International Outcome Inventory Research Articles

Adaptation of the International Outcome Inventory for Hearing Aids (IOI-HA) in Hindi

PurposeThe specific objectives of this study were as follows: (1) to translate and adapt the English version of the International Outcome Inventory for Hearing Aids (IOI-HA) into Hindi, (2) to present data obtained from the hearing aid users, (3) and to investigate the effect of different factors on effective hearing aid use using the Hindi version of the IOI-HA.MethodThe English version of IOI-HA was translated to Hindi by three native Hindi speakers who were proficient in both Hindi and English and had Hindi as their first language. The Hindi version of IOI-HA along with a demographic questionnaire was given to 100 experienced hearing aid users who were literate and more than 18 years of age.ResultsThe findings indicated 53% of individuals utilize their hearing aids for over 8 h daily, while 46% use them for 4 to 8 h a day. A greater number of participants experienced benefits from wearing their hearing aids, suggesting their overall effectiveness for users. Also, 64% of people said their HA was fulfilling their expectations. Sixty-seven percent of participants said life has become quite a lot better with HA usage. The results revealed that age, gender, and type of hearing loss showed no significant association with any test item.ConclusionThe Hindi version of the IOI-HA has proven to be a valuable self-assessment tool for hearing aid users. It aids clinicians and audiological practitioners in comprehending the challenges faced by users and can offer guidance for counseling and assessing the benefits derived from hearing aids.

Long-term follow-up of Bonebridge BCI 601 implantation for microtia patients with aural atresia: acoustic and subjective benefits.

This study evaluated the long-term acoustic and subjective outcomes of Bonebridge bone conduction implant (BCI) 601 implantation in Taiwanese microtia patients with aural atresia (AA). A total of 41 microtia patients (26 with bilateral AA and 15 with unilateral AA) who received Bonebridge BCI 601 implantation between December 2014 and March 2021 at Chang Gung Memorial Hospital, Linkou, Taiwan, were included in this retrospective study. Acoustic outcomes, including the functional hearing gain (FHG), speech reception threshold (SRT), and word recognition score (WRS), were assessed. Subjective outcomes were assessed using the Chinese versions of four questionnaires: the Abbreviated Profile of Hearing Aid Benefit (APHAB); the Speech, Spatial and Qualities of Hearing Scale; the International Outcome Inventory for Hearing Aids; and the Satisfaction with Amplification in Daily Living. The mean follow-up duration was 6.3 years (range, 2.8-9.1). The mean unaided air conduction pure tone average (PTA4) was 65.3 ± 8.8 decibels (dB) hearing level (HL) and the mean aided sound field PTA4 was 31.1 ± 9.1 dB HL, resulting in a FHG of 34.2 ± 11.7 dB HL (p < 0.05). After Bonebridge implantation, the mean SRT in quiet, SRT in noise, WRS in quiet, and WRS in noise improved from 58.3 ± 7.4 dB HL to 29.4 ± 7.0 dB HL, from -1.4 ± 7.3 dB signal-to-noise ratio (SNR) to -9.6 ± 5.4 dB SNR, from 46.4 ± 26.9% to 93.8 ± 3.1%, and from 46.7 ± 21.8% to 72.7 ± 19.3%, respectively (p < 0.05). Additionally, the bilateral AA group exhibited greater SRT and WRS improvements compared to the unilateral AA group (p < 0.05). All mean subscale scores in the four questionnaires showed improvement after Bonebridge implantation, except for the mean aversiveness to sounds subscale score in the APHAB questionnaire. Bonebridge BCI 601 implantation provided long-term acoustic and subjective benefits to microtia patients with AA, particularly those with bilateral AA.

Comparison between the international outcome inventory for hearing aids questionnaire and real-ear measurement.

