Effectiveness of a programable body-worn digital hearing aid for older adults in a developing country: a randomized controlled trial with a cross-over design.

BACKGROUND: Hearing aids are important assistive devices for hearing rehabilitation. However, the cost of commonly available commercial hearing aids is often higher than the average monthly income of individuals in some developing countries. Therefore, there is a great need to locally produce cheaper, but still effective, hearing aids. The Thai-produced P02 hearing aid was designed to meet this requirement. OBJECTIVE: To compare the effectiveness of the P02 hearing aid with two common commercially available digital hearing aids (Clip-II™ and Concerto Basic®). METHODS: A prospective, randomized controlled trial with a cross-over design was conducted from October 2012 to September 2014 in a rural Thai community. There were 73 participants (mean age of 73.7 ± 7.3 years) included in this study with moderate to severe hearing loss who were assessed for hearing aid performance, including probe microphone real-ear measurement, functional gain, speech discrimination, and participant satisfaction with the overall quality of perceived sound and the design of the device. RESULTS: There were no statistically significant differences in functional gain or speech discrimination among the three hearing aids evaluated (p-value > 0.05). Real-ear measurements of the three hearing aids met the target curve in 93% of the participants. The best real-ear measurement of the hearing aid following the target curve was significantly lower than that of Clip-II™ and Concerto Basic® (p-value < 0.05) at high frequency. However, participants rated the overall quality of sound higher for the P02 hearing aid than that of Clip-II™ but lower than that of Concerto Basic® (p-value > 0.05). Participants revealed that the P02 hearing aid provided the highest satisfaction ratings for design and user-friendliness with statistical significance (p-value < 0.05). CONCLUSION: The P02 hearing aid was an effective device for older Thai adults with hearing disabilities. Additionally, its modern design, simplicity of use, and ease of maintenance were attractive to this group of individuals. These benefits support the rehabilitation potential of this hearing aid model and its positive impact on the quality of life of older adults in developing countries. TRIAL REGISTRATION: This study was registered under Clinicaltrial.gov NCT01902914 . Date of registration: July 18, 2013.

Community-Based Hearing Screening of Disabled Elders Using the Thai-FMHT: Clinical Implications and Cost-Effectiveness.

OBJECTIVE: The aim of this study was to evaluate the feasibility of using the two-stage hearing test to detect hearing disabilities in the community elders. MATERIAL AND METHOD: A prospective cohort study was conducted in the Phuwieng District, Khon Kaen, Thailand from December 1, 2012 to January 31, 2013. All of the elders more than 60 years of age were invited. First, screening using the Thai version of five-minute hearing test (Thai-FMHT) with a score equal to or greater than 12 was included in the group and then given the next audiometric examination. RESULTS: Two hundred fifty-eight elders were interested in this program, but only 192 subjects consented to participate in the entire study. Six participants withdrew before completing the protocol; therefore, 107 males and 79 females were included. The age ranged 60-92 years old. Only 152 participants (81.7%; 95% CI: 75.5-86.6%) had a hearing disability that could be rehabilitated using a hearing aid. The cost of hearing screening using this program was reduced from $114.15 to $28.60 per positive case with the need for hearing rehabilitation. CONCLUSION: The two-stage hearing screening using the Thai-FMHT followed by an audiometric examination was found to be a suitable test for community-based mass screening of hearing loss, particularly in an area with limited resources.

Validation of the Thai five-minute hearing test to screen hearing loss in the community.

BACKGROUND: Hearing impairment affects communication, social interactions, and quality of life. Audiometry is the gold standard method for hearing assessment. However, it is impractical in a country with limited resources. This study aimed to validate the Thai version of the Five-Minute Hearing Test (Thai-FMHT) to screen hearing loss in the community. METHODS: This prospective cohort study was conducted in Phu Wieng district, Khon Kaen Province, Thailand during July to September 2011. Subjects who were older than 18 years, could read or understand the Thai language, and wanted to participate were enrolled. Those who had aphasia, severe mental disability, or other conditions that precluded audiometry were excluded. The Thai-FMHT was first administered, followed by standard audiometry performed by audiologists who were blinded to the result of Thai-FMHT, and finally an ear examination was performed. This trial was registered with ClinicalTrial.gov as No. NCT01408992. RESULTS: The 558 subjects, including 176 males (32%) and 382 females (68%), completed all of the procedures. The optimal cutoff point for hearing loss in this screen was 8. The sensitivity, specificity, and positive likelihood ratio of the Thai-FMHT to screen mild hearing loss (PTA0.5-2 kHz >25 dB) were 64.7% (95% CI, 56.1-72.7%), 60.0% (95% CI, 55.1-64.7%), and 1.62 (95% CI, 1.36-1.92), respectively. Regarding screening moderate hearing loss (PTA0.5-2 kHz >40 dB), the sensitivity, specificity, and positive likelihood ratio of the Thai-FMHT were 93.1% (95% CI, 77.2-99.2%), 56.5% (95% CI, 55.1-64.7%), and 2.1 (95% CI, 1.9-2.5), respectively. CONCLUSION: The Thai-FMHT has a lower cutoff point than does the original one. This test is suitable for use as a screening tool for hearing loss in the community.