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Ostevik AV, Hill-Feltham P, Johansson ML, McKinnon BJ, Monksfield P, Sockalingam R, Tysome JR, Wright T, Hodgetts WE. Psychosocial outcome measures for conductive and mixed hearing loss treatment: An overview of the relevant literature. Int J Audiol 2021; 60:641-649. [PMID: 33612075 DOI: 10.1080/14992027.2021.1872805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify the psychosocial assessments utilized with individuals with conductive and/or mixed hearing loss as part of a broader effort by the Auditory Rehabilitation Outcomes Network (AURONET) group to develop a core set of patient-centred outcome measures. DESIGN A review of articles published between 2006 and 2016 was completed. Included studies had more than three adult participants, were available in English, and reported a psychosocial outcome from any treatment of mixed and/or conductive hearing loss. STUDY SAMPLE Sixty-six articles from seven databases. RESULTS Sixty-six articles met our inclusion/exclusion criteria. Within this set, 15 unique psychosocial or patient-reported outcome measures (PROs) were identified, with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Glasgow Benefit Inventory (GBI) being the most frequently dispensed. Five of the fifteen were only administered in one study. In-house questionnaires (IHQs) were reported in 19 articles. CONCLUSIONS Only 66 (22%) of the 300 articles with outcomes contained a PRO. Some of the mostly frequently employed PROs (e.g., APHAB) were judged to include only social items and no psychological items. Lack of PRO standardization and the use of IHQs make psychosocial comparisons across treatments in this population difficult for patients, clinicians and stakeholders.
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Affiliation(s)
- Amberley V Ostevik
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
| | | | - Martin L Johansson
- Department of Biomaterials, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Oticon Medical, Askim, Sweden
| | | | | | | | - James R Tysome
- University of Cambridge, Cambridge, UK.,Cambridge University Hospitals, Cambridge, UK
| | | | - William E Hodgetts
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada.,Institute for Reconstructive Sciences in Medicine, Edmonton, Canada
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2
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Hill-Feltham PR, Johansson ML, Hodgetts WE, Ostevik AV, McKinnon BJ, Monksfield P, Sockalingam R, Wright T, Tysome JR. Hearing outcome measures for conductive and mixed hearing loss treatment in adults: a scoping review. Int J Audiol 2020; 60:239-245. [PMID: 32985284 DOI: 10.1080/14992027.2020.1820087] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Rehabilitation options for conductive and mixed hearing loss are continually expanding, but without standard outcome measures comparison between different treatments is difficult. To meaningfully inform clinicians and patients core outcome sets (COS), determined via a recognised methodology, are needed. Following our previous work that identified hearing, physical, economic and psychosocial as core areas of a future COS, the AURONET group reviewed hearing outcome measures used in existing literature and assigned them into different domains within the hearing core area. DESIGN Scoping review. STUDY SAMPLE Literature including hearing outcome measurements for the treatment of conductive and/or mixed hearing loss. RESULTS The literature search identified 1434 studies, with 278 subsequently selected for inclusion. A total of 837 hearing outcome measures were reported and grouped into nine domains. The largest domain constituted pure-tone threshold measurements accounting for 65% of the total outcome measures extracted, followed by the domains of speech testing (20%) and questionnaires (9%). Studies of hearing implants more commonly included speech tests or hearing questionnaires compared with studies of middle ear surgery. CONCLUSIONS A wide range of outcome measures are currently used, highlighting the importance of developing a COS to inform individual practice and reporting in trials/research.
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Affiliation(s)
- Penny R Hill-Feltham
- Audiology Department, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Martin L Johansson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Oticon Medical, Askim, Sweden
| | - William E Hodgetts
- Institute for Reconstructive Sciences in Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Amberley V Ostevik
- Institute for Reconstructive Sciences in Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Brian J McKinnon
- Otolaryngology-Head & Neck Surgery Department, The University of Texas Medical Branch, Galveston, Texas, USA
| | | | | | - Tracy Wright
- ENT Department, University Hospitals Birmingham, Birmingham, UK
| | - James R Tysome
- The Cambridge Hearing Group, University of Cambridge, Cambridge, UK.,Otolaryngology Department, Cambridge University Hospitals, Cambridge, UK
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Ferguson M, Maidment D, Henshaw H, Heffernan E. Evidence-Based Interventions for Adult Aural Rehabilitation: That Was Then, This Is Now. Semin Hear 2019; 40:68-84. [PMID: 30728650 PMCID: PMC6363556 DOI: 10.1055/s-0038-1676784] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
More than a decade after Arthur Boothroyd published "Adult Aural Rehabilitation: What Is It and Does It Work?," the four cornerstones of adult aural rehabilitation are re-examined in terms of research that we and others in the field have undertaken. The focus is on novel advances in high-quality research relating to interventions to support self-management for hearing aids and other listening devices (sensory management), knowledge and skill (instruction), auditory and cognitive training (perceptual training), and motivational engagement (counseling). Much of this new research has a theoretical underpinning (e.g., behavior change theory) to better guide the development and evaluation of interventions, with a focus on self-management and patient-centered approaches. New and emerging technologies that support e- and m-health delivery of interventions provide greater personalization and interactivity to promote self-management of hearing loss. Looking to the future, there remains a requirement for a set of relevant and appropriate outcome measures to evaluate the effectiveness of interventions trialed in clinical studies. There is a continuing need for high-quality evidence, underpinned by contemporary theory, to increase the likelihood that translational adult aural rehabilitation research that aims to benefit patients will be applied in future clinical practice.
