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Rootlieb JM, Polspoel S, Brienesse P, Smits C. Remote self-testing for adult cochlear implant users: the effect of wireless streaming on speech recognition in noise. Int J Audiol 2024:1-6. [PMID: 39101925 DOI: 10.1080/14992027.2024.2382201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES Wireless sound transfer methods for cochlear implant sound processors have become popular for remote self-assessed hearing tests. The aim of this study was to determine (1) spectral differences in stimuli between different wireless sound transfer options and (2) the effect on outcomes of speech recognition tests in noise. DESIGN In study 1, the frequency response of different streaming options (Phonak Roger Select, Cochlear Mini Mic 2+, telecoil and Bluetooth connection) was measured by connecting headphones to CI sound processors. Study 2 followed a repeated measures design in which digits-in-noise (DIN) tests were performed using wireless streaming to sound processors from Cochlear, Advanced Bionics, and MED-EL. STUDY SAMPLE 20 normal hearing participants. RESULTS Differences in frequency response between loudspeaker and wireless streaming conditions were minimal. We did not find significant difference in DIN outcome (F4,194 = 1.062, p = 0.376) between the wireless transfer options with the Cochlear Nucleus 7 processor. No significant difference in DIN outcomes was found between Bluetooth streaming and the loudspeaker condition for all of the three tested brands. The mean standard error of measurement was 0.72 dB. CONCLUSIONS No significant differences in DIN test outcomes between wireless sound transfer and the reference method were found.
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Affiliation(s)
- Jasmijn M Rootlieb
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Sigrid Polspoel
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Patrick Brienesse
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Cas Smits
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Lin MJ, Chen CK. Breaking Sound Barriers: Exploring Tele-Audiology's Impact on Hearing Healthcare. Diagnostics (Basel) 2024; 14:856. [PMID: 38667501 PMCID: PMC11049182 DOI: 10.3390/diagnostics14080856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare.
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Affiliation(s)
- Mien-Jen Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan;
| | - Chin-Kuo Chen
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204201, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan
- Department of Otolaryngology-Head and Neck Surgery and Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
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3
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Chee J, Eikelboom RH, Smits C, Swanepoel DW, Wee SL, Ng TP, Heywood RL. Digits in noise testing in a multilingual sample of Asian adults. Int J Audiol 2024; 63:269-274. [PMID: 36847757 DOI: 10.1080/14992027.2023.2179549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE Appropriate speech-in noise assessment is challenging in multilingual populations. This study aimed to assess whether first preferred language affected performance on an English Digits-in-noise (DIN) test in the local Asian multilingual population, controlling for hearing threshold, age, sex, English fluency and educational status. A secondary aim was to determine the association between DIN test scores and hearing thresholds. DESIGN English digit-triplets in noise testing and pure-tone audiometry were conducted. Multiple regression analysis was performed with DIN scores and hearing thresholds as dependent variables. Correlation analysis was performed between DIN-SRT and hearing thresholds. STUDY SAMPLE 165 subjects from the Singapore Longitudinal Ageing Study, a population-based longitudinal study of community-dwellers over 55 years of age. RESULTS Mean DIN speech reception threshold (DIN-SRT) was -5.7 dB SNR (SD 3.6; range 6.7 to -11.2). Better ear pure tone average and English fluency were significantly associated with DIN-SRT. CONCLUSIONS DIN performance was independent of first preferred language in a multilingual ageing Singaporean population after adjusting for age, gender and education. Those with poorer English fluency had a significantly lower DIN-SRT score. The DIN test has the potential to provide a quick, uniform method of testing speech in noise in this multilingual population.
