The Gaps between Knowing and Doing in Hearing Aid Fitting Management

Evidence based practice has become an important aspect in many healthcare provisions to improve patient outcomes. Investigating the gaps between knowing and doing in audiology practice will provide future directions for successful service delivery. The purpose of this study was to explore “know-do” gaps related to professional awareness and attitude in hearing aid fitting management (HAFM) by analyzing data of a questionnaire. It consisted of 22 questions focusing on 11 HAFM components. Each component had two sub-questions involving levels of the importance and practice for HAFM. Respondents answered each question based on subjective judgments for their own hearing aid fitting services with a Visual Analogue Scale. A total of 51 responses from hearing care professionals were collected and the scores for knowing and doing were compared. The results showed overall high scores in doing and knowing responses; however, there were significant “know-do” gaps demonstrating higher knowing scores than doing scores across all HAFM components. The largest “know-do” gaps were observed in three components mostly implemented during follow-up sessions which indicate the need to improve their corresponding services and practical guidelines emphasizing the follow-up services.

Preferred Compression Threshold and Release Time in Quiet and Noisy Conditions for Elderly Korean Hearing Aid Users

BACKGROUND AND OBJECTIVES: Listeners with sensorineural hearing loss want to compensate for their narrow dynamic range from appropriate compression functions of hearing aids. The present study aimed to determine which compression threshold and release time of nonlinear hearing aids might affect speech recognition and speech quality judgments. SUBJECTS AND METHODS: Ten elderly listeners with symmetrical moderate-to-severe sensorineural hearing loss participated in the study. To compare two compression threshold (31 dB SPL vs. 61 dB SPL) and two release time (50 ms vs. 500 ms) conditions, subjects’ speech recognition was measured using the Korean version of the Hearing in Noise Test in both quiet and noisy situations. All subjects were also asked to rate the degree of speech quality in terms of loudness, sharpness, clarity, and background noise immediately after completing the speech recognition test. RESULTS: Although no significant difference emerged in speech recognition thresholds between the two compression thresholds in the quiet situation, the compression threshold of 31 dB SPL showed a lower (or better) signal-to-noise ratio of speech recognition compared to that of 61 dB SPL. The release times of 50 and 500 ms did not statistically differ in both quiet and noisy situations. Subjective categories were found to be louder and clearer in the 50 ms release time for quiet and noisy, respectively. CONCLUSIONS: We expect that these patterns of current results will apply for better-fitting protocol of elderly Korean hearing aid users.

Preferred Compression Threshold and Release Time in Quiet and Noisy Conditions for Elderly Korean Hearing Aid Users

BACKGROUND AND OBJECTIVES: Listeners with sensorineural hearing loss want to compensate for their narrow dynamic range from appropriate compression functions of hearing aids. The present study aimed to determine which compression threshold and release time of nonlinear hearing aids might affect speech recognition and speech quality judgments. SUBJECTS AND METHODS: Ten elderly listeners with symmetrical moderate-to-severe sensorineural hearing loss participated in the study. To compare two compression threshold (31 dB SPL vs. 61 dB SPL) and two release time (50 ms vs. 500 ms) conditions, subjects’ speech recognition was measured using the Korean version of the Hearing in Noise Test in both quiet and noisy situations. All subjects were also asked to rate the degree of speech quality in terms of loudness, sharpness, clarity, and background noise immediately after completing the speech recognition test. RESULTS: Although no significant difference emerged in speech recognition thresholds between the two compression thresholds in the quiet situation, the compression threshold of 31 dB SPL showed a lower (or better) signal-to-noise ratio of speech recognition compared to that of 61 dB SPL. The release times of 50 and 500 ms did not statistically differ in both quiet and noisy situations. Subjective categories were found to be louder and clearer in the 50 ms release time for quiet and noisy, respectively. CONCLUSIONS: We expect that these patterns of current results will apply for better-fitting protocol of elderly Korean hearing aid users.

The Band-Importance Function for the Korean Standard Sentence Lists for Adults

BACKGROUND AND OBJECTIVES: The band-importance function (BIF) refers to a value characterizing the relative importance of different frequencies to speech intelligibility. The purpose of this study was to derive the BIF for the Korean standard sentence lists for adults (KS-SL-A). SUBJECTS AND METHODS: In this study, sentences from the KS-SL-A were used as the speech material. Twenty-six normal-hearing Korean listeners participated and intelligibility scores in 8 filters with 3 signal-to-noise ratio conditions were obtained. Based on the intelligibility score percentages, the BIF for the KS-SL-A was derived by using an established protocol. RESULTS: Band-importance weights varied across frequency bands. The most important frequency region was around 316 Hz (20.0%), and the importance of the frequency bands below the center frequency (CF) of 1,778 Hz was 59.6%. Therefore, low frequencies below the CF of 1,778 Hz were more important than high frequencies above the CF of 1,778 Hz. CONCLUSIONS: The BIF for KS-SL-A could be applied towards developing a hearing aid fitting formulae for Korean listeners.

