Ear and hearing outcomes in Aboriginal infants living in an urban Australian area: the Djaalinj Waakinj birth cohort study.

OBJECTIVE: Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area. DESIGN: Aboriginal infants enrolled in the Djaalinj Waakinj prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected. STUDY SAMPLE: 125 infants were enrolled in the study; 67 completed audiological assessment, 62, 54, and 58 of whom attended ear screenings at 2-4, 6-8 and 12-18 months. RESULTS: Of the children that attended the audiological assessment, 36.5%, 50% and 64.3% of infants had otitis media (OM) at 2-4, 6-8 and 12-18 months. Using a 10 dB correction factor, 44.8% of infants had hearing loss (HL) (≥ 25 dB HL) at ∼ 12 months of age. More males (X2=5.4 (1df, p = 0.02)) and infants with OM at audiological assessment (X2=5.8 (1df, p = 0.02)) had HL. More infants that used a pacifier at 12-18 months of age had HL (X2=4.7 (1df, p = 0.03)). CONCLUSION: Aboriginal infants in an urban area have high rates of HL and OM, which requires early surveillance and timely treatment to reduce the medical and developmental impacts of OM and HL.

Validation of teleaudiology hearing aid rehabilitation services for adults: a systematic review of outcome measurement tools.

PURPOSE: To investigate outcome measurement tools for the validation of teleaudiology hearing aid rehabilitation services for adults. METHODS: A search strategy was developed to identify tools used to evaluate standard and teleaudiology hearing aid rehabilitation services for adults. A seven-domain hearing-health-care service model for validation was defined and used to analyse the applicability and suitability of patient- and service-centred tools. This model and the applicability and suitability criteria were based on the literature, the International Classification of Functioning (ICF) framework, and gold standard professional practice guidelines, which together formed the validation framework used in this study. RESULTS: Eighteen tools were identified and assessed against the validation framework. These tools were found to primarily assess aspects in the patient communication domain and rarely in the domain of service provision. All the included tools had some applicable items for teleaudiology hearing aid services; three tools were judged as suitable and four partially suitable for validating these services. CONCLUSION: Although there is a set of suitable tools available to validate teleaudiology hearing aid rehabilitation services, none of them cover all the seven domains of the validation model used by this review and few are focussed on a specific domain. Further improvement and/or development of new tools to comprehensively validate these services is still necessary. At this stage, this still limits clinical audiology practice research, especially in teleaudiology.IMPLICATIONS FOR REHABILITATIONOutcome measurement tools are crucial for assessing the validity of hearing rehabilitation services.Findings of this study inform clinicians and researchers on how and what to assess and use to evaluate teleaudiology and standard hearing aid rehabilitation services.The use of the proposed validation framework may facilitate the standardisation of validation of both face-to-face and remotely delivered audiology rehabilitation services and improve consistency of methodology and reported real-world outcomes across studies and thus, the evidence.

The reliability of video otoscopy recordings and still images in the asynchronous diagnosis of middle-ear disease.

OBJECTIVE: To compare the asynchronous assessment of video otoscopic still images to recordings by an audiologist and ear, nose and throat surgeon (ENT) for diagnostic reliability and agreement in identifying middle-ear disease. DESIGN: A prospective cross-sectional study, asynchronously assessing video otoscopy, tympanometry and case history (Dx1). A subset was re-diagnosed (Dx2). STUDY SAMPLE: Video otoscopy and data from 146 children recruited at two public community events; a sub-set of 47 were re-assessed. RESULTS: The intra-rater diagnostic agreement between Dx1 and Dx2 was moderate (k = 0.445-0.552) for the ENT surgeon, and almost-perfect (k = 0.928) for the audiologist, in both procedures. The agreement between the two procedures was substantial (k = 0.624) and moderate (k = 0.416) for the ENT surgeon in Dx1 and Dx2 respectively, and almost-perfect for the audiologist (k = 0.854-0.978) in both rounds. In Dx1, the inter-rater agreement between the clinicians was substantial using still images (k = 0.672) and moderate using recordings (k = 0.593); in Dx2 it was moderate using both procedures (k = 0.477-0.488). CONCLUSION: Both video otoscopic procedures, in addition to tympanometry and case history information, can be reliably used for asynchronous diagnosis of childhood middle-ear disease. An audiologist has a potential role in triaging children with middle-ear abnormalities and, therefore, improving access to ear-health services.

