Speech perception,real-ear measurements and self-perceived hearing impairment after remote and face-to-face programming of hearing aids: A randomized single-blind agreement study
Restricted accessResearch articleFirst published online September, 2021
Speech perception,real-ear measurements and self-perceived hearing impairment after remote and face-to-face programming of hearing aids: A randomized single-blind agreement study
Current literature does not provide strong evidence that remote programming of hearing aids is effective, despite its increasing use by audiologists. We tested speech perception outcomes, real-ear insertion gain, and changes in self-perceived hearing impairment after face-to-face and remote programming of hearing aids in a randomized multicentre, single-blind crossover study.
Methods
Adult experienced hearing aid users were enrolled during routine follow-up visits to audiology clinics. Hearing aids were programmed both face to face and remotely, then participants randomly received either the face-to-face or remote settings in a blinded manner and were evaluated 5 weeks later. Participants then received the other settings and were evaluated 5 weeks later.
Results
Data from 52 out of 60 participants were analysed. We found excellent concordance in performance of hearing aids programmed face to face and remotely for speech understanding in quiet (phonetically balanced kindergarten test – intraclass correlation coefficient of 0.92 (95% confidence interval: 0.87–0.95)), and good concordance in performance for speech understanding in noise (phonetically balanced kindergarten +5 dB signal-to-noise ratio – intraclass correlation coefficient of 0.71 (95% confidence interval: 0.55–0.82)). Face-to-face and remote programming took 10 minutes (±2.9) and 10 minutes (±2.8), respectively. Real-ear insertion gains were highly correlated for input sound at 50, 65 and 80 dB sound pressure levels. The programming type did not affect the abbreviated profile of hearing aid questionnaire scores.
Conclusions
In experienced hearing aid users, face-to-face and remote programming of hearing aids give similar results in terms of speech perception, with no increase in the time spent on patients’ care and no difference in self-reported hearing benefit.
DavisAMcMahonCMPichora-FullerKM, et al.
Aging and hearing health: The life-course approach.Gerontologist2016;
56Suppl 2: S256–67.
2.
EmmettSDFrancisHW.The socioeconomic impact of hearing loss in U.S. adults.Otol Neurotol2015;
36: 545–550.
3.
LinFRThorpeRGordon-SalantS, et al.
Hearing loss prevalence and risk factors among older adults in the United States.J Gerontol. Series A, Biolog Sci Me Sci2011;
66: 582–590.
4.
KochkinS.MarkeTrak VIII: 25 years trends in the hearing market.Hearing Rev2009;
16: 12–31.
5.
KochkinS.MarkeTrak VIII: The key influencing factors in hearing aid purchase intent.Hear Rev2012;
19: 12–25.
6.
SwanepoelDClarkJLKoekemoerD, et al.
Telehealth in audiology: The need and potential to reach underserved communities.Int J Audiol2010;
49: 195–202.
7.
Molini-AvejonasDRRondon-MeloSAmatoCA, et al.
A systematic review of the use of telehealth in speech, language and hearing sciences.J Telemed Telecare. 2015;
21: 367–376.
8.
SwanepoelDHallJW3rd.A systematic review of telehealth applications in audiology.Telemed J E-Health Off J Am Telemed Assoc. 2010;
16: 181–200.
9.
TaoKFMBrennan-JonesCGCapobianco-FavaDM, et al.
Teleaudiology services for rehabilitation with hearing aids in adults: A systematic review.J Speech Lang Hear Res2018;
61: 1831–1849.
10.
CamposPDFerrariDV.Teleaudiology: evaluation of teleconsultation efficacy for hearing aid fitting.J Soc Brasil Fonoaudiol2012;
24: 301–308.
11.
JacobsPGSaundersGH.New opportunities and challenges for teleaudiology within Department of Veterans Affairs.J Rehab Res Dev2014;
51: vii–xii.
12.
MaroneSBattistellaLRamosS, et al.
Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy.Int Arch Otorhinolaryngol2013;
16: 371–381.
13.
PenteadoSPRamos SdeLBattistellaLR, et al.
Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy.Int Arch Otorhinolaryngol2012;
16: 371–381.
14.
ProssSEBourneALCheungSW.TeleAudiology in the Veterans Health Administration.Otol Neurotol2016;
37: 847–850.
15.
PolonenkoMJScollieSDMoodieS, et al.
Fit to targets, preferred listening levels, and self-reported outcomes for the DSL v5.0 a hearing aid prescription for adults.Int J Audiol2010;
49: 550–560.
16.
LupiAL. Essai d’adaptation, à la langue française, d’un test d’intelligibilité américain, le « phonetically balanced kindergarten word lists » ou PBK-50 (Haskins, 1949). Speech Therapy Department. Montpellier: University of Montpellier, France, 1998.
17.
CoxRMAlexanderGC.The abbreviated profile of hearing aid benefit.Ear Hear1995;
16: 176–186.
18.
VincentCGagneJPLerouxT, et al.
French-Canadian translation and validation of four questionnaires assessing hearing impairment and handicap.Int J Audiol2017;
56: 248–259.
19.
KottnerJAudigeLBrorsonS, et al.
Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed.Int J Nurs Stud2011;
48: 661–671.
20.
LiaoJJ.Quantifying an agreement study.Int J Biostat. 2015;
11: 125–133.