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Affiliation(s)
- Jeremy Chee
- Department of Otolaryngology - Head and Neck Surgery, National University Hospital, Singapore
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Curtin Medical School, Curtin University, Bentley, Australia
| | - Cas Smits
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - De Wet Swanepoel
- Ear Science Institute Australia, Subiaco, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Tze Pin Ng
- Geriatric Education and Research Institute, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Rebecca L Heywood
- Ear Science Institute Australia, Subiaco, Australia
- Ear Sciences Centre, Medical School, The University of Western Australia, Perth, Australia
- Department of Otolaryngology, Ng Teng Fong General Hospital, Singapore
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4
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Oslin SJ, Shi HH, Conner AK. Preventing Sudden Cessation of Implantable Pulse Generators in Deep Brain Stimulation: A Systematic Review and Protocol Proposal. Stereotact Funct Neurosurg 2024; 102:127-134. [PMID: 38432221 DOI: 10.1159/000535880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/14/2023] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Deep brain stimulation (DBS) requires a consistent electrical supply from the implantable pulse generator (IPG). Patients may struggle to monitor their IPG, risking severe complications in battery failure. This review assesses current literature on DBS IPG battery life management and proposes a protocol for healthcare providers. METHODS A literature search using four databases identified best practices for DBS IPG management. Studies were appraised for IPG management guidelines, categorized as qualitative, quantitative, or both. RESULTS Of 408 citations, only seven studies were eligible, none providing clear patient management strategies. Current guidelines lack specificity, relying on clinician suggestions. CONCLUSION Limited guidelines exist for IPG management. Specificity and adaptability to emerging technology are crucial. The findings highlight the need for specificity in patients' needs and adaptability to emerging technology in future studies. To address this need, we developed a protocol for DBS IPG management that we have implemented at our own institution. Further research is needed for effective DBS IPG battery life management, preventing therapy cessation complications.
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Affiliation(s)
- Spencer J Oslin
- Department of Neurosurgery, University of Oklahoma, Health Sciences Center, Oklahoma City, Oklahoma, USA,
| | - Helen H Shi
- Department of Neurosurgery, University of Oklahoma, Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrew K Conner
- Department of Neurosurgery, University of Oklahoma, Health Sciences Center, Oklahoma City, Oklahoma, USA
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Carner M, Bianconi L, Fulco G, Confuorto G, Soloperto D, Molteni G, Sacchetto L. Personal experience with the remote check telehealth in cochlear implant users: from COVID-19 emergency to routine service. Eur Arch Otorhinolaryngol 2023; 280:5293-5298. [PMID: 37393199 PMCID: PMC10620244 DOI: 10.1007/s00405-023-08045-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/26/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE To critically illustrate the personal experience with using the "Remote Check" application which remotely monitors the hearing rehabilitation level of cochlear implant users at home and further allows clinicians to schedule in-clinic sessions according to the patients' needs. METHODS 12-month prospective study. Eighty adult cochlear implant users (females n = 37, males n = 43; age range 20-77 years) with ≥ 36 months of cochlear implant experience and ≥ 12 months of stable auditory and speech recognition level volunteered for this 12-month long prospective study. For each patient, at the beginning of the study during the in-clinic session to assess the stable aided hearing thresholds and the cochlear implant integrity and patient's usage, the "Remote Check" assessment baseline values were obtained. "Remote Check" outcomes were collected at different times in the subsequent at-home sessions, to identify the patients that had to reach the Center. Chi-square test has been used for statistical analysis of the comparison of the "Remote Check" outcomes and in-clinic session results. RESULTS "Remote Check" application outcomes demonstrated minimal or no differences between all sessions. The at-home Remote Check application reached the same clinical outcomes as the in-clinic sessions in 79 out 80 of participants (99%) with high statistical significance (p < 0.05). CONCLUSIONS "Remote Check" application supported hearing monitoring in cochlear implant users that were not able to attend the in-clinic review during COVID-19 pandemic time. This study demonstrates that the application can be a useful routine tool also for clinical follow-up of cochlear implant users with stable aided hearing.
