ABSTRACT
OBJECTIVE: During the ongoing Covid-19 pandemic, many patients cancelled their scheduled hearing aid renewal. We offered to send them new hearing aids programmed according to the audiometric data on file. In this study we compared remote hearing aid renewal to a conventional renewal with a recent audiogram based on scores from the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. We also examined the need for a physical visit for hearing aid adjustment in the remote group and analysed the accuracy of the pre-existing audiogram correction method using data from the control group. DESIGN: Retrospective chart review. STUDY SAMPLE: 51 patients who underwent remote hearing aid renewal and 22 control patients who received office-based hearing aid renewal. RESULTS: IOI-HA scores were lower in the remote fitted group, but comparison with data from a Swedish nationwide database had no clinically significant differences. A follow-up physical appointment was required in only 20% of the remote group. The intraclass correlation coefficient (ICC) between the pure tone averages of the corrected former audiogram and measured audiogram was high. CONCLUSIONS: Remote hearing aid renewal using existing audiometric data is feasible, and most physical visits can be avoided.
Subject(s)
COVID-19 , Hearing Aids , Humans , Retrospective Studies , Patient Satisfaction , Pandemics , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To evaluate the accuracy of primary health care audiograms conducted by non-qualified examiners in a non-standard acoustic environment. STUDY DESIGN: Retrospective chart review. SETTING: Referring primary health care institutions and hospital hearing center. PATIENTS: One thousand two hundred twenty four adult patients evaluated for hearing aid fitting at North Karelia Central hospital in years 2017 and 2018. MAIN OUTCOME MEASURES: Intraclass correlation coefficient (ICC), mean threshold differences, and mean absolute errors were used to assess agreement between primary health care and hospital audiograms. Primary health care audiometry sensitivity, specificity and positive (PPV) and negative (NPV) predictive values were calculated for hearing aid candidacy in general and open ear mold candidacy in particular. RESULTS: ICC for both better ear hearing level (BEHL0.5,1,2,4â kHz) and pure-tone average (PTA0.5,1,2,4â kHz) in frequencies 0.5, 1, 2, and 4âkHz was 0.82, and in individual full octave frequencies from 0.125 to 8âkHz ranged from 0.70 to 0.83. Mean threshold differences in BEHL0.5,1,2,4â kHz and PTA0.5,1,2,4â kHz were 1.8 and 1.6âdB and mean absolute errors 4.9 and 5.3âdB, respectively. Sensitivity for hearing aid candidacy was 0.97, specificity 0.58, PPV 0.92, and NPV 0.79. CONCLUSIONS: Primary health care audiometry is reasonably accurate, allowing preselection of patients to adequate hearing care pathways.
Subject(s)
Primary Health Care , Adult , Audiometry, Pure-Tone , Auditory Threshold , Humans , Reproducibility of Results , Retrospective StudiesABSTRACT
Acute epiglottitis is nowadays a rare bacterial infection. Airway management and promptly started antimicrobial medication are essential in the treatment. Descending necrotizing mediastinitis is a life-threatening bacterial infection that typically spreads from an odontogenic, pharyngeal or neck infection. Despite the vagueness of symptoms, diagnosis must be made quickly. Owing to the high mortality rate, aggressive surgical treatment is indicated.
Subject(s)
Epiglottitis/diagnosis , Epiglottitis/therapy , Acute Disease , Anti-Infective Agents/therapeutic use , Diagnosis, Differential , Epiglottitis/complications , Humans , Male , Mediastinitis/etiology , Mediastinitis/therapy , Middle Aged , NecrosisABSTRACT
Hearing is usually examined by means of pure tone and speech audiometry. Alternative examinations are required when the level of hearing defect needs to be more closely defined or hearing is being measured from a patient who is unable to give reliable feedback on a test sound. Neonatal hearing screening involves measuring of otoacoustic emissions generated in the cochlea of the inner ear or brain stem responses formed within the auditory pathway. Immittance measurements are used to evaluate the function of the middle ear. Most commonly used methods include tympanometry probing the mobility of the tympanic membrane and middle ear pressure, and acoustic reflex assessing the functionality of the ossicular chain.
