated by the word recognition score (WRS), speech reception threshold, the international outcome inventory for hearing aids (IOI-HA), and the Speech, Spatial, and Qualities of Hearing Test for Parent (SSQ-P). Sound localization was measured using broadband noise stimuli randomly played from seven loudspeakers at different stimulus levels [65, 70, and 75 dB sound pressure levels (SPLs)]. The average unaided WRS and speech-to-noise ratio (SNR) for UMA patients was 18.27 ± 14.63 % and −5 ± 1.18 dB SPL, and the average aided WRS and SNR conspicuously changed to 85.45 ± 7.38 % and −7.73 ± 1.42 dB SPL, respectively. The mean IOI-HA score was 4.57 ± 0.73. Compared to the unaided condition, the mean SSQ-P score in each domain improved from 7.08 ± 2.5, 4.86 ± 2.27, and 6.59 ± 1.4 to 8.72 ± 0.95, 7.61 ± 1.52, and 8.55 ± 1.09, respectively. In the sound localization test, some children with UMA were able to detect sound sources quite well and the sound localization abilities did not deteriorate with the non-surgical BCD. Our study concludes that for children with UMA, the non-surgical BCD provided a definite benefit on speech recognition and high satisfaction without deteriorating their sound localization abilities. It is an efficient and safe solution for the early hearing intervention of these patients.

Working-age first-time hearing aid users’ self-reported outcomes

Objective To study patient-reported hearing aid (HA) rehabilitation outcomes, social-communicative functioning, and expectations/experiences during eight months of HA use. Design Three self-reporting instruments, the International Outcome Inventory for Hearing Aids (IOI-HA), the Quantified Denver Scale of Communicative Function (QDS), and questionnaires tapping pre-rehabilitation expectations (HA-EXP-Q1) and post-rehabilitation experiences (HA-EXP-Q2) were administered. Study sample 144 patients ages 23–66 with gradually acquired, adult-onset, mild-to-moderate sensorineural hearing loss affecting both ears who acquired their first HAs. Results According to self-reports, HA rehabilitation outcomes were good, and everyday social-communicative functioning improved after one month and after eight months of HA use. When the effects from demographic and audiological variables were analysed, younger age and positive expectations of HAs were associated with better outcomes and social-communicative functioning. The form or hearing loss severity, and the type or number of HAs did not affect outcomes. Conclusion Working-age HA users reported better HA outcomes than older adults in previous studies. Coping in work life may be a strong motivator for active HA use. Considering that younger age and positive expectations resulted in better outcomes, early rehabilitation that supports positive and realistic expectations of HA performance is essential.

Remote hearing aid renewal using pre-existing audiograms during the covid-19 pandemic

Objective During the ongoing Covid-19 pandemic, many patients cancelled their scheduled hearing aid renewal. We offered to send them new hearing aids programmed according to the audiometric data on file. In this study we compared remote hearing aid renewal to a conventional renewal with a recent audiogram based on scores from the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. We also examined the need for a physical visit for hearing aid adjustment in the remote group and analysed the accuracy of the pre-existing audiogram correction method using data from the control group. Design Retrospective chart review. Study sample 51 patients who underwent remote hearing aid renewal and 22 control patients who received office-based hearing aid renewal. Results IOI-HA scores were lower in the remote fitted group, but comparison with data from a Swedish nationwide database had no clinically significant differences. A follow-up physical appointment was required in only 20% of the remote group. The intraclass correlation coefficient (ICC) between the pure tone averages of the corrected former audiogram and measured audiogram was high. Conclusions Remote hearing aid renewal using existing audiometric data is feasible, and most physical visits can be avoided.

Comparative Analysis of Subjective Satisfaction Between Hearing Aid Users With Insurance Payment and General Payment

Background and Objectives This study aimed to compare subjective satisfaction and functional hearing gain between users of hearing aids with insurance payment (HA with IP) and hearing aids with general payment (HA with GP).Subjects and Method The functional hearing gain and subjective satisfaction of 42 HA with IP and 38 HA with GP were compared after the final fitting, retrospectively. Sound field pure tone and speech audiometry were performed after 4 sessions of hearing aids fitting. Subjective satisfaction was evaluated using the Korean version of abbreviated profile of hearing aid benefit (APHAB) and the international outcome inventory for hearing aids (IOI-HA).Results Sound field pure tone thresholds and speech discrimination scores were improved after the final fitting of hearing aids in both HA with IP and HA with GP groups. HA with IP group showed significantly better results in aversiveness of APHAB and the IOI-HA scores than HA with GP group did.Conclusion These results suggest that hearing aids with insurance payment provide considerable benefits and satisfaction, and can be a good alternative for hearing rehabilitation in hearing-impaired patients.