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Affiliation(s)
- Marco Carner
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy
| | - Luca Bianconi
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy
| | - Gianfranco Fulco
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy.
| | - Gennaro Confuorto
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy
| | - Davide Soloperto
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy
| | - Gabriele Molteni
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy
| | - Luca Sacchetto
- Unit of Otolaryngology, Head and Neck Department, University of Verona, Piazzale L. A. Scuro, 10, 37100, Verona, Italy
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Ferguson MA, Eikelboom RH, Sucher CM, Maidment DW, Bennett RJ. Remote Technologies to Enhance Service Delivery for Adults: Clinical Research Perspectives. Semin Hear 2023; 44:328-350. [PMID: 37484990 PMCID: PMC10361795 DOI: 10.1055/s-0043-1769742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
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Affiliation(s)
- Melanie A. Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M. Sucher
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca J. Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
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7
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Aboye GT, Vande Walle M, Simegn GL, Aerts JM. mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe. Digit Health 2023; 9:20552076231180972. [PMID: 37377558 PMCID: PMC10291558 DOI: 10.1177/20552076231180972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
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Affiliation(s)
- Genet Tadese Aboye
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
- School of Biomedical Engineering, Jimma University, Jimma, Ethiopia
| | - Martijn Vande Walle
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
| | | | - Jean-Marie Aerts
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
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8
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Cullington H, Kitterick P, Darnton P, Finch T, Greenwell K, Riggs C, Weal M, Walker DM, Sibley A. Telemedicine for Adults With Cochlear Implants in the United Kingdom (CHOICE): Protocol for a Prospective Interventional Multisite Study. JMIR Res Protoc 2022; 11:e27207. [PMID: 35416780 PMCID: PMC9047741 DOI: 10.2196/27207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/26/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cochlear implants provide hearing to approximately 750,000 people with deafness worldwide; these patients require lifelong follow-up. Care for adults with implants in the United Kingdom occurs at one of 19 centers, which may be far from the patients' homes. In a previous randomized controlled trial, we successfully introduced person-centered care. We designed, implemented, and evaluated the following remote care pathway: a personalized web-based support tool, home hearing check, self-device adjustment, and upgrading of sound processors at home rather than in the clinic. The remote care group had a significant increase in empowerment after using the tools, and the patients and clinicians were keen to continue. We would now like to scale up these improvements as an option for >12,000 UK adults using implants; we are commissioning an independent evaluation of this intervention and rollout to establish if it achieves its aims of more empowered and confident patients; more accessible and equitable care; stable hearing; more efficient, person-centered, and scalable service; and more satisfied and engaged patients and clinicians. OBJECTIVE This study aims to evaluate the impact and rollout of a person-centered clinical care pathway via telemedicine for adults with cochlear implants in the United Kingdom, using both outcomes and process evaluation. METHODS This project will scale up and evaluate a person-centered long-term follow-up pathway for adults using cochlear implants through a personalized website, including a home hearing check, uploading photos of cochlear implant site, listening in noise and music practice, ordering of spares, questionnaires, and other resources. Both quantitative and qualitative analyses will be conducted, and they will be both an outcome and process evaluation. RESULTS As of July 2021, the trial is closed, and all data collection is complete. The evaluation report is expected to be published in December 2021, and the research data have not yet been analyzed. CONCLUSIONS This project will present the results of the first scaling up of a remote care pathway for adults with cochlear implants in the United Kingdom. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number ISRCTN51668922; https://www.isrctn.com/ISRCTN51668922. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27207.