A Systematic Review of Audiology Terminology

The present report provides an overview of terminology studies in audiology including topics and study characteristics, as well as categorizing the main issues. The goals are to improve the understanding of the current issues for terminology in audiology and to provide some basic information that will be useful to develop an international standard. Search procedures were completed over two phases. Phase 1 included a systematic electronic searches using MEDLINE (PubMed), Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and International Organization for Standardization with keywords related to terminology of audiology. The studies were initially identified according to the titles of 2921 publications following careful abstract examination. Of these, whole texts of 16 publications were retrieved. Five papers met the inclusion criteria were further investigated. In phase 2, a manual search was conducted to collect additional publications with keywords related to terminology project in audiology. A total of 16 papers were found. The essential terminology issues classified included 'appropriateness,' 'classification/framework,' 'inconsistency of terminology,' 'multilingual and international aspects,' and 'service quality/delivery including communication and accessibility.' This was indicative of the paucity of terminology research in audiology, despite recurring terminology issues. Establishment of standardized terminology in audiology may minimize current challenging terminology issues by improving appropriateness and consistency of terminology as well as communication among relevant stakeholders at national and international levels.

General Framework of Hearing Aid Fitting Management

Hearing aids are one of the most widely used treatment options for the hearing impaired and optimal outcomes of hearing aids are supported by comprehensive hearing aid fitting protocols. Currently, the term 'hearing aid fitting' is prevalently used among service and industry sectors with its comprehensive procedures not systematically explicated. In addition, a variety of non-normalized guidelines for hearing aid fitting has led to non-uniform care, outcome variability, and dissatisfaction of the use of hearing aids. The main purpose of the present study is to suggest a general framework of standardized practice for hearing aid fitting management including its pre- and post-fitting stages. The management framework centers on its fitting process with its prior steps of assessment as well as its posterior steps of follow-up, thereby eliminating diverging interpretations and non-uniform practices. Outcomes of this study are also expected to improve potential benefits such as quality of hearing aid fitting, user satisfaction, and cost effectiveness across relevant stakeholders.

Test-Retest Reliability of Word Recognition Score Using Korean Standard Monosyllabic Word Lists for Adults as a Function of the Number of Test Words

BACKGROUND AND OBJECTIVES: The purpose was to establish the test-retest reliability of word recognition score (WRS) using Korean standard monosyllabic word lists for adults (KS-MWL-A) recently developed based on the international standard for speech audiometry (ISO 8253-3:2012). SUBJECTS AND METHODS: Subjects consisted of 159 adults aged to 18 to 25 years with normal hearing sensitivity. WRSs were obtained in 2 dB steps from the level of speech recognition thresholds to the level of 86% correct responses or greater. After one or two weeks, retest was performed. Correlation, confidence interval (CI) and prediction interval (PI) were calculated for the reliability. RESULTS: Correlation coefficients were 0.88 for 50 test words, 0.76 for 25 and 0.61 for 10 words. Results also showed that 95% CIs and PIs were narrower for 25 and 50 test words than those for 10 test words. CONCLUSIONS: Korean WRS using the KS-MWL-A has high reliability for 25 and 50 test words, but relatively low for 10 words. It suggested that 95% CIs for each test words would be criteria for significant differences in WRS for groups and 95% PIs at each score of WRS could be utilized for a considerable difference for each individual at retest.

Hearing Thresholds for a Geriatric Population Composed of Korean Males and Females

BACKGROUND AND OBJECTIVES: The purpose of the present study was to provide the hearing threshold levels in the elderly Korean population, and to compare Korean data with that in the International Organization for Standardization (ISO) 7029 (2000). SUBJECTS AND METHODS: Data were collected from a total of 526 ears from 112 males and 151 females aged 60-84 years. All participants were screened otologically by the procedure given in ISO 8253-1 (2010). RESULTS: Results showed that the pure-tone average was gradually elevated with increasing age. The amount of hearing loss was greater in males than in females, and the high frequency hearing thresholds were worse than the low frequency hearing thresholds in males and females. The hearing threshold levels were higher at low frequencies in males and at all frequencies in females than the norms of ISO 7029 (2000). CONCLUSIONS: Results from this study will be partly used for standardization of hearing thresholds as a function of age in Korea and for updating the ISO 7029.