21.
ShroutPEFleissJL.Intraclass correlations: Uses in assessing rater reliability.Psychol Bull1979;
86: 420–428.
22.
BeattieRCEdgertonBJ.Reliability of monosyllabic discrimination tests in white noise for differentiating among hearing aids.J Speec Hear Disord1976;
41: 464–476.
23.
EngelbergM.Test-retest variability in speech discrimination testing.Laryngosc. 1968;
78: 1582–1589.
24.
HawleyMLSherlockLPFormbyC.Intra- and intersubject variability in audiometric measures and loudness judgments in older listeners with normal hearing.Sem Hear2017;
38: 3–25.
25.
NelsonPBNieYSvecA, et al.
Variability in speech understanding in noise by listeners with hearing loss.J Acoust Soc Am2012;
132: 2077.
26.
MarriageJMooreBCAlcantaraJI.Comparison of three procedures for initial fitting of compression hearing aids. III. Inexperienced versus experienced users.Int J Audiol2004;
43: 198–210.
27.
MooreBCAlcantaraJIMarriageJ.Comparison of three procedures for initial fitting of compression hearing aids. I. Experienced users, fitted bilaterally.Braz J Audiol2001;
35: 339–353.
28.
EikelboomRHAtlasMD.Attitude to telemedicine, and willingness to use it, in audiology patients.J Telemed Telec2005;
11Suppl 2: S22–5.
29.
ReginatoTTPFerrariDV.Teleaudiology: Professional-patient communication in hearing aid programming and fitting via teleconsultation.Audiol Comm Res2014;
19: 299–309.
SinghGPichora-FullerMKMalkowskiM, et al.
A survey of the attitudes of practitioners toward teleaudiology.Int J Audiol2014;
53: 850–860.
32.
LancasterPKrummMRiberaJ, et al.
Remote hearing screenings via telehealth in a rural elementary school.Am J Audiol2008;
17: 114–122.
33.
PenteadoSPBentoRFBattistellaLR, et al.
Use of the satisfaction with amplification in daily life questionnaire to assess patient satisfaction following remote hearing aid adjustments (telefitting).J Med Internet Res Med Inform2014;
2: e18.
34.
FerrariDVBernardez-BragaGR.Remote probe microphone measurement to verify hearing aid performance.J Telemed Telecare. 2009;
15: 122–124.
35.
RiberaJ.Interjudge reliability and validation of telehealth applications of the hearing in noise test.Sem Hearing2005;
26: 13–18.
36.
KokeshJFergusonASPatricoskiC, et al.
Digital images for postsurgical follow-up of tympanostomy tubes in remote Alaska.Otolaryngol Head Neck Surg2008;
139: 87–93.
37.
SmithACPerryCAgnewJ, et al.
Accuracy of pre-recorded video images for the assessment of rural indigenous children with ear, nose and throat conditions.J Telemed Telecare. 2006;
12 (Suppl. 3.): 76–80.
38.
KrummMHuffmanTDickK, et al.
Telemedicine for audiology screening of infants.J Telemed Telecare2008;
14: 102–104.
RamkumarVHallJWNagarajanR, et al.
Tele-ABR using a satellite connection in a mobile van for newborn hearing testing.J Telemed Telecare2013;
19: 233–237.
41.
SwanepoelDEbrahimS.Auditory steady-state response and auditory brainstem response thresholds in children.Eur Arch Otorhinolaryngol2009;
266: 213–219.
42.
BexeliusCHonethLEkmanA, et al.
Evaluation of an internet-based hearing test–comparison with established methods for detection of hearing loss.J Med Int Res2008;
10: e32.
43.
ChoiJMLeeHBParkCS, et al.
PC-based tele-audiometry.Telemed J E-Health Off J Am Telemed Assoc2007;
13: 501–508.
44.
GivensGDElangovanS.Internet application to tele-audiology–“nothin' but net”.Am J Audiol2003;
12: 59–65.
45.
Laplante-LevesqueAPichora-FullerMKGagneJP.Providing an internet-based audiological counselling programme to new hearing aid users: A qualitative study.Int J Audiol2006;
45: 697–706.
46.
HughesMLGoehringJLBaudhuinJL, et al.
Use of telehealth for research and clinical measures in cochlear implant recipients: a validation study.J Speech Lang Hear Res2012;
55: 1112–1127.
47.
KuzovkovVYanovYLevinS, et al.
Remote programming of MED-EL cochlear implants: Users' and professionals' evaluation of the remote programming experience.Acta Otolaryngologica2014;
134: 709–716.
48.
McElveenJTJrBlackburnELGreenJDJr, et al.
Remote programming of cochlear implants: A telecommunications model.Otol Neurotol2010;
31: 1035–1040.
49.
RamosARodriguezCMartinez-BeneytoP, et al.
Use of telemedicine in the remote programming of cochlear implants.Acta Otolaryngolog2009;
129: 533–540.
50.
SamuelPAGoffi-GomezMVBittencourtAG, et al.
Remote programming of cochlear implants. Comm Disord Audiol Swallow2014;
26: 481–486.
51.
WesendahlT.Hearing aid fitting: Application of telemedicine in audiology.Int Tinnitus J. 2003;
9: 56–58.
