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

在退伍军人管理局系统中，听力损失是第二种最常见的服务连接情况 影响933,182名退伍军人，仅次于耳鸣，影响1,121,709名退伍军人(数据 摘自2016财年退伍军人福利报告)。2016财年，退伍军人管理局发放了750,075 助听器净采购近2.7亿美元(来自弗吉尼亚州丹佛的报告 采购和物流中心[DALC]远程订单录入系统[ROE])。听证过半 向接受更换助听器的有经验的助听器用户分发艾滋病 (丹尼斯，2014)。退伍军人听力科工作量很大，退伍军人可能会经历漫长的等待时间 用于安排获得新助听器的预约(监察长办公室，2014年)。 配戴预约的目的是对助听器进行编程和验证，并确定 病人使用助听器/护理。对于获得更换助听器的患者，定向 通常是不必要的，并且简化了编程；主要由匹配 个人的真实耳朵辅助反应(后方)和助听器输出到适当的目标值。 与成人不同的是，儿童对臀围的容忍度不高，因为 在耳道内放置探针管的要求。因此，助听器配件 避免需要进行现场后部测量的程序(实际耳联接器差异 或RECD)是儿童护理标准(SOC)。大量研究清楚地表明， 原位后方和RECD拟合程序的等价性(例如，Moodie等人，1994)。RECD拟合 成人很少使用程序；然而，这样的方法可以排除需要 在配戴助听器时与患者直接身体接触。三个实验是 建议。第一项研究的目的是评估基于耦合器的群体适配方法 有经验的用户获得更换的助听器，并比较这些助听器的准确性 药方的配件和它们的结果符合规范。第二项研究旨在开发 开放式助听器排气的修正系数。第三项研究将侧重于比较 敞开式助听器的基于耦合器的配件(使用研究二开发的校正系数 结果)给SOC(主动控制)组，他们将把开放式助听器安装在面对面的 通过标准的就地后方程序进行面部预约。在研究1和研究3中，两组都将返回 在佩戴助听器后1个月进行现场复查和自我报告结果评估。 这项研究的结果应该确定基于RECD的助听器配戴的有效性 为正在更换助听器的有经验的助听器用户提供的方法 由多种风格组成的。如果这些方法是等价的，那么这项研究将提供一个 以证据为基础的RECD适配方法，应能提高患者满意度和 降低了成本。

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.