Teleaudiology hearing aid fitting follow-up consultations for adults: single blinded crossover randomised control trial and cohort studies.

OBJECTIVE: To evaluate and compare the effectiveness and quality of standard face-to-face and teleaudiology hearing aid fitting follow-up consultations and blended services for adult hearing aid users. DESIGN AND STUDY SAMPLE: Fifty-six participants were randomly allocated to two equal groups, with equal numbers of new and experienced users. One standard and one teleaudiology follow-up consultation were delivered by an audiologist, the latter assisted by a facilitator. The order was reversed for the second group. Outcome measurement tools were applied to assess aspects of participants' communication, fitting (physical, sensorial), quality of life, and service. Cross-sectional and longitudinal outcomes were analysed. RESULTS: Most participants presented with moderate, sloping, and symmetrical sensorineural hearing loss. The duration of teleaudiology (42.96 ± 2.73 min) was equivalent to face-to-face consultations (41.25 ± 2.61 min). All modes of service delivery significantly improved outcomes for communication, fitting, and quality of life (p > 0.05). Satisfaction for both consultation modes was high, although significantly greater with standard consultations. The mode and order of delivery of the consultations did not influence the outcomes. CONCLUSION: Teleaudiology hearing aid follow-up consultations can deliver significant improvements, and do not differ from standard consultations. Blended services also deliver significant improvements. Satisfaction can be negatively impacted by technical or human-related issues.

Cochrane corner: interventions to prevent hearing loss caused by noise at work.

This Cochrane Corner features "Interventions to prevent hearing loss caused by noise at work", published in 2017. The aim of this Cochrane Review was to find out if hearing loss caused by noise at work is being prevented by current interventions. Tikka et al. identified 29 studies that studied the effect of preventive measures. One study evaluated legislation to reduce noise exposure, eleven studies evaluated effects of personal hearing protection devices and 17 studies evaluated effects of hearing loss prevention programmes (HLPPs). There was some very low-quality evidence that implementation of stricter legislation can reduce noise levels in workplaces and moderate-quality evidence that training of proper insertion of earplugs significantly reduces noise exposure at short-term follow-up. This Cochrane review has identified specific strategies that have shown effectiveness in reducing workplace noise, such as the implementation of stricter legislation and the need for training in the proper use of earplugs and earmuffs to reduce noise exposure to safe levels. The overall quality of evidence for the effectiveness of HLPPs in preventing hearing loss was very low, there was limited follow-up of participants receiving training for insertion of earplugs and no controlled studies examining engineering controls to reduce workplace noise.

Teleaudiology Services for Rehabilitation With Hearing Aids in Adults: A Systematic Review.

Purpose: This review examined (a) the current evidence from studies on teleaudiology applications for rehabilitation of adults with hearing impairment with hearing aids and (b) whether it is sufficient to support the translation into routine clinical practice. Method: A search strategy and eligibility criteria were utilized to include articles specifically related to hearing aid fitting and follow-up procedures that are involved in consultations for the rehabilitation of adults, where the service was provided by the clinician by teleaudiology. A search using key words and Medical Subject Headings (MeSH) was conducted on the main electronic databases that index health-related studies. The included studies were assessed using validated evaluation tools for methodological quality, level of evidence, and grade recommendations for application into practice. Results: Fourteen studies were identified as being within the scope of this review. The evaluation tools showed that none of these studies demonstrated either a strong methodological quality or high level of evidence. Analysis of evidence identified 19 activities, which were classified into service outcomes categories of feasibility, barriers, efficiency, quality, and effectiveness. Recommendations could be made regarding the (a) feasibility, (b) barriers, and (c) efficiency of teleaudiology for the rehabilitation of hearing loss with hearing aids. Conclusion: This review provides up-to-date evidence for teleaudiology hearing aid services in new and experienced hearing aid users in different practice settings. Findings direct future research priorities to strengthen evidence-based practice. There is a need for further studies of many aspects of teleaudiology services for rehabilitation with hearing aids to support their implementation into clinical practice. Supplemental Material: https://doi.org/10.23641/asha.6534473.