A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users Do group audiologic rehabilitation activities influence psychosocial outcomes? Rehabilitative online education versus internet discussion group for hearing aid users: a randomized controlled trial. Short- and Long-Term Outcomes of Adult Audiological Rehabilitation Longitudinal Benefit From and Satisfaction With the Baha System for Patients With Acquired Unilateral Sensorineural Hearing Loss Development and validation of the effectiveness of [corrected] auditory rehabilitation scale. A randomized, controlled trial of the efficacy of a communication course for first time hearing aid users. A randomized, controlled trial of the short-term effects of complementing an educational program for hearing aid users with telephone consultations. A comparison of the benefit provided by well-fit linear hearing aids and instruments with automatic reductions of low-frequency gain. Subjective Measures of Hearing Aid Benefit in the NIDCD/VA Clinical Trial The Effect of Telephone Intervention on Success with Amplification Motivational engagement in first-time hearing aid users: A feasibility study Adult hearing screening: follow-up and outcomes1. Hearing conservation program for agricultural students: short-term outcomes from a cluster-randomized trial with planned long-term follow-up. Preliminary support for a brief psychological intervention to improve first‐time hearing aid use among adults A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: A Randomized Placebo-Controlled Clinical Trial. Teleaudiology: evaluation of teleconsultation efficacy for hearing aid fitting.
Abstract Objective : Previous research shows that the internet can be used in the rehabilitation of hearing-aid users . By further developing the online program , it might be possible to foster behavioral changes that will positively affect hearing-aid users . Design : A r and omized controlled study with two groups of participants . The intervention group underwent a five-week online intervention while the control group was referred to a waiting list . Question naires were used as outcome measures . Study sample : Seventy-six experienced hearing-aid users participated in the study , ranging in age from 26 to 81 years ( mean 69.3 years ) . Results : The findings showed significant improvements in the intervention group after the intervention , measured by the hearing h and icap inventory for the elderly . The effects were maintained and improved at the follow-up . Furthermore , the results indicated that the participants in the intervention group improved at two items of the international outcome inventory for hearing aids , and the effects were partly maintained at the follow-up . Finally , significant improvements in the domain of psychosocial wellbeing were found at the follow-up . Conclusions : This study provides further evidence that the internet can be used to deliver intervention of rehabilitation to hearing-aid users PURPOSE To attempt to determine whether group audiologic rehabilitation ( AR ) content affected psychosocial outcomes . METHOD A r and omized controlled trial with at least 17 participants per group was completed . The 3 treatment groups included a communication strategies training group , a communication strategies training plus psychosocial exercise group , and an informational lecture plus psychosocial exercise group . Evaluations were conducted preclass , postclass , and 6-months postclass ; they included hearing loss-related and generic quality of life scales , and a class evaluation form . RESULTS All treatment groups demonstrated short- and long-term improvement on the hearing loss-related quality of life scale . Minimal differences were measured across treatment groups . A significant difference was observed between the lecture plus psychosocial exercise group and the communication strategies training group for 1 hearing loss-related quality of life subscale . Better outcomes were measured for the 2 groups with psychosocial exercises versus the communication strategies training group on 1 generic quality of life subscale . The results for the class evaluation did not discriminate among the treatment groups . CONCLUSIONS Class content had only a minimal influence on treatment outcomes . Recommended AR class content includes a mix of interventions including information , training , and psychosocial exercises BACKGROUND By using the Internet in the audiological rehabilitation process , it might be possible in a cost-effective way to include additional rehabilitation components by informing and guiding hearing aid users about such topics as communication strategies , hearing tactics , and how to h and le hearing aids . PURPOSE To evaluate the effectiveness of an online education program for adult experienced hearing aid users including professional guidance by an audiologist and