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.

Identifying the approaches used by audiologists to address the psychosocial needs of their adult clients.

OBJECTIVE: To identify the approaches taken by audiologists to address their adult clients' psychosocial needs related to hearing loss. DESIGN: A participatory mixed methods design. Participants generated statements describing the ways in which the psychosocial needs of their adult clients with hearing loss are addressed, and then grouped the statements into themes. Data were obtained using face-to-face and online structured questions. Concept mapping techniques were used to identify key concepts and to map each of the concepts relative to each other. STUDY SAMPLE: An international sample of 65 audiologists. RESULTS: Ninety-three statements were generated and grouped into seven conceptual clusters: Client Empowerment; Use of Strategies and Training to Personalise the Rehabilitation Program; Facilitating Peer and Other Professional Support; Providing Emotional Support; Improving Social Engagement with Technology; Including Communication Partners; and Promoting Client Responsibility. CONCLUSIONS: Audiologists employ a wide range of approaches in their attempt to address the psychosocial needs associated with hearing loss experienced by their adult clients. The approaches described were mostly informal and provided in a non-standardised way. The majority of approaches described were not evidence-based, despite the availability of several options that are evidence-based, thus highlighting the implementation gap between research and clinical practice.

Treatment of tinnitus with a customized, dynamic acoustic neural stimulus: clinical outcomes in general private practice.

OBJECTIVES: We evaluate the relative effectiveness of a newly available tinnitus treatment approach for different categories of patients in general private practice. METHODS: This was a cohort study, sponsored by Neuromonics, involving the first 470 patients to undertake the Neuromonics Tinnitus Treatment in 7 Neuromonics tinnitus clinics. All patients were provided with a dynamic acoustic neural stimulus, customized to each patient's audiometric profile, for daily use as part of a structured rehabilitation program. Tinnitus disturbance was assessed before, during, and after treatment with the Tinnitus Reaction Questionnaire. RESULTS: The outcomes displayed a relation with patients' suitability according to predefined criteria: among the most suitable patients (tier 1 cohort), 92% exceeded the threshold for success (defined as a reduction in tinnitus-related disturbance of at least 40%), and the mean improvement in tinnitus disturbance was 72%; the discontinuance rate was 4%. For other suitability categories, the success rates and mean improvements were somewhat lower, and the discontinuance rates higher (tier 2: 60%, 49%, and 16%, respectively; tier 3: 39%, 32%, and 17%, respectively). CONCLUSIONS: The results showed that the treatment is effective for suitable patients in the private practice setting, and they provide health-care professionals with guidance as to what patients might expect from treatment, depending on their degree of suitability.