Geographic Distribution of the Hearing Aid Dispensing Workforce: A Teleaudiology Planning Assessment for Arizona

Coco, Laura; Titlow, Kyle Sorlie; Marrone, Nicole

doi:10.1044/2018_aja-imia3-18-0012

Cited by 29 publications

(12 citation statements)

References 33 publications

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“…There is a shortage of audiological professionals around the world (Kamenov et al 2021), and the COVID-19 pandemic has further amplified the difficulties experienced by CI recipients accessing CI services (Ayas et al 2020). Currently, audiology services are concentrated in densely populated areas and teleaudiology can serve as a great way to provide access to patients living at a distance from the treatment center (Coco et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant Recipients

2021

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Background: A new Remote Check App permits remote self-testing of hearing function for Nucleus cochlear implant (CI) recipients and enables asynchronous review by their clinician to support patient-management decisions.Objectives: To evaluate the Remote Check App for: (1) ease of use; (2) overall acceptance of the test battery by CI recipient or their carer in the home setting; (3) test-retest reliability of audiological threshold and speech recognition measures via wireless streaming; and (4) to compare outcomes from patient-driven measures with conventional cliniciandriven measurements of aided-hearing function.Design: Single-site, prospective, repeated-measures cohort study with 32 experienced CI users (28 adults and 4 children).Methods: Participants completed self-testing using the Remote Check app at home and in the clinic. Measures include audiological, objective and subjective tests. Self-administered speech recognition in noise, via the digit triplets test (DTT) and aided thresholds, via the aided threshold test (ATT) were reassessed in free-field and by clinicians following conventional clinical protocols. Results of ATT and DTT were compared across test conditions. Completion time and perceived ease of selfdriven assessments were documented. Insights from subsequent realworld experience with Remote Check are summarized and compared to the study findings. Results:Remote Check was rated as easy to use by the majority (87%) of subjects. Mean group test-retest score differences for self-administered testing within the clinic versus at-home environments were nonsignificant (p > 0.05): 1.4 dB (SD = 1.97) for ATT and 1.6 dB (SD = 1.54) for DTT. Mean group test-retest score difference for patient-driven DTT in streamed versus the free-field condition was 1.8 dB (SD = 2.02). Selfadministered, streamed, ATT via Remote Check, resulted in significantly lower thresholds compared to clinician-driven warble-tone thresholds in the free-field by 6.7 dB (SD = 6.8) (p < 0.001). ATT thresholds via Remote Check were not significantly different from predicted thresholds based on the Threshold Sound Pressure Level of the sound processor. Conclusion:Remote Check is the first CI telehealth assessment tool that uses wireless streaming to enable comprehensive, easy and reliable self-testing of hearing function by the CI recipient or their carer, in the comfort of their home. Asynchronous access to test results can assist clinicians in monitoring and triaging individuals for appropriate patient-management based on their needs. Use of remote monitoring may also help to reduce the burden of unnecessary clinic visits on clinic resources, patient travel time and associated costs. Remote Check is an important step toward addressing the current growing need for asynchronous audiological telepractice to support long-term care of CI recipients.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant Recipients

2021

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“…Audiologists predominately practice in urban areas and in areas with individuals with higher income, with fewer audiologists in Southern and Western states [45]. For example, out of 15 counties in the state of Arizona, there were no audiologists practicing in six of those counties [46]. As the United States population ages and the prevalence of hearing loss increases, the demand for hearing healthcare professionals will rise.…”

Section: Access To Hearing Healthcarementioning

confidence: 99%

Socioeconomic position and hearing loss: current understanding and recent advances

Malcolm

Suen

Nieman

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewThe purpose of this review is to describe recent literature examining the relationship between socioeconomic position (SEP) and hearing loss, including the impact of hearing loss on several socioeconomic outcomes over the life course. Additionally, we highlight current policy advances in recent years and review alternative models of hearing care that aim to address disparities related to SEP and hearing healthcare. Recent findingsApplying a social epidemiologic lens to hearing health gives insight into the role of material and social contexts in understanding and improving hearing health outcomes. Recent studies investigating the intersection of SEP and hearing health highlight the disparities that exist for individuals with low SEP as well as the influence of hearing loss on SEP. Individuals with hearing loss are more likely to be unemployed, have lower educational attainment, lower income, and are less likely to use hearing aids and access hearing care. Legislation addressing cost and access to hearing care as well as transforming the current landscape of hearing care, is essential to creating equitable care for individuals, especially older adults, with low SEP.

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“…The PART application has already been used successfully to collect data both in the laboratory [ 11 , 12 , 13 , 14 ] and remotely with participant-owned equipment in their own homes [ 15 , 16 ]. Currently in the United States, the limited availability of hearing healthcare professionals relative to the number of people with hearing loss limits access to hearing healthcare, particularly in rural areas—a gap that will be exacerbated by the projected growth of the aging population [ 17 , 18 , 19 ]. The use of portable technologies such as PART can improve access to hearing healthcare for patients who have difficulty traveling to the clinic and will allow research investigators to recruit and test a more diverse population of study participants [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Relating Suprathreshold Auditory Processing Abilities to Speech Understanding in Competition

et al. 2022

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(1) Background: Difficulty hearing in noise is exacerbated in older adults. Older adults are more likely to have audiometric hearing loss, although some individuals with normal pure-tone audiograms also have difficulty perceiving speech in noise. Additional variables also likely account for speech understanding in noise. It has been suggested that one important class of variables is the ability to process auditory information once it has been detected. Here, we tested a set of these “suprathreshold” auditory processing abilities and related them to performance on a two-part test of speech understanding in competition with and without spatial separation of the target and masking speech. Testing was administered in the Portable Automated Rapid Testing (PART) application developed by our team; PART facilitates psychoacoustic assessments of auditory processing. (2) Methods: Forty-one individuals (average age 51 years), completed assessments of sensitivity to temporal fine structure (TFS) and spectrotemporal modulation (STM) detection via an iPad running the PART application. Statistical models were used to evaluate the strength of associations between performance on the auditory processing tasks and speech understanding in competition. Age and pure-tone-average (PTA) were also included as potential predictors. (3) Results: The model providing the best fit also included age and a measure of diotic frequency modulation (FM) detection but none of the other potential predictors. However, even the best fitting models accounted for 31% or less of the variance, supporting work suggesting that other variables (e.g., cognitive processing abilities) also contribute significantly to speech understanding in noise. (4) Conclusions: The results of the current study do not provide strong support for previous suggestions that suprathreshold processing abilities alone can be used to explain difficulties in speech understanding in competition among older adults. This discrepancy could be due to the speech tests used, the listeners tested, or the suprathreshold tests chosen. Future work with larger numbers of participants is warranted, including a range of cognitive tests and additional assessments of suprathreshold auditory processing abilities.

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Geographic Distribution of the Hearing Aid Dispensing Workforce: A Teleaudiology Planning Assessment for Arizona

Cited by 29 publications

References 33 publications

Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant Recipients

Evaluation of Remote Check: A Clinical Tool for Asynchronous Monitoring and Triage of Cochlear Implant Recipients

Socioeconomic position and hearing loss: current understanding and recent advances

Relating Suprathreshold Auditory Processing Abilities to Speech Understanding in Competition

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