compare it with the effects of participation in an online discussion forum without any professional contact . RESEARCH DESIGN A r and omized controlled study with two groups of participants . Repeated measures at pre study , immediate follow-up , and a 6 mo follow-up . STUDY SAMPLE Fifty-nine experienced hearing aid users participated in the study , ranging in age from 24 to 84 yr ( mean 63.5 yr ) . INTERVENTION The intervention group ( N = 29 ) underwent a five-week rehabilitative online education in which activities for each week included information , tasks , and assignments , and contact with a professional audiologist was included . The participants in the control group ( N = 30 ) were referred to an online discussion forum without any audiologist contact . DATA COLLECTION AND ANALYSIS A set of question naires administered online were used as outcome measures : ( 1 ) Hearing H and icap Inventory for the Elderly , ( 2 ) International Outcome Inventory for Hearing Aids , ( 3 ) Satisfaction with Amplification in Daily Life , and ( 4 ) Hospital Anxiety and Depression Scale . RESULTS Significant improvements measured by the Hearing H and icap Inventory for the Elderly were found in both groups of participants , and the effects were maintained at the 6 mo follow-up . The results on the Hospital Anxiety and Depression Scale showed that the participants in the intervention group showed reduced symptoms of depression immediately/6 mo after the intervention . At the 6 mo follow-up participants in the control group reported fewer symptoms of anxiety than they did before the intervention started . CONCLUSIONS This study provides preliminary evidence that the Internet can be used to deliver education to experienced hearing aid users who report residual hearing problems such that their problems are reduced by the intervention . The study also suggests that online discussion forums could be used in rehabilitation . A combination of online professional supervised education and online informal discussion s could be a promising rehabilitation tool Objective : To examine short- and long-term subjective benefits of providing a counseling-oriented audiological rehabilitation ( AR ) program as an adjunct to hearing aid intervention for individuals with adult-onset hearing loss . Design : One hundred six veterans ( 68 men and 38 women ) , fit binaurally with digitally programmable analog hearing aids , participated . The Communication Profile for the Hearing Impaired ( CPHI ; Demorest & Erdman , 1987 ) was administered to all participants before hearing aid fitting . Half the patients were r and omly assigned to receive hearing aids alone ( i.e. , control ) ; the other patients were assigned to participate in a 4-wk group AR program in conjunction with receiving hearing aids ( i.e. , HA+AR ) . At the end of the AR program , the CPHI was again administered to all participants to assess short-term benefit and at 6 mo and 1 yr after hearing aid fitting to assess long-term benefit . Results : A separate repeated- measures version of the general linear model was used to examine short- and long-term benefits for the CPHI factor scores ( communication importance , communication performance , adjustment , interaction , and reaction ) and for individual importance ratings and scale scores . Hearing aid use improved both short- and long-term self-perception of communication performance , with no additional benefits from participation in the AR program . Consistent with the goals of a counseling-oriented AR program , differential short-term treatment effects were found for communication strategy usage , which led to differential short-term benefits for the interaction and reaction factors . Although failing to reach strict criteria for statistical significance , there was an observable difference in short-term outcomes between the two groups for the adjustment factor , with greater improvements occurring for the HA+AR group . Over the course of the year , benefits measured for the HA+AR group remained stable , whereas scores for the control group continued to increase , result ing in no differences in factor scores between groups at 1 yr after intervention . Conclusions : The finding of a short-term differential treatment benefit for AR in terms of interaction and reaction , and possibly for adjustment , was important , as better outcomes in these areas may be important in the decision to keep hearing aids . If this is the case , then the data support the inclusion of a counseling-oriented AR program . Differential treatment effects in interaction and reaction appeared to result from communication strategy use , indicating that the AR program is meeting many of its goals in this area . The lack of long-term differential effects appeared as the result of continued changes in adjustment , interaction , and reaction with continued  hearing aid experience