Diagnostic Hearing Test System for Telehealth in Underserved Communities

项目摘要/摘要 听力对我们的身心健康很重要。不幸的是，听力损失排在第三位 美国常见的慢性身体疾病--比糖尿病或癌症更普遍。目前，14.1% (2,770万)20-69岁的成年人有单侧或双侧言语频率听力 减损。未经矫正的听力损失会导致较差的生活质量和增加的症状 抑郁症。对于儿童来说，听力损失会对言语语言发展产生负面影响，学术研究 表现和心理社会行为。在我们寿命的另一端，最近的研究表明听力 失落与认知功能减退和偶发性认知功能障碍独立相关 居住在社区的老年人。 许多形式的听力损失是可以用技术(例如助听器)治疗或解决的。然而， 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，即隔音隔音室，以及具有 进行考试方面的专门培训，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，特别是在 新的无Boothless解决方案，仍然需要(1)保持以下要求的质量的硬件 (2)自动测试常规测试，以实现以下功能 听力学家专注于更复杂的病例，以及(3)将听力学家与患者联系起来的新方法 通过目的性听力学-使听觉学家能够为更复杂的情况提供所需的专业知识 既不需要病人也不需要听力学专家长途跋涉。 Creare正在与其临床合作伙伴合作，开发一种移动、无线听力测听 测试系统以满足这些需求。克里尔选择专注于解决美国印第安人的需求 和阿拉斯加原住民(AIAN)。除了农村和有限的基础设施带来的挑战外，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，原型系统是 组装，对照相关标准进行评估，并在试点研究中用于测量以下方面的听力阈值 患有非对称性听力损失的受试者。第二阶段将专注于完善设备设计，建造几个预置 生产原型，并通过人体主题研究演示其用途和性能。第二阶段 结果将是一种便携式的无线听力测试系统，它将扩大诊断的范围 对农村社区进行测试。此外，该解决方案的时机恰到好处，人们对 远程听力学--新冠肺炎大流行加速了这一趋势。

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.