The international outcome inventory for hearing aids (IOI-HA) is a questionnaire widely used to assess the subjective benefits of hearing aids. This study aimed to evaluate the relationship between IOI-HA outcomes and target mismatch in real-ear measurement (REM). Thirty-four ears of 25 patients who had worn hearing aids were evaluated using the Korean version of the IOI-HA and REM after fitting for 2 months. Real-ear insertion gain (REIG) was measured at three different levels of input intensity-50, 65, and 80 dB sound pressure level (SPL)-and a frequency range of 0.25 to 6 kHz. Factors 1 and 2 and total IOI-HA scores were compared with the mismatches of REIGs and target gains of REM. Factor 1, Factor 2, and total IOI-HA scores were 14.6 ± 3.5, 11.4 ± 2.2, and 25.9 ± 5.1, respectively. The averages of the difference of REIGs and target gains in REM at 50, 65, and 80 dB SPL input levels were -3.1 ± 6.7, -2.3 ± 7.2, and -3.0 ± 8.2, respectively. Factors 1 and 2 scores of the IOI-HA showed significant correlations with target mismatch in REM at 1 kHz and 0.75 kHz frequencies, respectively. Total IOI-HA scores had significant correlations with target mismatches in REM at 0.75 and 1 kHz frequencies. IOI-HA scores correlated with target mismatch in REM at mid frequencies. The IOI-HA can be a useful screening measure for evaluating the necessity of further adjustments in hearing aids through REM at mid frequencies.

Comparing Self-Fitting Strategies for Over-the-Counter Hearing Aids

Fewer than 20% of US adults with hearing loss use hearing aids due to barriers like high cost. Over-the-counter (OTC) hearing aids offer a potential solution, incorporating self-fitting strategies via smartphone apps. Self-fitting strategies have been validated for Food and Drug Administration (FDA)-approved OTC hearing aids compared with prescription-based approaches. However, no direct comparative analysis exists between in situ audiometry and self-adjustment strategies using self-fitting OTC (OTC-SF) hearing aids. To compare self-adjustment and in situ audiometry self-fitting strategies in OTC-SF hearing aids for adults with mild to moderate hearing difficulties. A crossover, within-participant pseudorandomized clinical trial was conducted between July and November 2023. Twenty-eight participants were pseudo-randomly assigned to 1 of the 2 self-fitting strategies, and they experienced both interventions for 4 consecutive weeks. The self-adjustment group manually adjusted settings, including overall gain and spectral tilt, using Lexie B2 hearing aids, while the in situ audiometry group used Lexie B2 Plus hearing aids (Lexie Hearing by hearX Group), with an automated fitting based on in situ tests conducted through the app. The primary outcome was Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary outcomes were International Outcome Inventory for Hearing Aids (IOI-HA), speech-in-noise tests (DIN and QuickSIN), and real-ear measurements (REMs). Measures were completed at baseline and after the 4-week field trial using each strategy. Twenty-eight participants (mean [SD] age, 60.2 [12.0] years) were included; 14 men and 14 women. Self-adjustment and in situ audiometry strategies produced no clinically meaningful differences across various outcome measures, including overall APHAB benefit (Cohen d = 0.2; 95% CI, -0.2 to 0.6) and overall IOI-HA satisfaction (Rosenthal r = 0.0; 95% CI, -0.3 to 0.2). Self-adjustment users reported higher satisfaction (Rosenthal r = -0.4; 95% CI, -0.6 to -0.1) and longer daily use (Rosenthal r = -0.3; 95% CI, -0.5 to 0.0) compared with those using in situ audiometry. No clinically meaningful differences were observed in speech-in-noise benefit and real-ear measurements. In this clinical trial of OTC-SF hearing aids, self-adjustment and in situ audiometry strategies resulted in similar outcomes. However, self-adjustment may produce higher satisfaction and longer daily use, highlighting the potential advantages of active user involvement in the fitting process. Further investigation is needed for long-term outcomes. ClinicalTrials.gov Identifier: NCT05782153.

Evaluating the Clinical Reliability and Reference Values of the International Outcome Inventory for Cochlear Implants in a DOD Population.