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Affiliation(s)
- Helen Cullington
- University of Southampton Auditory Implant Service, University of Southampton, Southampton, United Kingdom
| | - Padraig Kitterick
- Nottingham Hearing Biomedical Research Unit, National Institute for Health Research, Nottingham, United Kingdom
| | - Philippa Darnton
- Wessex Academic Health Science Network, Southampton, United Kingdom
| | - Tracy Finch
- Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, United Kingdom
| | - Carol Riggs
- University of Southampton Auditory Implant Service, University of Southampton, Southampton, United Kingdom
| | - Mark Weal
- School of Electronics and Computer Science, University of Southampton, Southampton, United Kingdom
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Andrew Sibley
- Wessex Academic Health Science Network, Southampton, United Kingdom
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Yang A, Kim D, Hwang PH, Lechner M. Telemedicine and Telementoring in Rhinology, Otology, and Laryngology: A Scoping Review. OTO Open 2022; 6:2473974X211072791. [PMID: 35274073 PMCID: PMC8902203 DOI: 10.1177/2473974x211072791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Telemedicine and telementoring have had a significant boost across
all medical and surgical specialties over the last decade and
especially during the COVID-19 pandemic. The aim of this scoping
review is to synthesize the current use of telemedicine and
telementoring in otorhinolaryngology and head and neck
surgery. Data Sources PubMed and Cochrane Library. Review Methods A scoping review search was conducted, which identified 469
articles. Following full-text screening by 2 researchers, 173
articles were eligible for inclusion and further categorized via
relevant subdomains. Conclusions Virtual encounters and telementoring are the 2 main applications of
telemedicine in otolaryngology. These applications can be
classified into 7 subdomains. Different ear, nose, and throat
subspecialties utilized certain telemedicine applications more
than others; for example, almost all articles on patient
engagement tools are rhinology based. Overall, telemedicine is
feasible, showing similar concordance when compared with
traditional methods; it is also cost-effective, with high
patient and provider satisfaction. Implications for Practice Telemedicine in otorhinolaryngology has been widely employed during
the COVID-19 pandemic and has a huge potential, especially with
regard to its distributing quality care to rural areas. However,
it is important to note that with current exponential use, it is
equally crucial to ensure security and privacy and integrate
HIPAA-compliant systems (Health Insurance Portability and
Accountability Act) in the big data era. It is expected that
many more applications developed during the pandemic are here to
stay and will be refined in years to come.
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Affiliation(s)
- Angela Yang
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Dayoung Kim
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Peter H. Hwang
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
| | - Matt Lechner
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California, USA
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10
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van Wieringen A, Magits S, Francart T, Wouters J. Home-Based Speech Perception Monitoring for Clinical Use With Cochlear Implant Users. Front Neurosci 2021; 15:773427. [PMID: 34916902 PMCID: PMC8669965 DOI: 10.3389/fnins.2021.773427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/28/2021] [Indexed: 12/02/2022] Open
Abstract
Speech-perception testing is essential for monitoring outcomes with a hearing aid or cochlear implant (CI). However, clinical care is time-consuming and often challenging with an increasing number of clients. A potential approach to alleviating some clinical care and possibly making room for other outcome measures is to employ technologies that assess performance in the home environment. In this study, we investigate 3 different speech perception indices in the same 40 CI users: phoneme identification (vowels and consonants), digits in noise (DiN) and sentence recognition in noise (SiN). The first two tasks were implemented on a tablet and performed multiple times by each client in their home environment, while the sentence task was administered at the clinic. Speech perception outcomes in the same forty CI users showed that DiN assessed at home can serve as an alternative to SiN assessed at the clinic. DiN scores are in line with the SiN ones by 3–4 dB improvement and are useful to monitor performance at regular intervals and to detect changes in auditory performance. Phoneme identification in quiet also explains a significant part of speech perception in noise, and provides additional information on the detectability and discriminability of speech cues. The added benefit of the phoneme identification task, which also proved to be easy to administer at home, is the information transmission analysis in addition to the summary score. Performance changes for the different indices can be interpreted by comparing against measurement error and help to target personalized rehabilitation. Altogether, home-based speech testing is reliable and proves powerful to complement care in the clinic for CI users.
