Diagnostic Hearing Test System for Telehealth in Underserved Communities

用于服务欠缺社区远程医疗的诊断听力测试系统

• 批准号: 10255432
• 负责人: ODILE H CLAVIER
• 金额: $ 86.65万
• 依托单位: CREARE, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10255432
• 关键词: Acoustics; Address; Adult; Affect; Age-Years; Air; Alaska Native; American Indians; Android; Audiology; Auditory Threshold; Automobile Driving; Behavior; Bilateral; Bone Conduction; COVID-19 pandemic; Child; Chronic; Clinic; Clinical; Collaborations; Communities; Companions; Complex; Computer software; Conductive hearing loss; Device Designs; Diabetes Mellitus; Diagnostic; Diagnostic tests; Early Diagnosis; Early treatment; Economics; Elderly; Electronic Health Record; Electronics; Ensure; Ethnic group; External auditory canal; Feedback; Frequencies; Guidelines; Healthcare; Hearing; Hearing Aids; Hearing Tests; Human; Impaired cognition; Impairment; Indigenous; Infection; Infrastructure; Internet; Investments; Labyrinth; Language Development; Longevity; Low income; Malignant Neoplasms; Manuals; Measures; Mediating; Medical; Mental Health; Modeling; Noise; Outcome; Patients; Peer Review; Performance; Persons; Phase; Pilot Projects; Production; Publishing; Quality of life; Race; Recording of previous events; Research; Running; Rural; Rural Community; Secure; Security; Self-Help Devices; Special Equipment; Speech; Stimulus; Study Subject; System; Tablets; Technology; Testing; Training; Travel; Tympanic membrane; United States; Videoconferencing; Wireless Technology; aged; asymmetric hearing loss; automated algorithm; bone; clinical practice; depressive symptoms; design; ergonomics; handheld mobile device; health data; health disparity; hearing impairment; human subject; improved; innovation; interest; laptop; middle ear; mobile application; novel strategies; phase 1 designs; physical conditioning; portability; prototype; psychosocial; rural area; sound; teleaudiology; telehealth; telehealth systems; treatment planning; underserved community

PROJECT SUMMARY/ABSTRACT Hearing is important to our physical and mental health. Hearing loss, unfortunately, is the third most common chronic physical condition in the U.S.—more prevalent than diabetes or cancer. Presently, 14.1% (27.7 million) of adults aged 20–69 years of age have unilateral or bilateral speech-frequency hearing impairment. Uncorrected hearing loss gives rise to a poorer quality of life and increased symptoms of depression. For children, hearing loss can negatively impact speech language development, academic performance and psychosocial behavior. On the other end of our lifespan, recent research has shown hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community dwelling older adults. Many forms of hearing loss are treatable or addressable with technology (e.g., hearing aids). However, due to a lack of access to diagnostic testing, many cases go untreated. A major limiter to diagnostic quality hearing tests is the need for expensive infrastructure, i.e., sound-proofed booths, and audiologists with specialized training in conducting exams, which are traditionally conducted in-person and one-on-one. Although there has been investment in changing the model of delivering hearing assessment, particularly with new “boothless” solutions, there remains strong needs for (1) hardware that maintains the quality required for diagnostic audiometry in “boothless” settings, (2) automated testing for routine testing that would allow audiologists to focus on the more complex cases, and (3) new approaches to connect audiologists to patients through teleaudiology—enabling audiologists to provide the expertise needed for the more complex cases without requiring either the patients nor the audiologists to travel great distances. Creare, in collaboration with its clinical partners, is developing a mobile, wireless audiometric hearing test system to address these needs. Creare has chosen to focus on addressing the needs of American Indians and Alaska Natives (AIAN). In addition to the challenges due to rural and limited infrastructure, AIAN have the highest rate of hearing issues compared to other race/ethnicity groups. In Phase I, a prototype system was assembled, evaluated against relevant standards, and used in a pilot study to measure hearing thresholds on subjects with asymmetric hearing loss. Phase II will focus on refining the device design, building several pre- production prototypes, and demonstrating their use and performance with human subject studies. The Phase II outcome will be a portable, wireless audiometric hearing test system that will expand the reach of diagnostic testing to rural communities. Furthermore, the solution is well-timed with an increasing interest in teleaudiology—which has been accelerated by the COVID-19 pandemic.

项目摘要/摘要 听力对我们的身心健康很重要。不幸的是，听力损失是第三大的 美国常见的慢性身体状况比糖尿病或癌症更为普遍。目前，14.1％ （2770万）20-69岁的成年人有单方面或双边语音听证会 损害。未经纠正的听力损失会导致生活质量较差，并增加 沮丧。对于儿童，听力损失可能会对语音语言发展产生负面影响 表现和社会心理行为。在我们寿命的另一端，最近的研究表明听力 损失与认知能力下降和事件认知障碍是独立的 社区居住的老年人。 许多形式的听力损失是可以通过技术治疗或可解决的（例如助听器）。然而， 由于缺乏诊断测试的访问，许多情况未经治疗。诊断质量的主要限制 听力测试需要昂贵的基础设施，即防守摊位，以及听力学家 进行考试的专业培训，这些培训传统上是亲自进行的，一对一进行。 尽管已经投资于改变提供听力评估的模型，尤其是 新的“展位”解决方案，（1）硬件仍然有很强的需求，该硬件保持了所需的质量 “展位”设置中的诊断听觉计量法，（2）常规测试的自动测试，这将允许 听力学家专注于更复杂的病例，以及（3）将听力学家与患者联系起来的新方法 通过远程研究学 - 增强听力学家提供更复杂案例所需的专业知识 不要求患者或听力学家走得很长的距离。 Creare与临床合作伙伴合作，正在开发移动无线听力听力 测试系统以满足这些需求。克雷尔（Creare）选择专注于满足美洲印第安人的需求 和阿拉斯加的土著人（艾安）。除了由于农村和有限的基础设施引起的挑战外，Aian还有 与其他种族/种族群体相比，听力率最高。在第一阶段，原型系统是 组装，根据相关标准进行评估，并在试点研究中用于测量听力阈值 不对称听力损失的受试者。第二阶段将专注于完善设备设计，建造几个预 生产原型，并在人类学科研究中证明其使用和表现。 II期 结果将是一种便携式，无线听力测试系统，将扩大诊断的影响 对粗糙社区进行测试。此外，该解决方案及时地及时，对 远程研究学已经被19岁大流行加速了。