Toward a New Evidence-Based Fitting Paradigm for Over-the-Counter Hearing Aids.
Toward a New Evidence-Based Fitting Paradigm for Over-the-Counter Hearing Aids.
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DOI：
10.1044/2020_aja-20-00085
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发表时间：
2021-03-10
影响因子：
1.8
通讯作者：
Wu YH
中科院分区：
文献类型：
--
作者：
Urbanski D;Hernandez H;Oleson J;Wu YH
这项双重目标研究旨在开发和验证一种新的非处方（OTC）助听器验配模式。目标1旨在创建一组有限的基于证据的预配置增益-频率响应（“增益-频率响应”），用于OTC器械。目标2测试了相对于最佳实践验证的放大器的有效性，并确定了老年人从集合中自我选择放大的最佳方法。在目标1中，从国家健康和营养检查调查数据库中获得了267名患有轻度至中度感音神经性听力损失的老年人的测听数据。使用这些数据和国家声学实验室-非线性2（NAL-NL 2）规定公式，创建了一组四个可以适合大部分老年美国人的公式。在目标2中，37名听力损失的老年人使用五种方法选择听力损失。选择方法有听力图选择、自测选择、试测选择、问卷选择和随机分配。使用交叉设计，每个参与者完成了语音识别测试和声音质量评级在安静和噪音的所有选择方法和验证的NAL-NL 2条件。这组预设可以适合67.9%患有轻度至中度听力损失的美国老年人（目标1）。控制听力阈值和声音质量评级，线性混合效应模型表明，语音识别分数选择听力图，选择自我测试，并选择尝试没有统计学差异的NAL-NL 2条件。统计分析表明，自我选择测试产生的结果与NAL-NL 2条件（目标2）的个体结果最一致。这种新开发的验配范例可以提供与最佳实践验证相当的功效，并且可以用于OTC助听器。
This dual-aim study was intended to develop and validate a new fitting paradigm for over-the-counter (OTC) hearing aids. Aim 1 was undertaken to create a limited set of evidence-based preconfigured gain–frequency responses (“presets”) for use in OTC devices. Aim 2 tested the efficacy of the presets relative to best-practice verification and determined the best method(s) for older adults to self-select amplification from the set. In Aim 1, audiometry data from 267 older adults with mild-to-moderate sensorineural hearing loss were obtained from the National Health and Nutrition Examination Survey database. Using these data and the National Acoustic Laboratories–Non-Linear 2 (NAL-NL2) prescriptive formula, a set of four presets were created that can fit a large percentage of older Americans with presbycusis. In Aim 2, 37 older adults with hearing loss used five methods to select presets. The selection methods were select-by-audiogram, select-by-self-test, select-by-trying, select-by-questionnaire, and random assignment. Using a crossover design, each participant completed speech recognition testing and sound quality ratings in quiet and noise for all selection methods and a verified NAL-NL2 condition. The set of presets can fit 67.9% of older Americans with mild-to-moderate hearing loss (Aim 1). Controlling for hearing thresholds and sound quality ratings, liner mixed-effects models indicated that speech recognition scores for select-by-audiogram, select-by-self-test, and select-by-trying were not statistically different from the NAL-NL2 condition. Statistical analysis indicated that select-by-self-test produced outcomes most consistent with individual outcomes for the NAL-NL2 condition (Aim 2). This newly developed fitting paradigm may provide efficacy comparable to best-practice verification and could be used in OTC hearing aids.