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Affiliation(s)
- Melanie Ferguson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - David Maidment
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Helen Henshaw
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Eithne Heffernan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Calon TG, Johansson ML, de Bruijn AJ, van den Berge H, Wagenaar M, Eichhorn E, Janssen MM, Hof JR, Brunings JW, Joore MA, Jonhede S, van Tongeren J, Holmberg M, Stokroos RJ. Minimally Invasive Ponto Surgery Versus the Linear Incision Technique With Soft Tissue Preservation for Bone Conduction Hearing Implants: A Multicenter Randomized Controlled Trial. Otol Neurotol 2018; 39:882-893. [PMID: 29995008 PMCID: PMC6075882 DOI: 10.1097/mao.0000000000001852] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare the surgical outcomes of the Minimally Invasive Ponto Surgery (MIPS) technique with those of the linear incision technique with soft-tissue preservation for bone-anchored hearing systems (BAHS). DESIGN Sponsor-initiated multicenter, open, randomized, controlled clinical trial. SETTING Maastricht University Medical Centre, Ziekenhuisgroep Twente and Medisch Centrum Leeuwarden, all situated in The Netherlands. PARTICIPANTS Sixty-four adult patients eligible for unilateral BAHS surgery.Interventions Single-stage BAHS surgery with 1:1 randomization to the linear incision technique with soft-tissue preservation (control) or the MIPS (test) group. PRIMARY AND SECONDARY OUTCOME MEASUREMENTS Primary objective: compare the incidence of inflammation (Holgers Index ≥ 2) during 12 weeks' follow-up after surgery. Secondary objectives: skin dehiscence, pain scores, loss of sensibility around the implant, soft-tissue overgrowth, skin sagging, implant extrusion, cosmetic results, surgical time, wound healing and Implant Stability Quotient measurements. RESULTS Sixty-three subjects were analyzed in the intention-to-treat population. No significant difference was found for the incidence of inflammation between groups. Loss of skin sensibility, cosmetic outcomes, skin sagging, and surgical time were significantly better in the test group. No statistically significant differences were found for dehiscence, pain, and soft-tissue overgrowth. A nonsignificant difference in extrusion was found for the test group. The Implant Stability Quotient was statistically influenced by the surgical technique, abutment length, and time. CONCLUSION No significant differences between the MIPS and the linear incision techniques were observed regarding skin inflammation. MIPS results in a statistically significant reduction in the loss of skin sensibility, less skin sagging, improved cosmetic results, and reduced surgical time. Although nonsignificant, the implant extrusion rate warrants further research.
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Affiliation(s)
- Tim G.A. Calon
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Martin L. Johansson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg
- Oticon Medical AB, Askim, Sweden
| | | | | | - Mariet Wagenaar
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden
| | - Edwin Eichhorn
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden
| | - Miranda M.L. Janssen
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University
| | - Janny R. Hof
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jan-Wouter Brunings
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Manuela A. Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - Joost van Tongeren
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Robert-Jan Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
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5
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Johansson M, Tysome J, Hill-Feltham P, Hodgetts W, Ostevik A, McKinnon B, Monksfield P, Sockalingam R, Wright T. Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review. Clin Otolaryngol 2018; 43:1226-1234. [DOI: 10.1111/coa.13131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2018] [Indexed: 11/26/2022]
Affiliation(s)
- M.L. Johansson
- Department of Biomaterials; Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
- Oticon Medical; Askim Sweden
| | - J.R. Tysome
- University of Cambridge; Cambridge UK
- Cambridge University Hospitals; Cambridge UK
| | | | - W.E. Hodgetts
- Institute for Reconstructive Sciences in Medicine; University of Alberta Edmonton; Edmonton AB Canada
| | - A. Ostevik
- Institute for Reconstructive Sciences in Medicine; University of Alberta Edmonton; Edmonton AB Canada
| | - B.J. McKinnon
- Drexel University College of Medicine; Philadelphia PA USA
| | | | | | - T. Wright
- University Hospitals Birmingham; Birmingham UK
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Mandavia R, Dimitriadis PA, Monksfield P, Hall A, Ray J, Schilder AGM. UK bone conduction hearing device consensus workshop: Narrative summary. Cochlear Implants Int 2017; 18:187-191. [PMID: 28466683 DOI: 10.1080/14670100.2017.1322228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To identify United Kingdom (UK)-specific research priorities in the field of bone conduction hearing devices (BCHDs). METHOD Narrative summary of the discussions and outcomes of a UK BCHD research workshop. The workshop was organized on 8 September 2016 under the auspices of the National Institute for Health Research (NIHR) Clinical Research Network (CRN) ENT Specialty group and Royal College of Surgeons (RCS) Clinical Research Initiative. Representatives from a wide range of patient and professional groups from the UK and abroad were invited to attend. Main outcome measures were research priorities and approaches in the field of BCHDs. RESULTS Key research questions in the field of BCHDs are as follows: (1) What are the existing national BCHD practices? (2) What are the patient information and support needs on BCHDs? (3) Which outcomes should be measured across clinical studies in the field of BCHDs? The workshop suggested the following approaches to address these priorities: (1) a service evaluation of current UK BCHD practice; development of a national registry of BCHDs; (2) qualitative research to understand patient information and support needs; development of patient decision support tools; (3) development of core outcome sets for BCHDs. DISCUSSION Building upon the framework of the recent UK Research Agenda for ENT, Hearing and Balance, patients and professionals defined key UK-specific research priorities and approaches in the field of BCHDs. This approach promotes engagement, buy-in, national collaboration and thereby value of future BCHD research.