Hearing loss significantly affects an individual's well-being, communication, social interaction, and quality of life. Cochlear implants serve as a viable management option. Given the variability in the impact of impairment, self-report measures are crucial for evaluating the perceived benefits of management options. The study aims to assess the reliability of the International Outcome Inventory for Cochlear Implants (IOI-CI) and establish normative cutoffs. This questionnaire evaluates patient's satisfaction with cochlear implants and contributes to the understanding of their experiences, addressing the increasing interest among cochlear implant clinicians. The design relies on electronic medical databases within the Veterans Affairs (VA) and Department of Defense (DOD) systems. After identification of eligibility, recruitment was based on participants responding to mailed study documents. This research adopts a descriptive approach of the analysis of questionnaire responses as well as quantitatively evaluating the reliability. Forty-nine service members, Veterans, and their dependents, including 32 men and 17 women, participated in the study. The participants had a mean age of 68.0 years, with cochlear implants ranging from 6 months to 2 years post-initial stimulation. The majority had a unilateral cochlear implant with a hearing aid on the contralateral ear. Data collected involved mailing baseline study packets, including the IOI-CI questionnaire, to potential participants identified through medical databases. Participants indicated consent by returning the study packet. Follow-up packets were sent at a later time. Intraclass Correlation Coefficients (ICC) were utilized for test-retest reliability and Generalized Linear Models (GLM) for exploring the impact of clinical and demographic factors. Data were analyzed using R. The ICC revealed a good level of agreement (ICC=0.84) between baseline and follow-up assessments for the IOI-CI total score. The GLM did not identify significant factors influencing IOI-CI scores. Normative values were established, indicating total scores between 18 and 35 as within the normal range for this questionnaire. The study contributes valuable insights into the reliability of the IOI-CI and establishes normative cutoffs, aiding clinicians in assessing cochlear implant users' experiences and satisfaction.

Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids

With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy. To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists. Building on a previous randomized clinical trial, this follow-up comparative effectiveness research study reassessed a number of the original participants that were not lost to follow-up. Participants were initially divided into those with self-fit OTC hearing aids and those with audiologist-fit devices. Approximately 8 months after fitting, participants completed self-reported questionnaires. Missing data were addressed through multiple imputation. The original noninferiority trial was conducted at the University of Pretoria in South Africa from April 2022 to August 2022. The current analysis took place between July 7, 2023, to November 20, 2023. In the original trial, participants in the self-fit device group received a pair of OTC hearing aids and independently fit them with remote support as needed. The audiologist-fit device group received the same hearing aids fit by a certified audiologist using best practices. The main outcomes were self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the International Outcome Inventory for Hearing Aids (IOI-HA). Of 64 participants in the trial, 44 participants were included in the extension study (21 [47.7%] in the audiologist-fit group; 23 [52.3%] in the self-fit group). The mean (SD) age of these participants was 63.0 (13.2) years, and 21 (47.7%) were male. At the long-term follow-up, self-fit and audiologist-fit groups showed no significant differences in the APHAB global score (mean difference, 0.02 [95% CI, -7.1 to 7.1]; Cohen d, 0.01 [95% CI, -0.5 to 0.5]) or the IOI-HA total score (mean difference, 1.5 [95% CI, -1.4 to 4.4]; Cohen d, 0.3 [95% CI, -0.2 to 0.8]). From 6 weeks to 8 months, no clinically meaningful group-time interaction was found between groups for the APHAB global score (Cohen d, 0.1 [95% CI, -0.2 to 0.3]), but a significant interaction for the IOI-HA total score was found (Cohen d, -0.6 [95% CI, -0.8 to -0.3]), with the self-fit group generally performing better. This comparative effectiveness research study demonstrated that self-fit OTC hearing aids can offer comparable long-term benefits to audiologist-fit hearing aids for individuals with mild to moderate hearing loss.

Would a comprehensive hearing aid fitting process lead to placebo effects compared to a simple process?