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Affiliation(s)
| | - Sara Magits
- Experimental ORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Tom Francart
- Experimental ORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jan Wouters
- Experimental ORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
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11
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Reis M, McMahon CM, Távora-Vieira D, Humburg P, Boisvert I. Effectiveness of Computer-Based Auditory Training for Adult Cochlear Implant Users: A Randomized Crossover Study. Trends Hear 2021; 25:23312165211025938. [PMID: 34591702 PMCID: PMC8488513 DOI: 10.1177/23312165211025938] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The aim of this study was to assess whether a computer-based speech-in-noise auditory training (AT) program would lead to short- and long-term changes in trained and untrained measures of listening, cognition, and quality of life. A secondary aim was to assess whether directly training the underlying cognitive abilities required for speech perception in noise, using a computer-based visual training (VT) program without the auditory component, would elicit comparable outcomes as the AT program. A randomized crossover study with repeated measures was conducted with 26 adult cochlear implant users. Participants completed either 6 weeks of speech perception in noise training followed by 6 weeks of masked text recognition training, or vice versa. Outcome measures were administered twice before each training program, as well as twice after the completion of each program. The test battery was designed to evaluate whether training led to improvements in listening abilities, cognitive abilities, or quality of life. Mixed-effects models were conducted to analyze whether changes occurred on the trained tasks and on untrained outcome measures after training. Statistically significant improvements were shown for verbal recognition performance during both training programs, in particular for consonants in words, and during the first 2 weeks of training. This on-task learning, however, did not lead to clear improvements in outcomes measured beyond the training programs. This suggests that experienced cochlear implant users may not show transfer of on-task learning to untrained tasks after computer-based auditory and visual training programs such as the ones used in this study.
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Affiliation(s)
- Mariana Reis
- The HEARing Cooperative Research Centre, Melbourne, Australia.,Department of Linguistics, 7788Macquarie University, Macquarie University, Sydney, Australia
| | - Catherine M McMahon
- The HEARing Cooperative Research Centre, Melbourne, Australia.,Department of Linguistics, 7788Macquarie University, Macquarie University, Sydney, Australia.,Macquarie University HEAR Centre, Sydney, Australia
| | - Dayse Távora-Vieira
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia, Perth, Australia.,Fiona Stanley Fremantle Hospitals Group, Perth, Australia
| | - Peter Humburg
- Stats Central, Mark Wainwright Analytical Centre, UNSW, Sydney, Australia
| | - Isabelle Boisvert
- The HEARing Cooperative Research Centre, Melbourne, Australia.,Department of Linguistics, 7788Macquarie University, Macquarie University, Sydney, Australia.,Macquarie University HEAR Centre, Sydney, Australia.,Sydney School of Health Sciences, University of Sydney, Sydney, Australia
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12
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Maruthurkkara S, Allen A, Cullington H, Muff J, Arora K, Johnson S. Remote check test battery for cochlear implant recipients: proof of concept study. Int J Audiol 2021; 61:443-452. [PMID: 34431430 DOI: 10.1080/14992027.2021.1922767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES (1) To investigate the remote check test battery, designed for self-administration by cochlear implant (CI) recipients, parents/caregivers, to determine if the results give adequate information for clinicians to decide the necessity of an appointment and to capture suggestions for improvement. (2) To gauge acceptance of remote monitoring by CI-recipients and their parents/caregivers. DESIGN Prospective, multicentre, un-blinded, non-randomized, single-subject, repeated-measures evaluation. The test battery includes an implant-site photograph, impedance measurements, datalogs, questionnaires, speech perception and aided threshold tests. Clinicians reviewed test battery results, followed by a clinical appointment with each CI-recipient, and reported if the battery identified all the issues. Study sample: n = 93 CI-recipients (73 adults, 20 children) and 28 clinicians. RESULTS The test battery identified 94% (615/656) of all issues. The test battery and clinician observations agreed in 99% (92/93) of cases on the need for a clinic visit. For 68% (63/93) of cases, the test battery identified all clinician observed issues. The majority (77%, 72/93) of recipients would be satisfied if clinic visits were based on their test battery results. A significantly high proportion agreed that remote monitoring was more convenient than clinic visits and could result in travel, time and cost reductions. CONCLUSION This is the first comprehensive test battery designed for CI-recipient remote monitoring.
