初次适配时助听器技术水平对老年聋患者自我报告结局的影响：一项随机对照试验。
Impact of hearing aid technology level at first-fit on self-reported outcomes in patients with presbycusis: a randomized controlled trial.
作者信息
Houmøller Sabina Storbjerg, Wolff Anne, Tsai Li-Tang, Narayanan Sreeram Kaithali, Hougaard Dan Dupont, Gaihede Michael Lyhne, Neher Tobias, Godballe Christian, Schmidt Jesper Hvass
机构信息
Research Unit for ORL-Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
出版信息
Front Aging. 2023 Jun 1;4:1158272. doi: 10.3389/fragi.2023.1158272. eCollection 2023.
To provide clinical guidance in hearing aid prescription for older adults with presbycusis, we investigated differences in self-reported hearing abilities and hearing aid effectiveness for premium or basic hearing aid users. Secondly, as an explorative analysis, we investigated if differences in gain prescription verified with real-ear measurements explain differences in self-reported outcomes. The study was designed as a randomized controlled trial in which the patients were blinded towards the purpose of the study. In total, 190 first-time hearing aid users (>60 years of age) with symmetric bilateral presbycusis were fitted with either a premium or basic hearing aid. The randomization was stratified on age, sex, and word recognition score. Two outcome questionnaires were distributed: the International Outcome Inventory for Hearing Aids (IOI-HA) and the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-12). In addition, insertion gains were calculated from real-ear measurements at first-fit for all fitted hearing aids. Premium hearing aid users reported 0.7 (95%CI: 0.2; 1.1) scale points higher total SSQ-12 score per item and 0.8 (95%CI: 0.2; 1.4) scale points higher speech score per item, as well as 0.6 (95%CI: 0.2; 1.1) scale points higher qualities score compared to basic-feature hearing aid users. No significant differences in reported hearing aid effectiveness were found using the IOI-HA. Differences in the prescribed gain at 1 and 2 kHz were observed between premium and basic hearing aids within each company. Premium-feature devices yielded slightly better self-reported hearing abilities than basic-feature devices, but a statistically significant difference was only found in three out of seven outcome variables, and the effect was small. The generalizability of the study is limited to community-dwelling older adults with presbycusis. Thus, further research is needed for understanding the potential effects of hearing aid technology for other populations. Hearing care providers should continue to insist on research to support the choice of more costly premium technologies when prescribing hearing aids for older adults with presbycusis. https://register.clinicaltrials.gov/, identifier NCT04539847.
为了为患有老年性聋的老年人提供助听器验配方面的临床指导，我们调查了高级或基本款助听器使用者在自我报告的听力能力和助听器效果方面的差异。其次，作为一项探索性分析，我们研究了通过真耳测量验证的增益验配差异是否能解释自我报告结果的差异。该研究设计为一项随机对照试验，患者对研究目的不知情。共有190名首次使用助听器的60岁以上双侧对称性老年性聋患者，分别验配了高级或基本款助听器。随机分组按年龄、性别和言语识别得分进行分层。发放了两份结果调查问卷：《国际助听器结果量表》（IOI-HA）和《言语、空间和听力质量量表简版》（SSQ-12）。此外，根据所有验配助听器首次佩戴时的真耳测量结果计算插入增益。与基本款助听器使用者相比，高级款助听器使用者报告的SSQ-12总分每项高0.7（95%CI：0.2；1.1）分，言语得分每项高0.8（95%CI：0.2；1.4）分，质量得分高0.6（95%CI：0.2；1.1）分。使用IOI-HA未发现报告的助听器效果有显著差异。各公司的高级款和基本款助听器在1kHz和2kHz处的验配增益存在差异。高级款助听器在自我报告的听力能力方面略优于基本款助听器，但在七个结果变量中只有三个有统计学显著差异，且效果较小。该研究的可推广性仅限于社区居住的老年性聋老年人。因此，需要进一步研究以了解助听器技术对其他人群的潜在影响。听力保健提供者在为患有老年性聋的老年人验配助听器时，应继续坚持进行研究，以支持选择成本更高的高级技术。https://register.clinicaltrials.gov/，标识符NCT04539847 。
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