Department(s), Clinical and Experimental Audiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Otolaryngology Head and Neck Surgery, Ear and Hearing, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Boelelaan, The Netherlands.
Ear Hear. 2023;44(6):1514-1525. doi: 10.1097/AUD.0000000000001393. Epub 2023 Jun 9.
Hearing aids are an essential and important part of hearing rehabilitation. The combination of technical data on hearing aids and individual rehabilitation needs can give insight into the factors that contribute to the success of rehabilitation. This study sets out to investigate if different subgroups of (comparable) hearing aids lead to differences in the success of rehabilitation, and whether these differences vary between different domains of auditory functioning.
This study explored the advantages of including patient-reported outcome measures (PROMs) in the process of purchasing new hearing aids in a large sample of successful hearing aid users. Subject data were obtained from 64 (commercial) hearing aid dispensers and 10 (noncommercial) audiological centers in the Netherlands. The PROM was a 32-item questionnaire and was used to determine the success of rehabilitation using hearing aids by measuring auditory disability over time. The items were mapped on six domains of auditory functioning: detection, discrimination, localization, speech in quiet, speech in noise, and noise tolerance, encompassing a variety of daily-life listening situations. Hearing aids were grouped by means of cluster analysis, resulting in nine subgroups. In total, 1149 subjects were included in this study. A general linear model was used to model the final PROM results. Model results were analyzed via a multifactor Analysis of Variance. Post hoc analyses provided detailed information on model variables.
Results showed a strong statistically significant effect of hearing aids on self-perceived auditory functioning in general. Clinically relevant differences were found for auditory domains including detection, speech in quiet, speech in noise, and localization. There was only a small, but significant, effect of the different subgroups of hearing aids on the final PROM results, where no differences were found between the auditory domains. Minor differences were found between results obtained in commercial and noncommercial settings, or between novice and experienced users. Severity of Hearing loss, age, gender, and hearing aid style (i.e., behind-the-ear versus receiver-in-canal type) did not have a clinically relevant effect on the final PROM results.
The use of hearing aids has a large positive effect on self-perceived auditory functioning. There was however no salient effect of the different subgroups of hearing aids on the final PROM results, indicating that technical properties of hearing aids only play a limited role in this respect. This study challenges the belief that premium devices outperform basic ones, highlighting the need for personalized rehabilitation strategies and the importance of evaluating factors contributing to successful rehabilitation for clinical practice.
助听器是听力康复的重要组成部分。助听器的技术数据与个体康复需求相结合，可以深入了解有助于康复成功的因素。本研究旨在调查不同（可比）助听器亚组是否会导致康复成功率的差异，以及这些差异在不同听觉功能领域是否存在差异。
本研究在荷兰的 64 家（商业）助听器验配中心和 10 家（非商业）听力学中心的大量成功使用助听器的患者中，探索了将患者报告的结果测量（PROM）纳入购买新助听器过程的优势。受试者数据来自于 64 家（商业）助听器验配中心和 10 家（非商业）听力学中心。PROM 是一个 32 项的问卷，用于通过随时间测量听觉障碍来确定使用助听器进行康复的成功程度。这些项目映射到六个听觉功能领域：检测、辨别、定位、安静环境下的言语、噪声环境下的言语和噪声耐受，涵盖了各种日常生活中的聆听情况。通过聚类分析对助听器进行分组，共分为 9 个亚组。共有 1149 名受试者参与了这项研究。使用广义线性模型对最终的 PROM 结果进行建模。通过多因素方差分析对模型结果进行分析。事后分析提供了模型变量的详细信息。
结果显示助听器对总体自我感知听觉功能有很强的统计学显著影响。在检测、安静环境下的言语、噪声环境下的言语和定位等听觉领域发现了临床相关的差异。助听器的不同亚组对最终 PROM 结果的影响很小，但具有统计学意义，在听觉领域没有发现差异。在商业和非商业环境之间，或新手和经验丰富的用户之间，存在细微但显著的差异。听力损失的严重程度、年龄、性别和助听器样式（即耳后式与耳道式）对最终 PROM 结果没有临床相关影响。
使用助听器对自我感知的听觉功能有很大的积极影响。然而，助听器的不同亚组对最终 PROM 结果没有明显影响，这表明助听器的技术特性在这方面仅发挥有限的作用。这项研究挑战了优质设备优于基本设备的观点，强调了个性化康复策略的必要性，以及评估有助于康复成功的因素对于临床实践的重要性。