ObjectivesPlacebo effects refer to the impact of a treatment on health outcomes that cannot be attributed to the treatment itself. The current study aimed to investigate whether a comprehensive hearing aid fitting process would induce placebo effects compared to a simple process, and whether personal attributes such as personality traits could predict susceptibility to these effects.DesignThirty adults with hearing loss completed the study. The study began with a fitting session in which the field trial hearing aid configuration (the actual fitting) was set, followed by two experimental conditions. Each condition involved a fake hearing aid fitting and a 3-week field trial. In the fake fitting, bilateral hearing aids were fitted using the Comprehensive protocol (CM) that included multiple assessments and probe-microphone verification or the Streamlined protocol (ST) that did not involve any assessments other than a hearing test. The same hearing aid amplification settings established in the actual fitting, rather than the settings from the fake fittings, were used in the field trials for both conditions. Patient outcomes were measured using the International Outcome Inventory for Hearing Aids (IOI-HA), which was administered as both retrospective self-reports and ecological momentary assessment (EMA) surveys. Personality was assessed using the NEO Five-Factor Inventory. Upon completion of the study, participants expressed their hearing aid preferences based on hearing aids' real-world performances (prefer CM, prefer ST, or no preference).ResultsFor both retrospective self-reports and EMA, the IOI-HA scores of the CM and ST conditions did not significantly differ. Among the 30 participants, 22 expressed a preference for either CM (n = 14) or ST (n = 8). Younger participants and those with higher levels of agreeableness were more likely to have a hearing aid preference.ConclusionsAt the group level, comprehensive hearing aid fitting process did not generate a placebo effect leading to better outcomes compared to a simple process. However, despite the absence of differences in hearing aid settings, most (73%) participants were affected by placebo effects, believing that one fitting process yielded better real-world outcomes than the other. Personal attributes including personality traits and age are associated with susceptibility to placebo effects.

Piezoelectric Bone Conduction Hearing Implant: A Case Series of Audiological, Surgical and Patient-Reported Outcomes.

Objective: To examine the surgical, audiological and patient-reported outcomes of the Osia 2 implant. Methods: Data from 14 consecutive subjects undergoing implantation between April 2022 and November 2023 were reviewed. Ten subjects had conductive hearing loss, three had mixed hearing loss and one had single-sided deafness (SSD). Warble tone thresholds, Pure Tone Average (PTA4) and Speech Discrimination Score (SDS) in quiet and in noise were determined unaided and aided. The subjective outcome was determined from two standardized questionnaires: (1) International Outcome Inventory for Hearing Aids (IOI-HA) and (2) Speech, Spatial and Qualities of Hearing Scale 12 (SSQ12b). Results: Unexpected postoperative pain was found in four cases. The warble tone thresholds exhibited a consistent reduction across all frequencies, contributing to a mean decrease of 27 dB in the aided PTA4. SDS demonstrated notable improvements, with a 57.3% increase at 50 dB and a 55.6% increase at 65 dB. In noise, SDS exhibited a 43.9% improvement. The mean IOI-HA Score was 3.8, and the mean overall score for SSQ12b was 6.6, with consistent findings across the subgroups. Conclusions: The Osia device emerges as a promising recommendation for individuals with conductive or mixed hearing loss, possibly also for those with SSD. Its safety and efficacy profile aligns with the broader category of active transcutaneous devices, demonstrating a reduced risk of wound infection compared to percutaneous alternatives. Both audiological assessments and subjective evaluations revealed positive outcomes.

Deterioration of Hearing Due to Hearing Aids.

