Al-Salim Sarah, Skretta Delaney, Merchant Gabrielle Ryan
Center for Hearing Research, Boys Town National Research Hospital, Omaha, NE.
Am J Audiol. 2024 Mar 4;33(1):254-268. doi: 10.1044/2023_AJA-23-00228. Epub 2024 Feb 5.
Wideband acoustic immittance (WAI) is a promising measure of middle-ear mechanics. In contrast to standard tympanometry, which is generally measured at a single stiffness-dominated low frequency, WAI detects mechanical effects on both the mass and stiffness properties of the middle ear across a wide range of frequencies, resulting in a more comprehensive assessment of middle-ear mechanics in healthy and pathological ears. Despite a plethora of research demonstrating the clinical utility of this measure, clinical adoption of WAI is still limited. This work explores audiologists' use and perceptions of WAI, with the goal of identifying the barriers to its clinical adoption.
A survey on the perception and use of WAI by clinical audiologists in the United States was developed and administered using the Research Electronic Data Capture application. The survey was distributed broadly across the United States. Participation was voluntary and anonymous, and no compensation was provided.
Findings from 132 survey respondents across 32 states were included in the analyses. Overall, findings suggest the largest barriers to clinical adoption of WAI are lack of access to equipment that measures WAI and lack of training and/or confidence in measuring or interpreting WAI.
Several barriers to clinical adoption of WAI were identified. However, findings also provide optimism in that audiologists utilizing WAI find it more useful than standard tympanometry, and most audiologists who do not currently use WAI are open to implementing the measure in their clinical practice. We proposed steps to address the highest priority issues and increase the clinical viability of WAI.
宽带声导抗(WAI)是一种很有前景的中耳力学测量方法。与通常在单一以劲度为主导的低频下进行测量的标准鼓室声导抗测试不同,WAI能在很宽的频率范围内检测中耳质量和劲度特性上的力学效应,从而对健康和患病耳朵的中耳力学进行更全面的评估。尽管有大量研究证明了该测量方法的临床实用性,但WAI在临床中的应用仍然有限。这项研究探讨了听力学家对WAI的使用情况和看法,目的是找出其临床应用的障碍。
利用研究电子数据采集应用程序开发并实施了一项关于美国临床听力学家对WAI的看法和使用情况的调查。该调查广泛分布于美国各地。参与是自愿且匿名的,不提供任何报酬。
分析纳入了来自32个州的132名调查受访者的结果。总体而言,结果表明WAI临床应用的最大障碍是缺乏测量WAI的设备以及在测量或解读WAI方面缺乏培训和/或信心。
确定了WAI临床应用的几个障碍。然而,研究结果也带来了乐观的一面,即使用WAI的听力学家发现它比标准鼓室声导抗测试更有用,而且大多数目前不使用WAI的听力学家愿意在临床实践中采用该测量方法。我们提出了应对最优先问题并提高WAI临床可行性的步骤。