Efficacy of a Coupler-Based Hearing-Aid Fitting Approach for Experienced Users

James H Quillen Va Medical Center, Mountain Home TN

Investigators

Abstract

? DESCRIPTION (provided by applicant): Project Summary Hearing loss is a significant health concern for American adults, especially older adults, with approximately 36 million affected (Donahue, Dubno, & Beck, 2010). Hearing loss is the second- most common service-connected (SC) condition in the VA. Hearing aids are the primary treatment option for hearing loss for these aging and/or SC Veterans. The VA dispensed nearly 700,000 hearing aids in 2013 (VA Denver Acquisition and Logistics Center, 2013). Half of the hearing aids dispensed were to experienced hearing aid users receiving replacement hearing aids (Dennis, 2014). VA Audiology caseload is significant and Veterans have excessively long wait-times for fitting appointments to obtain new hearing aids (Office of the Inspector General, 2014). The purpose of the fitting appointment is to program and verify the hearing aids and orient the patient to hearing aid use/care. For patients obtaining replacement hearing aids, the orientation typically is unnecessary, and the programming is simplified; consisting mainly of matching the individual's real-ear aided response (REAR) and hearing aid output to appropriate target values. In contrast to adults, REAR measurements are not well-tolerated by children due to the requirement for placement of a probe tube in the ear canal. Therefore, a hearing aid fitting procedure that circumvents the need for in situ REAR measurements (real ear coupler difference or RECD) is the standard-of-care (SoC) for children. Considerable research clearly has shown the equivalency of in situ REAR and RECD fitting procedures (e.g., Moodie et al., 1994). RECD fitting procedures rarely are used with adults; however, such an approach could preclude the need for direct physical contact with the patient at the time of the hearing aid fitting. The purpose of the proposed study is to compare hearing aid fittings for three groups of experienced users obtaining replacement hearing aids. The SoC (active control) group will have their hearing aids fitted in face-to-face appointment via standard in situ REAR procedures. Two experimental groups will have their hearing aids fitted via RECD-based procedures (average vs. measured RECDs) to predict their REARs and their hearing aids mailed to them. All groups will return for in situ REARs and self-report outcomes assessment one month after the hearing-aid fitting. The results of this study should determine the efficacy of a RECD-based, hearing-aid fitting approach for experienced hearing-aid users who are receiving replacement hearing aids. If the approaches are equivalent, then this study will provide an evidence-based, RECD fitting approach that should result in greater patient satisfaction and reduced costs.