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Affiliation(s)
- Rishi Mandavia
- a evidENT, Ear Institute , University College London, UCLH Royal National Throat, Nose and Ear Hospital , 330 Grays Inn Road, London WC1X 8DA , UK
| | | | - Peter Monksfield
- c Department of Otolaryngology , University Hospitals Birmingham , Birmingham B15 2TH , UK
| | - Amanda Hall
- d School of Life and Health Sciences , Aston University , Birmingham B4 7ET , UK
| | - Jaydip Ray
- b Department of Otolaryngology , Sheffield Teaching Hospitals , Sheffield S10 2JF , UK
| | - Anne G M Schilder
- a evidENT, Ear Institute , University College London, UCLH Royal National Throat, Nose and Ear Hospital , 330 Grays Inn Road, London WC1X 8DA , UK
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7
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Calon TGA, van Hoof M, van den Berge H, de Bruijn AJG, van Tongeren J, Hof JR, Brunings JW, Jonhede S, Anteunis LJC, Janssen M, Joore MA, Holmberg M, Johansson ML, Stokroos RJ. Minimally Invasive Ponto Surgery compared to the linear incision technique without soft tissue reduction for bone conduction hearing implants: study protocol for a randomized controlled trial. Trials 2016; 17:540. [PMID: 27829464 PMCID: PMC5103483 DOI: 10.1186/s13063-016-1662-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the last years, less invasive surgical techniques with soft tissue preservation for bone conduction hearing implants (BCHI) have been introduced such as the linear incision technique combined with a punch. Results using this technique seem favorable in terms of rate of peri-abutment dermatitis (PAD), esthetics, and preservation of skin sensibility. Recently, a new standardized surgical technique for BCHI placement, the Minimally Invasive Ponto Surgery (MIPS) technique has been developed by Oticon Medical AB (Askim, Sweden). This technique aims to standardize surgery by using a novel surgical instrumentation kit and minimize soft tissue trauma. METHODS A multicenter randomized controlled trial is designed to compare the MIPS technique to the linear incision technique with soft tissue preservation. The primary investigation center is Maastricht University Medical Center. Sixty-two participants will be included with a 2-year follow-up period. Parameters are introduced to quantify factors such as loss of skin sensibility, dehiscence of the skin next to the abutment, skin overgrowth, and cosmetic results. A new type of sampling method is incorporated to aid in the estimation of complications. To gain further understanding of PAD, swabs and skin biopsies are collected during follow-up visits for evaluation of the bacterial profile and inflammatory cytokine expression. The primary objective of the study is to compare the incidence of PAD during the first 3 months after BCHI placement. Secondary objectives include the assessment of parameters related to surgery, wound healing, pain, loss of sensibility of the skin around the implant, implant extrusion rate, implant stability measurements, dehiscence of the skin next to the abutment, and esthetic appeal. Tertiary objectives include assessment of other factors related to PAD and a health economic evaluation. DISCUSSION This is the first trial to compare the recently developed MIPS technique to the linear incision technique with soft tissue preservation for BCHI surgery. Newly introduced parameters and sampling method will aid in the prediction of results and complications after BCHI placement. TRIAL REGISTRATION Registered at the CCMO register in the Netherlands on 24 November 2014: NL50072.068.14 . Retrospectively registered on 21 April 2015 at ClinicalTrials.gov: NCT02438618 . This trial is sponsored by Oticon Medical AB.
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Affiliation(s)
- Tim G A Calon
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Marc van Hoof
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Herbert van den Berge
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Arthur J G de Bruijn
- Department of Otorhinolaryngology, ZiekenhuisGroep Twente, Almelo, The Netherlands
| | - Joost van Tongeren
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Janny R Hof
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan Wouter Brunings
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Lucien J C Anteunis
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Miranda Janssen
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Manuela A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Martin L Johansson
- Oticon Medical AB, Askim, Sweden.,Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
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