Objective : To analyze the short- , medium- , and long-term benefits from and satisfaction with the Baha for patients with profound unilateral sensorineural hearing loss ( SNHL ) . Design : Prospect i ve clinical study . Setting : Head and Neck Institute at the Clevel and Clinic . Patients : Eight patients with acquired profound unilateral SNHL . Interventions : Patients underwent unaided baseline testing and aided Baha testing using laboratory and self-report measures at 6 postfitting intervals . Main Outcome Measures : Laboratory measures included the revised Speech Perception in Noise test , Hearing in Noise Test , and localization testing . Disease-specific self-report measures included the Abbreviated Profile of Hearing Aid Benefit , Hearing H and icap Inventory for Adults , and Single-Sided Deafness Question naire . The Medical Outcomes Study SF-36 Health Survey was used to assess health-related quality of life . Results : Based on 95 % confidence intervals for unaided testing , significant improvements on aided revised Speech Perception in Noise , Abbreviated Profile of Hearing Aid Benefit , and Hearing H and icap Inventory for Adults scores were sustained during the 18-month test interval . Variable performance was observed for the Hearing in Noise Test over time and patients . No acclimatization effects were shown for localization testing or the generic health-related quality -of-life measure . Patients reported satisfaction in a variety of situations as quantified by the Single-Sided Deafness Question naire in the long-term . Conclusion : The Baha is effective in reducing psychosocial consequences of unilateral profound SNHL for the long-term . Improvement in speech underst and ing occurred when the primary signal was spatially separated from background noise . Localization performance did not improve with Baha use . Overall , patients were satisfied with their Baha and would still elect to have this procedure if given a second chance OBJECTIVE To develop a new scale of hearing-related function and quality of life in patients with hearing aids that addresses overlooked concerns , such as hearing-aid comfort , convenience , and cosmetic appearance , that may influence hearing-aid adherence while maintaining brevity and sensitivity to clinical change . DESIGN Prospect i ve , multicenter instrument validation . SETTING Four diverse sites in Washington State , including 2 private practice s , 1 university setting , and 1 Veterans Affairs hospital . PATIENTS Seventy-eight patients with hearing aids . INTERVENTIONS We created 2 modules in the Effectiveness of Auditory Rehabilitation ( EAR ) scale . The first module ( Inner EAR ) covers intrinsic hearing issues such as hearing in quiet and hearing in noise and is administered both before and after treatment . The second module ( Outer EAR ) covers extrinsic ( hearing-aid related ) issues such as comfort , appearance , and convenience and is administered after hearing-aid fitting . MAIN OUTCOME MEASURES Both scales were developed and vali date d in 3 stages . Stage 1 used a qualitative approach from multiple data sources to develop preliminary instruments . Stage 2 used approaches from classic test theory to reduce the number of items and psychometrically vali date the instruments . Stage 3 examined the responsiveness or sensitivity to clinical change . RESULTS A 10-item Inner EAR module and a 10-item Outer EAR module were created and vali date d. Internal consistency of individual domains ( Cronbach alpha = 0.85 and 0.72 , respectively ) and test-retest reliability ( intraclass correlation coefficients = 0.76 and 0.81 , respectively ) were excellent . Evidence of construct validity included concurrent validity with other hearing scales and global visual analog scales , discriminant validity with dizziness h and icap , correlation with hearing-aid adherence , and confirmatory factor analyses . Both scales had strong evidence of responsiveness ( sensitivity to change ) , with higher effect sizes and Guyatt responsiveness statistics than the 2 widely used hearing scales in this study . The scales took an average of 5 minutes to complete . CONCLUSIONS The EAR scale is a valid and reliable measure of the effectiveness of amplification in the treatment of sensorineural hearing loss . It addresses the range of issues that are of importance to hearing-aid patients . The scales have excellent psychometric properties , are more responsive than several widely used hearing scales , and are minimally burdensome for patients to complete . The EAR may be a valuable outcome measure in future studies of both existing hearing aids and newer hearing-aid technologies , such as bone-anchored aids or middle ear implants Many centres include a communication course as part of their auditory rehabilitation . These usually take the form of a small group and include discussion of the