使用患者报告的结果和听力学测量评估助听器的效果。
Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA,
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
出版信息
Audiol Neurootol. 2020;25(4):215-223. doi: 10.1159/000506666. Epub 2020 Apr 2.
PURPOSE
To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures.
METHODS
Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit.
RESULTS
Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively).
CONCLUSION
Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.
目的
确定患者报告的结果和听力学测量对助听器效果的贡献。
方法
对中耳植入物 FDA 临床试验中收集的助听器效果的听力学和患者报告结果进行独立审查。从 95 名经验丰富的助听器使用者的术前资料中提取未助听和助听数据，并评估患者报告的结果与听力学测量之间的关系。提取的数据包括：未助听和助听听阈（纯音或啭音）（PTA）、安静环境下的言语识别（NU-6）、噪声环境下的言语感知（低/高语境 SPIN）以及患者报告的受益（助听器受益简明量表，APHAB）。助听器效果定义为声场中测量的未助听和助听条件下的阈值或评分差异。计算了听力学测量值与全球 APHAB 和助听器受益子量表评分之间的相关性。
结果
与未助听相比，所有听力学测量值和 APHAB 评分均有显著改善（均 p < 0.001）。然而，助听听力学和患者报告的助听表现或助听器受益测量值之间的相关性较低或较弱，甚至不存在。未发现助听听力学测量值（PTA、NU-6、SPIN）与任何助听 APHAB 评分之间存在显著相关性（均 p > 0.0125），且除了少数例外，助听器受益与大多数助听 APHAB 评分之间不存在显著关系。使用 NU-6 和 SPIN 评分的全球 APHAB 定义的助听器受益与言语感知测试（r = 0.37，p < 0.001；r = 0.28，p = 0.005）和言语可懂度 APHAB 子量表评分（r = 0.32，p < 0.001；r = 0.33，p = 0.001）呈显著正相关。
结论
使用听力学测量评估的助听器效果是患者报告受益的不良预测指标。因此，患者报告的结果可能为患者对助听器受益的感知提供独特的评估，这可用于指导助听器编程、培训或推荐替代听力服务。
Zotero 插件