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Affiliation(s)
| | - Agnes Allen
- Scottish Cochlear Implant Programme, Kilmarnock, UK
| | - Helen Cullington
- Auditory Implant Service, University of Southampton, Southampton, UK
| | - Joanne Muff
- Emmeline Centre for Hearing Implants, Cambridge, UK
| | | | - Susan Johnson
- Nottingham Auditory Implant Programme, Nottingham, UK
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13
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Lau K, Greenwood L, Proctor V, Yardley M, Ray J. Remote assessments for bone conduction hearing devices during the COVID-19 pandemic. Eur Arch Otorhinolaryngol 2021; 279:3297-3300. [PMID: 34363503 PMCID: PMC8346775 DOI: 10.1007/s00405-021-07025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/28/2021] [Indexed: 11/24/2022]
Abstract
Purpose The COVID-19 pandemic had resulted in the suspension of many routine audiology services due to the risk of cross-infections in closed spaces. This has driven the need for exploring alternatives to conventional face-to-face consultations in the hospital outpatient setting. The aim of this study was to determine the efficacy of remote consultations and assessments for patients on the waiting list for consideration of bone conduction hearing devices (BCHDs), and whether this type of consultation could continue beyond the COVID-19 era. Methods This was a prospective cross-sectional study in a tertiary Neuro-otology Department. All new patients on the waiting list for assessment for BCHD as of 1 March 2020 were included. Patients’ case notes were reviewed. All underwent a telephone consultation with an implant audiologist. If the patient wanted to go ahead with the remote trial, a BCHD sound processor on a headband would be mailed out and the patient would then have to use the device for two weeks and return the device after with their diary. Results There were 49 patients. The mean age was 55 (range 27–88, SD 16.3). Four did not proceed with the trial. All patients returned their devices to the department. Majority of patients (95.6%, n = 43), completed their diary. 75.6% wanted to proceed with surgery. All patients proceeding with surgery were happy with the remote assessment and would recommend this for the future. Conclusion It is possible to satisfactorily assess appropriately screened patients for BCHDs remotely with a structured approach and explanation of process and expectations. It might be possible to consider this type of consultation as an option for assessing potential candidates for BCHDs beyond the COVID-19 era to reduce the number of hospital visits for patients.
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Affiliation(s)
- Kimberley Lau
- Neuro-otology Department, Sheffield Teaching Hospitals, Sheffield, UK.
| | - Larissa Greenwood
- Hearing Services Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - Vicki Proctor
- Hearing Services Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - Mark Yardley
- Neuro-otology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - Jaydip Ray
- Neuro-otology Department, Sheffield Teaching Hospitals, Sheffield, UK
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14
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Carter JM, Killan CF, Ridgwell JJ. Telehealth rehabilitation for adults with cochlear implants in response to the Covid-19 pandemic: platform selection and case studies. Cochlear Implants Int 2021; 23:43-51. [PMID: 34238138 DOI: 10.1080/14670100.2021.1949524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Effective information giving and goal setting before cochlear implantation and individualised rehabilitation following implantation are both crucial for shaping patients' expectations and optimising outcomes. The Covid-19 pandemic led to temporary cessation of face to face clinic appointments. This created a need for telehealth rehabilitation for adults whose hearing loss presents unique communication challenges. AIMS We describe the piloting and implementation of telehealth rehabilitation within an adult cochlear implant service. METHOD Video conferencing and telehealth tools were assessed in terms of security, accessibility and functionality. Written support materials were developed. Telehealth sessions were piloted with lay volunteers. During service implementation, feedback was collected from patients and staff. OUTCOMES & RESULTS A video call platform was identified that was supported by the host Trust and also met the rehabilitation service's needs. A telehealth service was successfully implemented, ensuring continuity of care during lockdown. We share the platform selection framework used, practical lessons learned and patient support materials. CONCLUSION .Telehealth rehabilitation facilitated a well-received, effective service for adult cochlear implant patients. It is predicted that the benefits of telehealth rehabilitation will last beyond the lockdown restrictions posed by Covid-19.
