Optimizing Hearing Aid Fitting for Older Adults

GRANT=R556222-01 这项研究旨在改善助听器对老年人的适应性。尽管助听器技术有了很大的改进，但助听器的使用率和对已安装助听器的满意度在过去十年中并没有提高。这在一定程度上是因为研究界未能制定和传播最新的贴合方法，以促进从业人员利用现有新技术的潜力。这项提案中的两个实验将产生指导方针，以帮助临床医生根据配型前进行的测试结果，做出关于扩增需求的科学决定。 第一个实验在高频增益特性的选择上弥合了实验室研究和临床研究之间的差距。最近的研究表明，对于一些高频听力损失的人来说，高频放大实际上是有害的，而不是有帮助的。迫切需要一种临床实用的方法，能够有效地识别高频增益被禁止的患者。这项研究评估了此类患者的患病率，并评估了为识别这些患者而开发的两种新的临床程序。这两个程序被用来识别由20对受试者组成的试验组和控制组。每个受试者都配备了助听器，可以比较两种高频增益。受试者接受实验室测试和现场试验，以确定哪种高频增益设置更好。结果表明，这两种新的临床程序是否能准确预测最佳高频增益。 第二个实验探索双耳(双耳)助听器为双侧听力损失的老年人配戴的适应症。大约20%到30%的两侧配戴的人实际上选择只戴一个助听器。对于这些人来说，分配给助听器购买的资源本可以更有效地用于替代康复方法。目前尚不清楚为什么一些患者更喜欢一种助听器而不是两种，也不清楚哪些患者会属于这一类。这项研究在三个月的时间里评估了100个双边助听器试戴的结果。Logistic回归被用来建立一个模型，在该模型中，双耳总和、双耳积分、双耳干扰以及对助听器和听力损失的态度相结合，以预测哪些人最终将更喜欢使用一种助听器而不是两种。

GRANT=R556222-01 This research is directed towards improving hearing aid fitting for older adults. Despite substantial improvements in hearing aid technology, the hearing aid take-up rate, and the satisfaction with fitted hearing aids has not improved in the last decade. This is partly due to a failure by the research community to produce and disseminate updated fitting methods that facilitate the ability of practitioners to capitalize on the potential of existing new technologies. The two experiments in this proposal will produce guidelines to assist clinicians to make scientifically based decisions about amplification needs, based on the results of tests conducted before the fitting. The first experiment bridges the gap between laboratory research and clinical in selection of high frequency gain characteristic. Recent studies have demonstrated that, for some individuals with high-frequency hearing loss, high frequency amplification is actually detrimental rather than helpful. There is a pressing need for a clinically practical method that would validly identify patients for whom high-frequency gain is contraindicated. The study assesses the prevalence of such patients, and evaluates two new clinical procedures that have been developed to identify these individuals. The two procedures are used to identify experimental and control groups comprising 20 pairs of subjects. Each subject is fitted with a hearing aid that allows comparison of two amounts of high-frequency gain. Subjects undergo laboratory testing and a field trial to determine which high-frequency gain setting is better. Results show whether the two new clinical procedures yield accurate prediction of optimal high-frequency gain. The second experiment explores the indications for bilateral (binaural) hearing aid fittings for older adults with bilateral hearing loss. About 20 to 30% of bilaterally fitted individuals actually elect to wear only one hearing aid. For these individuals, resources allocated to hearing aid purchase would have been more effectively used for alternate rehabilitation methods. It is not clear why some patients prefer one hearing aid over two, or which patients will fall into this category. This study evaluates outcomes of 100 bilateral hearing aid fittings over a three-month period. Logistic regression is used to develop a model in which binaural summation, binaural integration, binaural interference, and attitudes towards hearing aids and hearing loss are combined to predict which individuals will ultimately prefer to use one hearing aid rather than two.