Can real-ear insertion gain deviations from generic fitting prescriptions predict self-reported outcomes?

Objective The aim of this study was to determine whether the differences in insertion gains from the first fit to generic prescriptions of hearing aids can predict the self-reported hearing aid (HA) outcomes for first-time and experienced HA users. Design This was a prospective observational study. Study Sample The study included 885 first-time and 330 experienced HA users with a valid real-ear measurement on both ears and answers to the abbreviated version of the Speech, Spatial, and Quality of Hearing (SSQ12) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires. Results K-means clustering of gain differences between individual real-ear insertion gain to three generic gain prescriptions (NAL-NL2, NAL-RP, and one-third gain rules) was performed. The gain difference at higher frequencies generally differentiated the clusters. The experienced users in the cluster with fittings closest to NAL-NL2 and NAL-RP prescription were found to exhibit a higher IOI-HA Factor 1 score (representing the overall benefit of the hearing aid use). The gain differences to generic prescription did not affect other self-reported outcomes for first-time and experienced HA users. Conclusion The experienced HA users with minimal gain deviations from generic prescriptions reported better self-perceived benefits than users with larger deviations. However, this was not apparent in first-time users.

Effects of demographic, audiologic, and hearing-aid-related variables on the outcomes of using hearing aids.

To examine the influence of demographic, audiologic, and hearing-aid (HA)-related variables on HA outcomes. In total, 235 adults with hearing loss (HL) who used HAs for at least 3months were included in the study, and completed audiologic tests and the Chinese version of the International Outcome Inventory for Hearing Aids (IOI-HA). Spearman correlation analysis and Wilcoxon test were conducted to identify factors related to IOI-HA overall and subscales scores. Stepwise multiple linear regression analysis was subsequently performed to determine the influence of factors on HA outcomes. Age, daily use time, HA price, pure tone average (PTA) threshold, word recognition score (WRS), fitting (bilateral or unilateral), and HA style were associated with IOI-HA overall and subscales scores. However, only WRS, daily HA use time, HA price, and age entered the final regression model and were factors determining HA outcomes. HA outcome is a multi-dimensional construct. In this study, WRS had the greatest influence on HA outcomes and seemed to be a primary predictor. Thus, HA owners with a higher WRS before HA fitting may indicate better satisfaction. Daily use time, HA price, and patient age also made significant contributions to HA outcomes and should be considered in clinical practice to facilitate auditory rehabilitation.

Objective and Subjective Outcomes in Patients with Hearing Aids: A Cross-Sectional, Comparative, Associational Study

Introduction: Outcome assessment for hearing aids (HAs) is an essential part of HA fitting and validation. There is no consensus about the best or standard approach for evaluating HA outcomes. And, the relationship between objective and subjective measures is ambiguous. This study aimed to determine the outcomes after HA fitting, explore correlations between subjective benefit and acoustic gain improvement as well as objective audiologic tests, and investigate several variables that may improve patients’ perceived benefits. Methods: Eighty adults with bilateral symmetrical hearing loss using HAs for at least 1 month were included in this study. All subjects completed the pure tone average (PTA) threshold and word recognition score (WRS) tests in unaided and aided conditions. We also administered the Chinese version of International Outcome Inventory for Hearing Aids (IOI-HA), to measure participants’ subjective benefits. Objective HA benefit (acoustic gain improvement) was defined as the difference in thresholds or scores between aided and unaided conditions indicated with ΔPTA and ΔWRS. Thus, patients’ baseline hearing levels were taken into account. Correlations were assessed among objective audiologic tests (PTA and WRS), acoustic gain improvement (ΔPTA and ΔWRS), multiple potential factors, and IOI-HA overall scores. Results: PTA decreased significantly, but WRS did not increase when aided listening was compared to unaided listening. Negative correlations between PTAs and IOI-HA scores were significant but weak (r = −0.370 and r = −0.393, all p < 0.05). Significant weak positive correlations were found between WRSs and IOI-HA (r = 0.386 and r = 0.309, all p < 0.05). However, there was no correlation among ΔPTA, ΔWRS, and IOI-HA (r = 0.056 and r = −0.086, all p > 0.05). Moreover, 2 nonaudiological factors (age and daily use time) were significantly correlated with IOI-HA (r = −0.269 and r = 0.242, all p < 0.05). Conclusions: Correlations among objective audiologic tests, acoustic gain, and subjective patient-reported outcomes were weak or absent. Subjective questionnaires and objective tests do not reflect the same hearing capability. Therefore, it is advisable to evaluate both objective and subjective outcomes when analyzing HA benefits on a regular basis and pay equal attention to nonaudiological and audiological factors.