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Affiliation(s)
- Julie M Carter
- Yorkshire Auditory Implant Service, Bradford Teaching Hospitals Foundation NHS Trust, Bradford, UK
| | - Catherine F Killan
- Yorkshire Auditory Implant Service, Bradford Teaching Hospitals Foundation NHS Trust, Bradford, UK.,NIHR Nottingham Hearing Biomedical Research Centre, University of Nottingham, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jillian J Ridgwell
- Yorkshire Auditory Implant Service, Bradford Teaching Hospitals Foundation NHS Trust, Bradford, UK
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15
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McMaster T, Wright T, Mori K, Stelmach W, To H. Current and future use of telemedicine in surgical clinics during and beyond COVID-19: A narrative review. Ann Med Surg (Lond) 2021; 66:102378. [PMID: 33996071 PMCID: PMC8105355 DOI: 10.1016/j.amsu.2021.102378] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Telemedicine has emerged as a powerful tool in the delivery of healthcare to surgical patients and enhances clinician-patient encounters during all phases of patient care. Our study aims were: to review the current use and applicability of telemedicine; evaluate its suitability, safety and effectiveness in a surgical outpatient setting, particularly in the era of social distancing restrictions and provide insight into future applications. Methods Databases searched included: PubMed, OVID Medline, Embase, Scopus, Web of Science and review of reference lists. Key words used were "telemedicine"; "telehealth"; "videoconference"; "outpatient" and "surgical clinic". For inclusion, articles required to be in English, published between 2000 and 2021, were in an outpatient surgical setting and if they had a focus during the COVID-19 pandemic. Results 335 articles were identified and screened, so that 63 articles were included in the review. Almost all articles were from Western countries (n = 60), mostly in surgical journals (n = 35) and from a range of sub-specialities, but pre-dominantly orthopaedics (n = 12) and general surgery (n = 7). The majority were original comparative studies where 31 studies directly compared telemedicine to in-person appointments and 14 papers focused on implementation during COVID-19. Discussion/conclusions Telemedicine has been safely used across various phases of surgical outpatient care, with its effectiveness evaluated by clinical outcomes, economics and user/provider satisfaction. Telemedicine has multiple accepted benefits including time efficiency, patient/healthcare cost savings and community access, but with reported limitations of clinical uncertainty, technology infrastructure requirements, cybersecurity vulnerabilities and healthcare regulatory restraints. These limitations are being overcome by accelerated implementation during COVID-19 via fast-tracked practice development. Further work is required via development of research protocols to refine the application of emerging telemedicine technologies and their applicability to different surgical sub-specialties.
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Affiliation(s)
- Thomas McMaster
- Medical School, The University of Melbourne, Parkville, VIC, Australia
| | - Timothy Wright
- Department of Surgery, St. Vincent's Hospital, Fitzroy, VIC, Australia
| | - Krinal Mori
- Department of Surgery, Northern Health, Epping, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Wanda Stelmach
- Department of Surgery, Northern Health, Epping, VIC, Australia
| | - Henry To
- Department of Surgery, Northern Health, Epping, VIC, Australia.,Department of Surgery, Werribee Mercy Hospital, Werribee, VIC, Australia
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16
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Digital Health Applications for Pharmacogenetic Clinical Trials. Genes (Basel) 2020; 11:genes11111261. [PMID: 33114567 PMCID: PMC7692850 DOI: 10.3390/genes11111261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/20/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022] Open
Abstract
Digital health (DH) is the use of digital technologies and data analytics to understand health-related behaviors and enhance personalized clinical care. DH is increasingly being used in clinical trials, and an important field that could potentially benefit from incorporating DH into trial design is pharmacogenetics. Prospective pharmacogenetic trials typically compare a standard care arm to a pharmacogenetic-guided therapeutic arm. These trials often require large sample sizes, are challenging to recruit into, lack patient diversity, and can have complicated workflows to deliver therapeutic interventions to both investigators and patients. Importantly, the use of DH technologies could mitigate these challenges and improve pharmacogenetic trial design and operation. Some DH use cases include (1) automatic electronic health record-based patient screening and recruitment; (2) interactive websites for participant engagement; (3) home- and tele-health visits for patient convenience (e.g., samples for lab tests, physical exams, medication administration); (4) healthcare apps to collect patient-reported outcomes, adverse events and concomitant medications, and to deliver therapeutic information to patients; and (5) wearable devices to collect vital signs, electrocardiograms, sleep quality, and other discrete clinical variables. Given that pharmacogenetic trials are inherently challenging to conduct, future pharmacogenetic utility studies should consider implementing DH technologies and trial methodologies into their design and operation.