A primary reason for the low adoption of hearing aids (HAs) among the large population with sensorineural hearing loss is the perception that these devices may negatively impact remaining hearing ability. Research addressing this issue has yielded conflicting results. This study examined the long-term effects of HAs on standard audiometric changes in individuals with sensorineural hearing loss. We retrospectively analyzed patients who acquired unilateral HAs between 2015 and 2017 and demonstrated consistent use over a 5-year period. We examined demographics, medical comorbidities, audiometric data, and questionnaire results from the Hearing Handicap Inventory for the Elderly and the International Outcome Inventory for Hearing Aids. Additionally, we reviewed each patient's history of noise exposure and prior HA use. The study included 55 patients who used unilateral HAs, with a mean follow-up period of 5.32 years. Among them, 31 patients (56.4%) used the HA on the right side. Audiometric data from the aided side showed no significant difference from the unaided side in either the pre-fit pure-tone average of air conduction (AC) or word recognition score (WRS) (P =0.73 and P =0.11, respectively). Similarly, no significant differences were noted in the 5-year follow-up audiometry of AC and WRS (P=0.98 and P=0.07, respectively) or in the change from pre-fit to final audiometry for either parameter (AC, P=0.58; WRS, P=0.70). Eleven patients (20%) exhibited a deterioration in hearing (as measured by AC) of 5 dB or greater on the aided side compared with the unaided side, while 23 (53.5%) showed greater WRS deterioration on the aided side. No significant factors were found to contribute to the difference in hearing deterioration between groups for either AC or WRS. No significant factors were identified as contributing to hearing deterioration after prolonged HA use. Overall, the use of HAs did not adversely impact 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.

The impact of the Cochlear™ Osia® 2 System on patients with mixed or conductive hearing loss: A comparison with Cochlear™ Baha® Attract System outcomes.

This prospective study assessed the efficacy of the Cochlear™ Osia® 2 System compared to the previous Baha® Attract System in patients with mixed or conductive hearing loss (MHL/CHL). In this prospective case-control study, 10 patients (2 men and 8 women) with MHL/CHL were implanted with the Osia® 2 System. Their audiological outcomes were compared with 13 patients (2 men and 11 women) who had previously been implanted with the transcutaneous Baha® Attract system. We compared the complications and compliance of the two groups. Also, in the Osia 2 System group, subjective satisfaction was assessed using the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Complications such as poor magnetization, pain & infection, and abnormal noise were more common in the Baha Attract group, although not statistically significant. Also, the Osia 2 group exhibited better compliance. Subjective satisfaction was assessed using the K-IOI-HA and APHAB questionnaires with the Osia 2 group, revealing significantly improved scores in ease of communication, reverberation, background noise, and higher K-IOI-HA scores post-implantation. Postoperative-aided thresholds with both systems were significantly lower than preoperative-unaided thresholds, with the Osia 2 System demonstrating notably high satisfaction levels. Although both systems showed similar preoperative and postoperative word-recognition scores, the Osia 2 System provided greater audiological gain, especially at 2 kHz and 4 kHz frequencies. Additionally, the functional gain of both systems was comparable across all frequencies. The Osia 2 System demonstrated high subjective satisfaction and improved audiological outcomes compared to the Baha Attract system in patients with conductive or mixed hearing loss. Its superior audiological gain, particularly at critical frequencies, along with better compliance, suggests it as a favorable option for this patient population.

Comparative Effectiveness of Personal Sound Amplification Products Versus Hearing Aids for Unilateral Hearing Loss: A Prospective Randomized Crossover Trial.

This study compared hearing outcomes with use of personal sound amplification products (PSAPs) and hearing aids (HAs) in patients with moderate to moderately severe unilateral hearing loss. Thirty-nine participants were prospectively enrolled, and randomly assigned to use either one HA (basic or premium type) or one PSAP (basic or high-end type) for the first 8 weeks and then the other device for the following 8 weeks. Participants underwent a battery of examinations at three visits, including sound-field audiometry, word recognition score (WRS), speech perception in quiet and in noise, real-ear measurement, and self-report questionnaires. Functional gain was significantly higher with HAs across all frequencies (P < 0.001). While both PSAPs and HAs improved WRS from the unaided condition, HAs were superior to PSAPs. The speech recognition threshold in quiet conditions and signal-to-noise ratio in noisy conditions were significantly lower in the HA-aided condition than in the PSAP-aided condition, and in the PSAP-aided condition than in the unaided condition. Subjective satisfaction also favored HAs than PSAPs in questionnaires, Abbreviated Profile of Hearing Aid Benefit, International Outcome Inventory for Hearing Aids, and Host Institutional Questionnaire. While PSAPs provide some benefit for moderate to moderately severe unilateral hearing loss, HAs are more effective. This underscores the potential role of PSAPs as an accessible, affordable first-line intervention in hearing rehabilitation, particularly for individuals facing challenges in accessing conventional HAs.

