Efficacy of a coupler-based fitting approach for experienced users receiving replacement hearing aids

基于耦合器的验配方法对于有经验的用户更换助听器的效果

• 批准号: 10329952
• 负责人: Sherri L. Smith
• 金额: --
• 依托单位: DURHAM VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10329952
• 关键词: Address; Adult; Affect; Appointment; Audiology; Caring; Child; Child Care; Client satisfaction; Clinic; Control Groups; Coupling; Custom; Data; Ear; External auditory canal; Frequencies; Hearing Aids; Improve Access; In Situ; Individual; Infant; Intervention; Logistics; Measurement; Measures; Methods; Minor; Mission; Modeling; Outcome; Outcome Assessment; Output; Participant; Patient Care; Patient Self-Report; Patient-Focused Outcomes; Patients; Pilot Projects; Procedures; Protocols documentation; Publishing; Reporting; Research; Sampling; Service delivery model; Services; System; Time; Tinnitus; Travel; Tube; Variant; Vent; Veterans; Visit; Wait Time; Work; active control; base; cost; disability; evidence base; experience; experimental study; hearing impairment; improved; patient oriented; programs; response; service delivery; standard of care

In the VA system, hearing loss is the second-most common service-connected condition affecting 933,182 Veterans, exceeded only by tinnitus which affects 1,121,709 Veterans (data from Veterans Benefit Report for Fiscal Year 2016). In FY 2016, the VA dispensed 750,075 hearing aids at a net procurement of nearly $270 million (report generated from VA Denver Acquisition and Logistics Center [DALC] Remote Order Entry System [ROES]). Half of the hearing aids dispensed were to experienced hearing aid users receiving replacement hearing aids (Dennis, 2014). VA Audiology caseload is significant and Veterans can experience long wait-times for fitting appointments to obtain new hearing aids (Office of the Inspector General, 2014). The purpose of the fitting appointment is to program and verify the hearing aids and orient the patient to hearing aid use/care. For patients obtaining replacement hearing aids, the orientation typically is unnecessary, and the programming is simplified; consisting mainly of matching the individual's real-ear aided response (REAR) and hearing aid output to appropriate target values. In contrast to adults, REAR measurements are not well-tolerated by children due to the requirement for placement of a probe tube in the ear canal. Therefore, a hearing aid fitting procedure that circumvents the need for in situ REAR measurements (real ear coupler difference or RECD) is the standard-of-care (SoC) for children. Considerable research clearly has shown the equivalency of in situ REAR and RECD fitting procedures (e.g., Moodie et al., 1994). RECD fitting procedures rarely are used with adults; however, such an approach could preclude the need for direct physical contact with the patient at the time of the hearing aid fitting. Three experiments are proposed. The purpose of the first study is to evaluate coupler-based fitting approach for groups of experienced users obtaining replacement hearing aids and compare the accuracy of those fittings to the prescription and their outcomes to norms. The second study aims to develop correction factors for venting of open-fit hearing aids. The third study will focus on comparing coupler-based fittings of open-fit hearing aids (using correction factors developed from study two results) to an SoC (active control) group who will have their open-fit hearing aids fitted in face-to- face appointment via standard in situ REAR procedures. In Study 1 and 3, both groups will return for in situ REARs and self-report outcomes assessment one month after the hearing-aid fitting. The results of this study should determine the efficacy of a RECD-based, hearing-aid fitting approach for experienced hearing-aid users who are receiving replacement hearing aids consisting of a variety of styles. If the approaches are equivalent, then this study will provide an evidence-based, RECD fitting approach that should result in greater patient satisfaction and reduced costs.

在VA系统中，听力损失是第二常见的服务连接条件 影响933，182退伍军人，仅超过耳鸣，影响1，121，709退伍军人（数据 2016财年退伍军人福利报告）。在2016财年，VA分配了750，075 助听器的净采购额接近2.7亿美元（来自VA Denver的报告 采购和物流中心[DALC]远程订单输入系统[ROES]）。听证会的一半 助听器分发给有经验的助听器使用者， （Dennis，2014）。VA听力学病例量很大，退伍军人可能会经历很长的等待时间 为获得新的助听器进行验配预约（监察长办公室，2014年）。 验配预约的目的是对助听器进行编程和验证， 助听器使用注意事项对于需要更换助听器的患者， 通常是不必要的，并且编程被简化;主要包括匹配 个人的真耳辅助响应（REAR）和助听器输出到适当的目标值。 与成人相比，儿童对REAR测量的耐受性较差，因为 要求将探头管放置在耳道中。助听器选配 避免现场REAR测量（真实的耳耦合器差异）的程序 或RECD）是儿童的护理标准（SoC）。大量研究清楚地表明， 原位REAR和RECD拟合过程的等效性（例如，Moodie等人，1994年）。RECD拟合 手术很少用于成人;然而，这种方法可能会排除 在助听器验配时与患者直接身体接触。三个实验 提出了第一项研究的目的是评估基于耦合器的群体拟合方法 经验丰富的用户获得更换助听器并比较其准确性 拟合处方和他们的结果规范。第二项研究旨在开发 开放式助听器通气的校正系数。第三项研究将侧重于比较 基于耦合器的开放式助听器的验配（使用从研究2中开发的校正因子 结果）到SoC（主动控制）组，他们将在面对面的情况下安装开放式助听器， 通过标准的现场REAR程序进行预约。在研究1和3中，两组都将返回 在现场REAR和自我报告的结果评估后一个月的助听器配件。 这项研究的结果应确定的有效性，一个基于RECD，助听器配件 助听器使用者更换助听器的方法 由多种风格组成的。如果这些方法是等效的，则本研究将提供 基于证据的RECD拟合方法，应能提高患者满意度， 降低成本。