Objectives: Hearing aids (HAs) provide the basis for improving audibility and minimizing developmental delays in children with mild to severe hearing loss. Multiple guidelines exist to recommend methods for optimizing amplification in children, but few previous studies have reported HA fitting outcomes for a large group of children. The present study sought to evaluate the proximity of the fitting to prescriptive targets and aided audibility of speech, as well as survey data from pediatric audiologists who provided HAs for the children in the present study. Deviations from prescriptive target were predicted to have a negative impact on aided audibility. In addition, children who were fitted using verification with probe microphone measurements were expected to have smaller deviations from prescriptive targets and greater audibility than cohorts fitted without these measures.
Design: HA fitting data from 195 children with mild to severe hearing losses were analyzed as part of a multicenter study evaluating outcomes in children with hearing loss. Proximity of fitting to prescriptive targets was quantified by calculating the average root-mean-square (RMS) error of the fitting compared with Desired Sensation Level prescriptive targets for 500, 1000, 2000, and 4000 Hz. Aided audibility was quantified using the Speech Intelligibility Index. Survey data from the pediatric audiologists who fit amplification for children in the present study were collected to evaluate trends in fitting practices and relate those patterns to proximity of the fitting to prescriptive targets and aided audibility.
Results: More than half (55%) of the children in the study had at least 1 ear that deviated from prescriptive targets by more than 5 dB RMS on average. Deviation from prescriptive target was not predicted by pure-tone average, assessment method, or reliability of assessment. Study location was a significant predictor of proximity to prescriptive target with locations that recruited participants who were fit at multiple clinical locations (University of Iowa and Boys Town National Research Hospital) having larger deviations from target than the location where the participants were recruited primarily from a single, large pediatric audiology clinic (University of North Carolina). Fittings based on average real-ear to coupler differences resulted in larger deviations from prescriptive targets than fittings based on individually measured real-ear to coupler differences. Approximately 26% of the children in the study has aided audibility less than 0.65 on the Speech Intelligibility Index (SII). Aided audibility was significantly predicted by the proximity to prescriptive targets and pure-tone average, but not age in months.
Conclusions: Children in the study had a wide range of fitting outcomes in terms of proximity to prescriptive targets (RMS error) and aided speech audibility (SII). Even when recommended HA verification strategies were reported, fittings often exceeded the criteria for both proximity to the prescriptive target and aided audibility. The implications for optimizing amplification for children are also discussed.
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http://dx.doi.org/10.1097/AUD.0b013e31828f1033 | DOI Listing |
Ear Hear
January 2025
Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany.
Objectives: Hearing aids (HAs) are a widely accepted first-line treatment option for individuals suffering from both hearing loss and chronic tinnitus. Though HAs are highly effective at improving speech understanding, their effectiveness in ameliorating tinnitus symptoms is less clear. In recent years, several investigators have reported on attempts to predict HAs effectiveness on tinnitus symptoms using an array of variables.
View Article and Find Full Text PDFPLoS One
January 2025
Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Within competency-based medical education (CBME) residency programs, Entrustable Professional Activity (EPA) assessments endeavor to both bolster learning and inform promotion decisions. Recent implementation studies describe successes but also adverse effects, including residents and preceptors drifting towards bureaucratic / purely administrative behaviors and attitudes, although the drivers behind this tendency are not adequately understood. This study sought to examine resident and faculty experiences with implemented EPA processes to elucidate what leads them toward a 'tick-box' approach that has been described in the literature.
View Article and Find Full Text PDFAm J Crit Care
January 2025
Mona N. Bahouth is medical director, Brain Rescue Unit and an associate professor of neurology, Johns Hopkins University School of Medicine.
Background: Therapeutic activity after stroke is a component of early recovery strategies. Interactive video games have been shown to be safe as an adjunct rehabilitation therapy in the medical intensive care setting, but patients with neurologic disease were often excluded from those protocols.
Objectives: To evaluate the feasibility and safety of individualized interactive video game therapy in critically ill neurologic patients.
Front Artif Intell
October 2024
Institute of Informatics, LMU Munich, Munich, Germany.
Machine learning has made tremendous progress in predictive performance in recent years. Despite these advances, employing machine learning models in high-stake domains remains challenging due to the opaqueness of many high-performance models. If their behavior cannot be analyzed, this likely decreases the trust in such models and hinders the acceptance of human decision-makers.
View Article and Find Full Text PDFPsychiatry Res
December 2024
University of California, Berkeley, CA, USA.
Background: Quantitative research on non-randomized-samples, focused on statute-mandated-outcomes, has found positive results favoring compulsory-community-treatment (CCT) in jurisdictions fully supporting its implementation. In contrast, three randomized-studies "failed-to-find" a difference between randomly-assigned-CCT and control-groups-each study repeatedly summarized in revisions of a Cochrane-meta-analysis reporting this failure. Considering the potential health and safety threats to people with severe-mental-illness and those with whom they interact, there is a critical need for this investigation to resolve these conflicting results.
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