Impacto do uso da verificação eletroacústica dos aparelhos de amplificação sonora individual na percepção de fala e desempenho do usuário nas atividades diárias

ABSTRACT Purpose: to assess the impact of electroacoustic verification on the satisfaction level and speech recognition in quiet and noise of hearing aid users. Methods: 24 individuals who had been using the device for at least 1 year and had not previously performed electroacoustic verification were assessed. In the first session, participants responded to the International Outcome Inventory for Hearing Aids validation questionnaire and indicated their satisfaction level on a visual analog scale. They were, then, subjected to speech perception tests in quiet and noise and electroacoustic verification, returning after 3 months and repeating the first stage assessments. The Wilcoxon test and paired t-test were used for data analysis, with significance set at p-value ≤ 0.05. Results: the visual analog scale assessment, the International Outcome Inventory for Hearing Aids score, the speech perception threshold in quiet and noise, and the signal/noise ratio improved after 3 months. Conclusion: individuals who had been using the device for at least 1 year had a substantial improvement in their satisfaction level and speech perception in quiet and noise after the electroacoustic verification.

Daily Speaking Time and Voice Intensity before and after Hearing Aid Rehabilitation in Adult Patients with Hearing Loss

Introduction: Hearing loss (HL) strongly impacts communication abilities and impairs social interactions. Moreover, it modifies the vocal parameters of affected patients. The effects of hearing rehabilitation through hearing aids (HA) on the vocal production of patients suffering from HL have not been thoroughly analyzed in the literature. The aim of this study was to use the ambulatory phonation monitor (APM), a portable vocal dosimeter, to evaluate the variations in the vocal production of a group of patients suffering from moderate-to-severe HL treated with HA and the relationship between such modifications and quality of life (QoL). Materials and Methods: Twenty-six patients suffering from a variable degree of HL and treated with HA have been enrolled. Each of them underwent an evaluation before and 4 months after rehabilitation with HA. The analysis of daily voice production was carried out with the APM, while subjective QoL data were collected through the Speech, Spatial, and Qualities questionnaire (SSQ) and the International Outcome Inventory for Hearing Aids (IOI-HA). The differences in phonatory measurements and subjective evaluations before and after HA rehabilitation were assessed using Wilcoxon signed rank test. The Spearman correlation test was used to analyze the correlation between phonatory measurements, auditory measurements, and SSQ scores. Results: Significant differences in the APM parameters before and after HA rehabilitation were found. After 4 months of HA use, we recorded a significant increase in phonation time and percentage of phonation time and a significant decrease in average amplitude in dB SPL. We also found a significant increase in the SSQ scores after HA rehabilitation. Finally, we were able to detect low but significant correlations between phonatory measurements and SSQ results. Conclusions: The APM proved to be a useful instrument in the evaluation of the benefits of HA and its measurements can be used as indicators of the participation in communication and social life of patients with HL, which are strongly related to QoL.

A country-wide health policy in Chile for deaf adults using cochlear implants: Analysis of health determinants and social impacts.

