Effectiveness of basic and premium hearing aid features for older adults

基本和高级助听器功能对老年人的有效性

• 批准号: 8083121
• 负责人: ROBYN Masterton COX
• 金额: $ 29.23万
• 依托单位: UNIVERSITY OF MEMPHIS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8083121
• 关键词: Address; Adopted; Adoption; Adult; Advocate; Auditory; Blinded; Characteristics; Chronic; Client satisfaction; Cognitive; Collection; Communication; Complex; Cross-Over Studies; Crossover Design; Data; Devices; Disadvantaged; Economics; Educational workshop; Effectiveness; Elderly; Emotional; Evidence based practice; Goals; Guidelines; Health; Health Personnel; Healthcare; Hearing; Hearing Aids; Hearing problem; Individual; Interview; Laboratories; Life; Life Style; Manufacturer Name; Marketing; Measures; Modeling; National Institute on Deafness and Other Communication Disorders; Noise; Outcome; Outcome Measure; Participant; Patient Self-Report; Patients; Personality; Provider; Public Health; Publishing; Recommendation; Relative (related person); Research; Research Personnel; Research Proposals; Scientific Advances and Accomplishments; Sensorineural Hearing Loss; Sound Localization; Speech; Technology; Terminology; Testing; Third-Party Payer; United States National Institutes of Health; base; cost; cost effective; cost effectiveness; design; digital; effective therapy; evidence base; evidence based guidelines; experience; hearing impairment; help-seeking behavior; improved; instrument; preference; public health priorities; satisfaction; social

DESCRIPTION (provided by applicant): About one-third of older adults have a hearing loss, but fewer than 25% of those who have the problem seek help. Among people with mild to moderate hearing loss, the rate of help-seeking is even lower: 10% or less. There are significant societal ramifications of this situation because untreated hearing problems have been shown to cause social, emotional, and communication difficulties as well as economic disadvantages. Hearing aids are the first and most effective treatment for the hearing loss sustained by most older adults. Thus, it is an important public health priority to increase the hearing aid adoption rate in this group. Several barriers to adoption of hearing aids by older adults have been identified. One of the primary barriers is the cost of the most advanced (premium-level) modern hearing aids, which tend to be about $2000 or more per instrument. Premium-level hearing aids contain the most sophisticated existing technology. However, much less-costly (basic-level) modern hearing aids are available. Basic-level devices include less sophisticated technology but still are very advanced compared to hearing aids available in the past. It is likely that basic-level hearing aids would be substantially helpful for many older adults with mild-moderate hearing loss. But there are very limited independent (i.e., non-manufacturer) data that explore the differences in laboratory and, especially, real world outcomes for patients using basic-level versus premium-level hearing aids, despite the obvious importance of this type of information in promoting evidence-based practice in hearing health care. As a result, when recommending hearing aids to patients, practitioners must rely mostly on unsupported manufacturer claims about feature benefits. Not surprisingly, premium-level devices are very frequently recommended. In this research, the long-term goal is to advance the scientific basis of hearing aid provision for older adults with mild to moderate hearing loss. The effectiveness of basic-level hearing aids and premium-level hearing aids will be determined and compared. In addition, evidence-based guidelines will be formulated to facilitate the selection of the appropriate feature level for a particular individual. The research plan is a blinded, repeated, crossover design. Each participant will complete two crossover trials separated by a washout period. Each trial will feature current hearing aids from one of 6 major manufacturers. In each crossover trial, outcomes will be measured for a basic-level device pair and a matching premium-level device pair. Outcomes will be quantified objectively, by standardized self-report, and qualitatively by interview, in each of four domains: speech understanding, listening effort, localization, and sound acceptability. The results will help practitioners, third-party payers, and informed patients to make more evidence-based decisions about appropriate hearing aids. In the long run, this will improve the cost-effectiveness of hearing aid fittings and support efforts to create and utilize more affordable devices that effectively optimize the listening experience for older adults with mild to moderate hearing loss. PUBLIC HEALTH RELEVANCE: Untreated hearing problems are a leading public health concern because they have negative social, emotional, communication and economic consequences. Fewer than 25% of older adults with hearing loss seek help, partly because of the high cost of the latest modern hearing aids. This research examines the differences in real world benefits between higher-cost and lower-cost hearing aids, with the goal of providing increased access to successful, lower cost, hearing health care for underserved older adults.

描述（由申请人提供）：大约三分之一的老年人有听力损失，但只有不到 25% 的有听力损失的人寻求帮助。在轻度至中度听力损失的人群中，寻求帮助的比例甚至更低：10%或更低。这种情况会产生重大的社会影响，因为未经治疗的听力问题已被证明会导致社交、情感和沟通困难以及经济不利。助听器是大多数老年人听力损失的首选也是最有效的治疗方法。因此，提高这一群体的助听器采用率是一项重要的公共卫生优先事项。已经发现了老年人使用助听器的一些障碍。主要障碍之一是最先进（高级）现代助听器的成本，每台助听器往往约为 2000 美元或更多。高级助听器包含最先进的现有技术。然而，可以使用成本低得多（基础级）的现代助听器。基础级设备的技术不太复杂，但与过去的助听器相比仍然非常先进。基础级助听器可能对许多患有轻度至中度听力损失的老年人有很大帮助。但是，探索实验室结果差异的独立（即非制造商）数据非常有限，尤其是使用基础级助听器与高级助听器的患者在现实世界中的结果，尽管此类信息在助听器中具有明显的重要性。促进听力保健方面的循证实践。因此，在向患者推荐助听器时，从业者必须主要依赖于不受支持的制造商关于功能优势的声明。毫不奇怪，高级设备经常受到推荐。在这项研究中，长期目标是为轻度至中度听力损失的老年人提供助听器的科学基础。将对基础级助听器和高级助听器的有效性进行确定和比较。此外，将制定基于证据的指南，以方便为特定个人选择适当的特征级别。研究计划是盲法、重复、交叉设计。每个参与者将完成两次交叉试验，中间有一个洗脱期。每次试验都将采用 6 个主要制造商之一的当前助听器。在每次交叉试验中，将测量基本级设备对和匹配的高级设备对的结果。结果将通过标准化自我报告客观量化，并通过访谈定性，在四个领域中的每一个领域：语音理解、听力努力、本地化和声音可接受性。研究结果将帮助从业者、第三方付款人和知情的患者就合适的助听器做出更多基于证据的决定。从长远来看，这将提高助听器配件的成本效益，并支持创造和利用更实惠的设备，有效优化轻度至中度听力损失老年人的听力体验。 公共卫生相关性：未经治疗的听力问题是主要的公共卫生问题，因为它们会产生负面的社会、情感、沟通和经济后果。不到 25% 的听力损失老年人寻求帮助，部分原因是最新现代助听器的成本高昂。这项研究探讨了高成本和低成本助听器在现实世界中的益处之间的差异，目的是为服务不足的老年人提供更多获得成功、成本较低的听力保健服务的机会。