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.

Mobile Digital Recording: Adequacy of the iRig and iOS Device for Acoustic and Perceptual Analysis of Normal Voice.

OBJECTIVE: To determine whether the iRig and iOS device recording system is comparable with a standard computer recording system for digital voice recording. METHODS: Thirty-seven vocally healthy adults, between ages 20 and 62, with a mean age of 33.9 years, 13 males and 24 females, were recruited. Recordings were simultaneously digitalized in an iPad and iPhone using a unidirectional condenser microphone for smartphones/tablets (iRig Mic, IK Multimedia) and in a computer laptop (Dell-Inspiron) using a unidirectional condenser microphone (Samson-CL5) connected to a preamplifier with phantom power. Both microphones were lined up at an equal fixed distance from the subject's mouth. Speech tasks consisted of a sustained vowel "ah" at comfortable pitch/loudness, counting from 1 to 10, and a glissando "ah" from a low to a high note. The samples captured on the iOS devices were transferred via SoundCloud in WAV format, and analyzed using the Praat software. The acoustic parameters measured were mean, min, and max F0, SD F0, jitter local, jitter rap, jitter ppq5, jitter ddp, shimmer local, shimmer local-dB, shimmer apq3, shimmer apq5, shimmer apq11, shimmer dda, NHR, and HNR. RESULTS: There were no statistically significant differences for any parameter and speech task analyzed for both iOS devices as compared with the gold standard computer/preamp system (all P values > 0.050). In addition, there were no statistical differences in the perceptual identification of the recordings among devices (P < 0.001). CONCLUSION: In the present study, the iRig and iOS device may provide reliable digital recording of normal voices.

The Use of Sound Level Meter Apps in the Clinical Setting.

PURPOSE: The purpose of this study was to compare sound level meter (SLM) readings obtained using a Larson-Davis (Depew, NY) Model 831 Type 1 SLM, a RadioShack (Fort Worth, TX) SLM, and iPhone 5 (Apple, Cupertino, CA) SLM apps. METHOD: In Procedure 1, pure tones were measured in an anechoic chamber (125, 250, 500, 1000, 2000, 4000, and 8000 Hz); sound pressure levels (SPLs) ranged from 60 to 100 dB SPL in 10-dB increments. In Procedure 2, human voices were measured. Participants were 20 vocally healthy adults (7 women, 13 men; mean age = 25.1 years). The task was to sustain a vowel "ah" at 3 intensity levels: soft, habitual, and loud. Microphones were lined up equal distances from the participant's mouth, and recordings were captured simultaneously. RESULTS: Overall, the 3 SLM apps and the RadioShack SLM yielded inconsistent readings compared with the Type 1 SLM. CONCLUSION: The use of apps for SPL readings in the clinical setting is premature because all 3 apps adopted were incomparable with the Type 1 SLM.

Cross-cultural adaptation, validation, and cutoff point of the Italian version of the voice activity and participation profile: Profilo di Attività e Partecipazione Vocale.

OBJECTIVES/HYPOTHESIS: The purpose of the study was to investigate the validity of the Profilo di Attività e Partecipazione Vocale (PAPV) and to identify the cutoff point of the total score that discriminates dysphonic from vocally healthy individuals. STUDY DESIGN: Cross-sectional, nonrandomized, prospective study with controls. METHODS: The PAPV was administered to 239 individuals, 108 with vocal complaint, 131 without vocal complaint, 141 female, 98 male, mean age of 45.8 years. The instrument was submitted to validity, reliability, reproducibility, and responsiveness. RESULTS: Construct-related validity was evaluated by comparing the scores of the groups with and without voice problem (Job: P < 0.001, self-perceived severity: P < 0.001, daily communication: P < 0.001, social communication: P < 0.001, emotion: P < 0.001, total: P < 0.001). The evaluation of criterion-related validity showed moderate-strong correlation coefficients between the PAPV, Voice Handicap Index, and vocal self-assessment. High alpha coefficients showed good internal consistency (job: 0.910, daily communication: 0.981, social communication: 0.981, emotion: 0.948, total: 0.989). High intraclass correlation coefficient showed good reproducibility (Job: 0.967, self-perceived severity: 0.979, daily communication: 0.990, social communication: 0.950, emotion: 0.976, total: 0.993). Changes after treatment were statistically significant for all PAPV scores (self-assessment P < 0.001, job P < 0.001, daily communication P < 0.001, social communication P = 0.005, emotion P < 0.001, total P < 0.001). The cutoff point with the highest sensitivity (84%) and specificity (100%) was 37.45 points. CONCLUSIONS: The PAPV has undergone important steps required for cultural adaptation and validation process of outcome measures and it may be considered an important instrument to compose the assessment of Italian patients with dysphonia. The cutoff point that discriminates individuals with dysphonia from vocally healthy ones was 37.45 points for its total score.

Cross-cultural adaptation of the Italian version of the Voice Activity Participation Profile.

The Vocal Activity Participation Profile (VAPP), originally developed in English, is a self-assessment tool used to measure individuals' voice activity limitation and participation restriction. Based on the fact that the cultural/linguistic adaptation is an essential step of validating a protocol in another language, the purpose was to linguistically and culturally adapt the VAPP into Italian. The adaptation was performed in accordance to the Scientific Advisory Committee of the Medical Outcomes Trust. The translation was performed by one bilingual speech-language pathologist and by one bilingual interpreter, who knew about the purpose of this project. A bilingual English teacher, who had not participated in the previous step, performed the back translation. A committee composed by three speech-language pathologists specialized in voice and one laryngologist compared the forward and backward translations, to assess for any discrepancies. A final version was produced and called Profilo di Attività e Partecipazione Vocale (PAPV). A "not applicable" option was included to each item and was administered to 17 individuals with voice problems, six males and 11 females, aged between 21 to 55 years. All items were relevant, as no patients chose the "not applicable" option. However, four individuals, who had a lower educational level, did not fully understand the instructions of the opening statement. Therefore, the questionnaire was further reviewed and adjusted to clarify the information. Otherwise, no items were changed and/or deleted. The PAPV kept the same structure as the original version. The cultural equivalence of the Italian VAPP was demonstrated and entitled PAPV, whose validation is currently in process.