Diagnostic Hearing Test System for Telehealth in Underserved Communities

用于服务欠缺社区远程医疗的诊断听力测试系统

• 批准号: 10452703
• 负责人: ODILE H CLAVIER
• 金额: $ 80.25万
• 依托单位: CREARE, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10452703
• 关键词: Acoustics; Address; Adult; Affect; Age-Years; Air; Alaska Native; American Indians; Android; Audiology; Auditory Threshold; Automobile Driving; Behavior; Bilateral; Bone Conduction; COVID-19 pandemic; Child; Chronic; Clinic; Clinical; Collaborations; Communities; Companions; Complex; Computer software; Conductive hearing loss; Device Designs; Diabetes Mellitus; Diagnostic; Diagnostic tests; Early Diagnosis; Early treatment; Economics; Elderly; Electronic Health Record; Electronics; Ensure; Ethnic group; External auditory canal; Feedback; Frequencies; Guidelines; Healthcare; Hearing; Hearing Aids; Hearing Tests; Human; Impaired cognition; Impairment; Indigenous; Infection; Infrastructure; Internet; Investments; Labyrinth; Language Development; Longevity; Low income; Malignant Neoplasms; Manuals; Measures; Mediating; Medical; Mental Health; Modeling; Noise; Outcome; Patients; Peer Review; Performance; Persons; Phase; Pilot Projects; Production; Publishing; Quality of life; Race; Recording of previous events; Research; Running; Rural; Rural Community; Secure; Security; Self-Help Devices; Special Equipment; Speech; Stimulus; Study Subject; System; Tablets; Technology; Testing; Training; Travel; Tympanic membrane; United States; aged; asymmetric hearing loss; automated algorithm; bone; clinical practice; depressive symptoms; design; ergonomics; handheld mobile device; health data; health disparity; hearing impairment; human subject; improved; innovation; interest; laptop; middle ear; mobile application; novel strategies; phase 1 designs; physical conditioning; portability; prototype; psychosocial; rural area; sound; teleaudiology; telehealth; telehealth systems; treatment planning; underserved community; video chat; wireless

PROJECT SUMMARY/ABSTRACT Hearing is important to our physical and mental health. Hearing loss, unfortunately, is the third most common chronic physical condition in the U.S.—more prevalent than diabetes or cancer. Presently, 14.1% (27.7 million) of adults aged 20–69 years of age have unilateral or bilateral speech-frequency hearing impairment. Uncorrected hearing loss gives rise to a poorer quality of life and increased symptoms of depression. For children, hearing loss can negatively impact speech language development, academic performance and psychosocial behavior. On the other end of our lifespan, recent research has shown hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community dwelling older adults. Many forms of hearing loss are treatable or addressable with technology (e.g., hearing aids). However, due to a lack of access to diagnostic testing, many cases go untreated. A major limiter to diagnostic quality hearing tests is the need for expensive infrastructure, i.e., sound-proofed booths, and audiologists with specialized training in conducting exams, which are traditionally conducted in-person and one-on-one. Although there has been investment in changing the model of delivering hearing assessment, particularly with new “boothless” solutions, there remains strong needs for (1) hardware that maintains the quality required for diagnostic audiometry in “boothless” settings, (2) automated testing for routine testing that would allow audiologists to focus on the more complex cases, and (3) new approaches to connect audiologists to patients through teleaudiology—enabling audiologists to provide the expertise needed for the more complex cases without requiring either the patients nor the audiologists to travel great distances. Creare, in collaboration with its clinical partners, is developing a mobile, wireless audiometric hearing test system to address these needs. Creare has chosen to focus on addressing the needs of American Indians and Alaska Natives (AIAN). In addition to the challenges due to rural and limited infrastructure, AIAN have the highest rate of hearing issues compared to other race/ethnicity groups. In Phase I, a prototype system was assembled, evaluated against relevant standards, and used in a pilot study to measure hearing thresholds on subjects with asymmetric hearing loss. Phase II will focus on refining the device design, building several pre- production prototypes, and demonstrating their use and performance with human subject studies. The Phase II outcome will be a portable, wireless audiometric hearing test system that will expand the reach of diagnostic testing to rural communities. Furthermore, the solution is well-timed with an increasing interest in teleaudiology—which has been accelerated by the COVID-19 pandemic.

项目总结/摘要 听力对我们的身心健康很重要。不幸的是，听力损失是第三大 在美国常见的慢性身体状况-比糖尿病和癌症更普遍。目前，14.1% (27.7 20-69岁的成年人中有2000万人具有单侧或双侧语音频率听力， 损伤未矫正的听力损失会导致生活质量下降， 萧条对于儿童来说，听力损失会对言语语言发育、学业和语言能力产生负面影响。 表现和心理社会行为。在我们生命的另一端，最近的研究表明， 丧失与加速认知衰退和偶发性认知损害独立相关， 社区居住的老年人。 许多形式的听力损失都可以通过技术治疗或解决（例如，助听器（Hearing Aids）然而，在这方面， 由于无法获得诊断检测，许多病例得不到治疗。诊断质量的主要限制因素 听力测试需要昂贵的基础设施，即，隔音室，听力学家， 进行考试的专门培训，传统上是面对面和一对一进行的。 尽管在改变提供听力评估的模式方面进行了投资，特别是 新的“无展位”解决方案，仍然存在对（1）硬件的强烈需求， 在“无亭”设置中的诊断测听，（2）用于常规测试的自动化测试， 听力学家专注于更复杂的情况下，（3）新的方法来连接听力学家与患者 通过远程听力学，使听力学家能够为更复杂的病例提供所需的专业知识 而不需要患者或听力学家长途跋涉。 Creare与其临床合作伙伴合作，正在开发一种移动的无线听力测定仪 测试系统来满足这些需求。Creare选择专注于解决美国印第安人的需求 阿拉斯加原住民（Alaska Natives）除了农村和基础设施有限的挑战外，AIAN还拥有 与其他种族/民族群体相比，听力问题的发生率最高。在第一阶段， 组装，根据相关标准进行评估，并用于试点研究， 非对称性听力损失患者。第二阶段将专注于完善设备设计，建造几个预处理设备， 生产原型，并展示其使用和性能与人类受试者的研究。II期 结果将是一个便携式，无线听力听力测试系统，将扩大诊断范围 测试农村社区。此外，该解决方案恰逢其时， 远程听力学--这一领域因2019冠状病毒病疫情而加速发展。