Post-lingual deafness represents a critical challenge for adults' well-being with substantial public health burdens. One treatment of choice has been cochlear implants (CI) for people with severe to profound hearing loss (HL). Since 2018, Chile has implemented a high-cost policy to cover CI treatment, the "Ley Ricarte Soto" (LRS) health policy. However, wide variability exists in the use of this device. To date, no related study has been published on policy evaluation in Chile or other Latin American countries. This study aimed to evaluate the impact of the LRS policy on the treatment success and labour market inclusion among deaf or hard of hearing (DHH) adults using CI. We examined and characterised outcomes based on self-reports about treatment success and occupation status between 2018 and 2020. We performed a prospective study using hospital clinical records and an online questionnaire with 76 DHH adults aged >15 who had received CIs since the introduction of the LRS policy in 2018. Using univariate and multivariate regression models, we investigated the relationship between demographic, audiological, and social determinants of health and outcomes, including treatment success for social inclusion (International Outcome inventory for Hearing Aids and CIs assessment: IOI-HA) and occupation status for labour market inclusion. Our study showed elevated levels of treatment success in most of the seven sub-scores of the IOI-HA assessment. Similarly, around 70% of participants maintained or improved their occupations after receiving their CI. We found a significant positive association between treatment success and market inclusion. Participants diagnosed at younger ages had better results than older participants in both outcomes. Regarding social determinants of health, findings suggested participants with high social health insurance and a shorter commute time to the clinic had better results in treatment success. For labour market inclusion, participants with high education levels and better pre- CI occupation had better post-CI occupation status. In evaluating the LRS policy for providing CIs for DHH adults in Chile, we found positive effects relating to treatment success and occupation status. Our study supports the importance of age at diagnosis and social determinants of health, which should be assessed by integrating public services and bringing them geographically closer to each beneficiary. Although evidence-based guidelines for candidate selection given by the LRS policy might contribute to good results, these guidelines could limit the policy access to people who do not meet the requirements of the guidelines due to social inequalities.

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.

A Feasible Sound Field Measurement in ENT Clinics for Contralateral Routing of Signals Hearing Aids: A Pilot Study

Background and Objectives The hearing in noise test (HINT) or sound localization test (SLT) is used as the standardized assessment for contralateral routing of signals (CROS) and bilateral microphones with contralateral routing of signals (BiCROS) hearing aids (HAs). However, implementing HINT or SLT can be challenging in most ENT clinics. In this study, we propose a new feasible method specifically designed for conducting a sound field hearing test for CROS and BiCROS HA users.Subjects and Method CROS/BiCROS HA users who visited Seoul St. Mary’s hospital between 2019 and 2021 were enrolled for the study. SLT was conducted in a sound-proof room equipped with two speakers positioned at a 45° angle from the patient on each side: noise stimuli were presented to the better ear the headphone patient was wearing while signals were presented to the worse ear via the speakers in the room. To validate the sound field test, a correlation analysis was conducted using the Bern benefit in single-sided deafness and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) Questionnaires.Results The aided speech discrimination score was significantly higher in the signal 60 dB HL/masking 50 dB HL condition than 50 dB HL/masking 50 dB HL condition (&lt;i&gt;p&lt;/i&gt;&lt;0.05). A significant correlation was found between the gain of sound field speech audiometry and the K-IOI-HA questionnaire (&lt;i&gt;p&lt;/i&gt;&lt;0.05).Conclusion Our novel sound field hearing test for CROS/BiCROS HA users, which presents appropriate noise stimuli via headphones to the better ear, appears to be a feasible approach for CROS/BiCROS HA users.

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.

Adapting to New Hearing Aids and Hearing Aid Adjustments in Adult Danish Users.

This study was aimed at understanding the effect of time taken to adapt to the new hearing aids (HAs) and the timeline of HA adjustments performed over more than a year of rehabilitation on self-reported HA outcomes. A self-report of the time it took to get accustomed to the new HAs and adjustment of the HAs during a year of rehabilitation collected from 690 HA users using a nonstandardized questionnaire were analyzed. The abbreviated version of the Speech, Spatial, and Quality of Hearing questionnaire and the International Outcome Inventory for Hearing Aids were used as the self-reported HA outcome. Out of 690 participants, 442 (64%) got accustomed to HAs within 2 months. Ninety-one participants (13%) did not get accustomed to the HAs at all, out of which 74 (81%) were first-time HA users. Eighty-four participants (12%) did not receive any HA adjustments after their initial fitting, and 49 (7%) had their HAs adjusted four or more times during the 1 year of rehabilitation. Three hundred ninety (57%) participants got their HA adjusted only at the 2-month follow-up visit, showing the intent to adjust given an opportunity. The stepwise multiple linear regression results showed the significant impact of getting accustomed to the HA and having HA adjusted at multiple instances on the self-reported HA outcomes. This study showed the importance of getting accustomed to the HA and having a minimal number of adjustments to have a better long-term self-reported HA outcome.