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Redleaf MI, Welling DB, Wackym PA. Expanded use of teleservices in otology and neurotology in response to the COVID-19 (SARS-Cov-2) pandemic. Laryngoscope Investig Otolaryngol 2020; 5:950-953. [PMID: 33134544 PMCID: PMC7585254 DOI: 10.1002/lio2.466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/30/2020] [Accepted: 09/18/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Miriam I Redleaf
- Professor of Otology/Neurotology, Ethiopian Otology Fellowship Director, Division of OHNS Department of Surgery, University of New Mexico, Rio Rancho NM University of New Mexico Albuquerque NM USA
| | - D Bradley Welling
- Harvard Department of Otolaryngology Head & Neck Surgery Harvard Medical School Boston Massachusetts USA
| | - P Ashley Wackym
- Department of Otolaryngology-Head and Neck Surgery Rutgers Robert Wood Johnson Medical School, Rutgers University New Brunswick New Jersey USA
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Zhang F, Underwood G, McGuire K, Liang C, Moore DR, Fu QJ. Frequency change detection and speech perception in cochlear implant users. Hear Res 2019; 379:12-20. [PMID: 31035223 PMCID: PMC6571168 DOI: 10.1016/j.heares.2019.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/21/2019] [Accepted: 04/15/2019] [Indexed: 10/27/2022]
Abstract
Dynamic frequency changes in sound provide critical cues for speech perception. Most previous studies examining frequency discrimination in cochlear implant (CI) users have employed behavioral tasks in which target and reference tones (differing in frequency) are presented statically in separate time intervals. Participants are required to identify the target frequency by comparing stimuli across these time intervals. However, perceiving dynamic frequency changes in speech requires detection of within-interval frequency change. This study explored the relationship between detection of within-interval frequency changes and speech perception performance of CI users. Frequency change detection thresholds (FCDTs) were measured in 20 adult CI users using a 3-alternative forced-choice (3AFC) procedure. Stimuli were 1-sec pure tones (base frequencies at 0.25, 1, 4 kHz) with frequency changes occurring 0.5 s after the tone onset. Speech tests were 1) Consonant-Nucleus-Consonant (CNC) monosyllabic word recognition, 2) Arizona Biomedical Sentence Recognition (AzBio) in Quiet, 3) AzBio in Noise (AzBio-N, +10 dB signal-to-noise/SNR ratio), and 4) Digits-in-noise (DIN). Participants' subjective satisfaction with the CI was obtained. Results showed that correlations between FCDTs and speech perception were all statistically significant. The satisfaction level of CI use was not related to FCDTs, after controlling for major demographic factors. DIN speech reception thresholds were significantly correlated to AzBio-N scores. The current findings suggest that the ability to detect within-interval frequency changes may play an important role in speech perception performance of CI users. FCDT and DIN can serve as simple and rapid tests that require no or minimal linguistic background for the prediction of CI speech outcomes.
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Affiliation(s)
- Fawen Zhang
- Department of Communication Sciences and Disorders, University of Cincinnati, Ohio, USA.
| | - Gabrielle Underwood
- Department of Communication Sciences and Disorders, University of Cincinnati, Ohio, USA
| | - Kelli McGuire
- Department of Communication Sciences and Disorders, University of Cincinnati, Ohio, USA
| | - Chun Liang
- Department of Communication Sciences and Disorders, University of Cincinnati, Ohio, USA; Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Otolaryngology, University of Cincinnati, Ohio, USA
| | - Qian-Jie Fu
- Department of Head and Neck Surgery, University of California, Los Angeles, Los Angeles, CA, USA
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