Ecological Momentary Assessment in Hearing Disorders

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DESCRIPTION (provided by applicant): The two most common auditory disorders among middle-aged Americans are hearing loss and tinnitus. Approximately 32% of those 55 years of age or older have self-reported hearing loss and about 8% of all adults currently report that they experience a ringing or buzzing in the ears daily or all of the time. Recent data indicate that the age-adjusted prevalence of both hearing loss and tinnitus may be increasing in the United States. However, only a relatively small proportion of adults with either condition will seek treatment for tinnitus or hearing loss. Indeed, only about 25% of those with adult-onset hearing loss currently use hearing aids and some data have shown that only about 37% of adults who say that they have constant ringing in the ears have reported this condition to a health care professional. Studies utilizing standard questionnaire methods have shown that those suffering from both hearing loss and tinnitus report that their problems and distress are often episodic and situational. Several decades of research in cognitive psychology have shown that there are known and predictable biases in the way people recollect and report health problems and symptoms, particularly those that may wax and wane in severity or occur more frequently in specific situations. In an effort to provide a more sensitive measure of the day-to-day real-life experiences associated with health problems, clinical researchers in a variety of fields have turned to a technique known as ecological momentary assessment or EMA. In essence, a standard Personal Digital Assistant (PDA) is programmed to signal a patient/participant with an audible or vibratory alert at either preset, random, or participant-chosen time points. This alert serves as a prompt to provide a series of assessments using a PDA stylus and touch screen. By asking individuals to provide reports of symptoms, distress, and situations close to the time of occurrence, recall and report biases may be substantially reduced and diurnal or other forms of temporal variation in symptoms or distress may be examined. It is the objective of the project to conduct pilot studies examining the applications of EMA methods to both hearing loss and tinnitus. In Study 1, we will examine temporal and situational ratings of hearing difficulty and distress for a 1-week period before and after 24 research participants have received a new and more technologically advanced hearing aid. In Study 2, we will examine situational and temporal variation in ratings of tinnitus severity and distress for a 2-week period in 24 research participants who have previously reported experiencing severe tinnitus. In both studies, data obtained with EMA methods will be compared to standard clinical assessment tools. The findings and methods developed in these two studies will guide future clinical research using EMA technologies. Further, as the technologies underlying portable computing devices and hearing assistive devices converge, these pilot studies may serve as the foundation for a future program of research integrating both audiometric and questionnaire-based data streams in real-life day-to-day settings. Public Health Relevance Paragraph: Although hearing loss and tinnitus are the two most common hearing problems among middle-aged and older Americans, most of those who experience these disorders do not seek treatment. The objective of this investigation is to use a PDA-based technology to study the effect of hearing loss and tinnitus on people as they go about their daily activities. It is our hope that this pilot project will provide the basis for future clinical research examining the real-time real-world impact of auditory disorders on everyday life.