Cochlear Implantation in Chronic Otitis Media with and without Cholesteatoma: Surgical Considerations and Auditory Outcomes

Introduction: Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs. Methods: The study group consisted of 39 patients with COM who received CIs. Age- and gender-matched 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared. Results: The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (p > 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (p > 0.05). Conclusion: Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery performed. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable.

The Impact of Hearing Aids on Quality of Life of Hearing Impaired Individuals

The regular use of hearing aids (more than 8 hours a day) benefits people in hearing for bettercommunication than those who are less-likely to use hearing aids Objective: The objective of thestudy was to assess the impact of hearing aids on the quality of life of hearing impaired individualsMethods: In this cross-sectional study total 50 participants were recruited by convenient samplingtechnique from Lahore, Pakistan. 50 patients who were diagnosed with hearing loss and wererecommended with hearing aids of both genders were included in the study. The International OutcomeInventory for Hearing Aids (IOI-HA), questionnaire was used for data collection. Data were analyzedthrough Statistical Package for Social Sciences (SPSS) version 23.0 Results: In this research 50hearing impaired individuals who were hearing aid users, participated. The mean age of participants was64.10+15.88 years. Among which 25 (50%) were males and 25(50%) were females. The average time ofhearing aid use was 3.88 hours, majority of patients responded that hearing aid helped quite a lot in thedaily routine (mean score of IOI-HA, 3.62), have moderate difficulty in residual activity (mean score of IOIHA,3.26), moderately satisfied with their hearing aid (mean score of IOI-HA, 3.28), moderately affect theparticipation restriction (mean score of IOI-HA, 3.20), impact of their hearing loss bothered moderately(mean score of IOI-HA, 3.14) and quality of life (QOL) was very much better (3.90). There was insignificantassociation between the QOL of males and females (p-value&gt;0.05) Conclusions: It was concluded fromthe study that the hearing aids have a greater impact on the quality of life and socio-economic aspectsof hearing impaired individuals. Hearing loss is such a problem, which separates certain community ofhearing impaired individuals from the normal population. Individuals with hearing impairment not onlyhave to face personal communication problems but also it affects their health, independency and qualityof life in their daily routine.

WPŁYW PAMIĘCI ROBOCZEJ I UMIEJĘTNOŚCI PERCEPCJI MOWY NA UŻYWANIE APARATÓW SŁUCHOWYCH I KORZYŚCI U OSÓB STARSZYCH

BackgroundHearing aids are equipped with many features to improve the speech perception abilities in quiet as well as in challenging situations. Despite that, older adults who use and benefit from hearing aids remain less satisfied. The present study focuses on aspects such as working memory, speech perception in noise (SNR-50), hearing aid usage, and its impact on perceived hearing aid benefit in older adults.Material and methodsDigit backward test and speech perception in noise test were administered on 34 older adults having mild to moderately-severe sensorineural hearing loss who were naïve users of hearing aids. The participants were divided into good and poor performers based on SNR-50. Two months later, the same tests were repeated along with administration of International Outcome Inventory - Hearing Aids (IOI-HA).ResultsThere was a significant difference in working memory and speech perception in noise with hearing aid outcome measures. It was also seen that individuals with better working memory and lower SNR-50 scores benefited more from a hearing aid. Cognition plays an important role in determining the amount of benefit derived from hearing aids in older adults.ConclusionsThe present study highlights the importance of measuring working memory and speech perception abilities in older adults with hearing loss before fitting a hearing aid. These measures have a significant role in counselling about the realistic expectations of benefits from a hearing aid.