Efficacy of 3 commonly used hearing aid circuits - A crossover trial
Efficacy of 3 commonly used hearing aid circuits - A crossover trial
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DOI：
10.1001/jama.284.14.1806
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发表时间：
2000-10-11
影响因子：
120.7
通讯作者：
Rappaport, BZ
中科院分区：
文献类型：
--
作者：
Larson, VD;Williams, DW;Rappaport, BZ
背景大量研究表明，助听器对广泛的感音神经性听力损失具有显着益处，但尚未进行比较助听器功效的仔细对照、多中心临床试验。目的比较3种常用助听器电路为感音神经性听力损失患者提供的益处。设计1996年5月至1998年2月进行双盲、3期、3次治疗交叉试验。在退伍军人事务部医疗中心设置8个听力学实验室患者 360 名双侧感音神经性听力损失患者作为样本（平均年龄 67.2 岁；57% 男性，78.6% 白人）。 干预 患者被随机分配至线性削峰器 (PC)、压缩限制器 (CL) 和宽动态范围压缩器 (WDRC) 助听器电路的 6 个序列中的一个。所有患者均佩戴安装在相同窗扇中的 3 个助听器 3 个月。 主要结果指标 语音识别、声音质量和主观助听器效益测试结果，在基线时以及每 3 个月干预后使用和不使用助听器进行。实验结束时，患者对 3 个助听器电路进行排名。 结果 每个电路均显着改善了语音识别能力，对于轻声和对话式大声语音的改善更大（所有 52 dB 和 62 dB 条件，P 小于或等于 0.001）。所有 3 个回路都显着降低了言语交流中遇到问题的频率。一些测试结果表明，CL 和 WDRC 电路在单词识别 (P = .002)、响度 (P = .003)、总体喜好 (P = .001)、环境声音厌恶度 (P = .02) 和失真 (P = .02) 方面提供了明显优于 PC 电路的聆听体验。在排序评级中，患者更喜欢 CL 助听器电路 (41.6%)，而不是 WDRC (29.8%) 和 PC (28.6%)（CL 与 WDRC 和 PC 相比，P = 0.001）。 结论 每个电路在安静和嘈杂的聆听环境中都具有显着的优势。与 PC 相比，CL 和 WDRC 电路似乎提供了更优越的优势，尽管它们之间的差异远小于辅助条件与无辅助条件之间的差异。
Context Numerous studies have demonstrated that hearing aids provide significant benefit for a wide range of sensorineural hearing loss, but no carefully controlled, multicenter clinical trials comparing hearing aid efficacy have been conducted.Objective To compare the benefits provided to patients with sensorineural hearing loss by 3 commonly used hearing aid circuits.Design Double-blind, 3-period, 3-treatment crossover trial conducted from May 1996 to February 1998.Setting Eight audiology laboratories at Department of Veterans Affairs medical centers across the United States.Patients A sample of 360 patients with bilateral sensorineural hearing loss (mean age, 67.2 years; 57% male, 78.6% white).Intervention Patients were randomly assigned to 1 of 6 sequences of linear peak clipper (PC), compression limiter (CL), and wide dynamic range compressor (WDRC) hearing aid circuits. All patients wore each of the 3 bearing aids, which were installed in identical casements, for 3 months,Main Outcome Measures Results of tests of speech recognition, sound quality, and subjective hearing aid benefit, administered at baseline and after each 3-month intervention with and without a hearing aid. At the end of the experiment, patients ranked the 3 hearing aid circuits.Results Each circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech (all 52-dB and 62-dB conditions, P less than or equal to .001). All 3 circuits significantly reduced the frequency of problems encountered in verbal communication. Some test results suggested that CL and WDRC circuits provided a significantly better listening experience than PC circuits in word recognition (P = .002), loudness (P = .003), overall liking (P = .001), aversiveness of environmental sounds (P = .02), and distortion (P = .02). In the rank-order ratings, patients preferred the CL hearing aid circuits more frequently (41.6%) than the WDRC (29.8%) and the PC (28.6%) (P = .001 for CL vs both WDRC and PC).Conclusions Each circuit provided significant benefit in quiet and noisy listening situations. The CL and WDRC circuits appeared to provide superior benefits compared with the PC, although the differences between them were much less than the differences between the aided vs unaided conditions.