Crum Rachel, Chowsilpa Sanathorn, Kaski Diego, Giunti Paola, Bamiou Doris-Eva, Koohi Nehzat
The Ear Institute, University College London, London, United Kingdom.
Otology Neurotology and Communication Disorder Unit, Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Front Hum Neurosci. 2024 Jun 21;18:1406916. doi: 10.3389/fnhum.2024.1406916. eCollection 2024.
For adults with auditory processing disorder (APD), listening and communicating can be difficult, potentially leading to social isolation, depression, employment difficulties and certainly reducing the quality of life. Despite existing practice guidelines suggesting treatments, the efficacy of these interventions remains uncertain due to a lack of comprehensive reviews. This systematic review and meta-analysis aim to establish current evidence on the effectiveness of interventions for APD in adults, addressing the urgent need for clarity in the field.
Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search across MEDLINE (Ovid), Embase (Ovid), Web of Science and Scopus, focusing on intervention studies involving adults with APD. Studies that met the inclusion criteria were grouped according to intervention with a meta-analysis only conducted where intervention, study design and outcome measure were comparable.
Out of 1,618 screened records, 13 studies were included, covering auditory training (AT), low-gain hearing aids (LGHA), and personal remote microphone systems (PRMS). Our analysis revealed: AT, Mixed results with some improvements in speech intelligibility and listening ability, indicating potential benefits but highlighting the need for standardized protocols; LGHA, The included studies demonstrated significant improvements in monaural low redundancy speech testing ( < 0.05), suggesting LGHA could enhance speech perception in noisy environments. However, limitations include small sample sizes and potential biases in study design. PRMS, Demonstrated the most consistent evidence of benefit, significantly improving speech testing results, with no additional benefit from combining PRMS with other interventions.
PRMS presents the most evidence-supported intervention for adults with APD, although further high-quality research is crucial for all intervention types. The establishment and implementation of standardized intervention protocols alongside rigorously validated outcome measures will enable a more evidence-based approach to managing APD in adults.
对于患有听觉处理障碍(APD)的成年人来说,倾听和交流可能会很困难,这可能会导致社交孤立、抑郁、就业困难,并肯定会降低生活质量。尽管现有实践指南提出了治疗方法,但由于缺乏全面的综述,这些干预措施的疗效仍不确定。本系统综述和荟萃分析旨在确立目前关于成人APD干预措施有效性的证据,以满足该领域迫切需要明确的需求。
按照系统综述和荟萃分析的首选报告项目(PRISMA)指南,我们在MEDLINE(Ovid)、Embase(Ovid)、科学网和Scopus上进行了系统检索,重点关注涉及患有APD的成年人的干预研究。符合纳入标准的研究根据干预措施进行分组,仅在干预措施、研究设计和结果测量具有可比性的情况下进行荟萃分析。
在筛选的1618条记录中,纳入了13项研究,涵盖听觉训练(AT)、低增益助听器(LGHA)和个人远程麦克风系统(PRMS)。我们的分析显示:AT,结果不一,语音清晰度和听力能力有一些改善,表明有潜在益处,但突出了标准化方案的必要性;LGHA,纳入的研究在单耳低冗余语音测试中显示出显著改善(<0.05),表明LGHA可以提高在嘈杂环境中的语音感知。然而,局限性包括样本量小和研究设计中的潜在偏差。PRMS,显示出最一致的有益证据,显著改善语音测试结果,将PRMS与其他干预措施联合使用没有额外益处。
PRMS是对患有APD的成年人最有证据支持的干预措施,尽管对所有干预类型而言,进一步的高质量研究至关重要。建立和实施标准化干预方案以及经过严格验证的结果测量方法,将使管理成人APD的方法更具循证性。