effects of hearing loss , use of the hearing aid , hearing tactics and lip reading . To investigate the efficacy of such a rehabilitation programme a r and omized , controlled trial of a communication course was undertaken . All subjects were first time hearing aid users ;  h and icap was measured using the Quantified Denver Scale of Communication Function ( QDS ) at the time of hearing aid fitting , and then 13 weeks later . All subjects had a hearing aid follow-up appointment , but the treatment group ( n = 22 ) also underwent a four-week communication course , while the control group ( n = 25 ) had no further rehabilitation . The reduction in h and icap measured by the change in QDS was significantly greater for the treatment group than for the control group ( Mann Whitney U test , tied p value = 0.014 ) . This indicates that such a communication course is efficacious in reducing h and icap . Further research is required to identify the population s that will benefit most from such a course BACKGROUND Audiologic rehabilitation aims to improve communication for people with hearing impairment . Education is widely regarded as an integral part of rehabilitation , but the effect of the delivery method of an educational program on the experience of hearing problems has rarely been investigated in controlled trials . PURPOSE The purpose of this study was to examine the short-term effects of complementing an educational program for hearing aid users with telephone consultations , delivered through weekly discussion s with the subjects about information obtained from a book on hearing and hearing aids . RESEARCH DESIGN This study used a r and omized , controlled design . STUDY SAMPLE In total , 69 hearing aid users were r and omly assigned to an intervention group ( n = 33 ) or a control group ( n = 36 ) . INTERVENTION The intervention group had access to a book and received weekly topic-based reading instructions related to the different chapters of the book . Five telephone calls were made to the members of the intervention group . During the calls , an audiologist discussed new information with the participant as needed . The control participants also read the book , but they did not discuss the contents of the book with a professional . DATA COLLECTION AND ANALYSIS The Hearing H and icap Inventory for the Elderly ( HHIE ) , the Hospital Anxiety and Depression Scale ( HADS ) , and the International Outcome Inventory for Hearing Aids ( IOI-HA ) were used to measure the outcomes of this study . RESULTS Participants in the intervention group had a reduction in self-reported hearing h and icap , while there were no significant changes in the control group . In the intervention group , 45 % of the participants showed an improvement of ≥36 % on the HHIE , while only 17 % of the control group showed an improvement of ≥36 % . There were also improvements on the HADS total and the depression subscale for the intervention group . No changes occurred on the IOI-HA . CONCLUSIONS Reading about hearing and hearing aids can reduce the hearing h and icap and reported anxiety in hearing aid users . In this study , discussing the content of the book that was provided with a professional during weekly telephone consultations and having weekly home assignments further improved emotional well-being , as demonstrated by the HHIE ( emotional scale ) and HADS ( depression scale ) , but these activities had no effect on hearing aid outcomes as measured by the IOI-HA In this clinical study , 110 patients seen at three different clinical facilities were fit binaurally with linear , in-the-canal ( ITC ) hearing aids .  All patients were new hearing aid users . Each of the hearing aids was equipped with an adjustable control that could be set by one of the audiologists ( Audiologist A ) at each site to convert it from a linear instrument to an experimental nonlinear one with automatic reduction of low-frquency gain at high input levels ( or base increase at low levels , BILL ) . Both the patient and the audiologist performing the outcome testing at each site ( Audiologist B ) were blind as to the present setting of the hearing aid . Each participant was enrolled in the study for a total of 12 weeks , with the hearing aid set to either the linear or BILL-processing mode of operation for the first 8 weeks and the opposite setting for a subsequent 4-week period . In summary , this was a prospect i ve , doubleblind , crossover study of 110 new hearing aid users . Outcome measures focused on hearing-aid benefit and included both objective and subjective measures . Objective measures were derived from scores on the Northwestern University Auditory Test NO . 6 ( NU-6 ) and the Connected Speech Test ( CST ) obtained for all possible combinations of two speech presentation levels ( 60 and 75 dB SPL ) two types of background noise ( cafeteria noise and multitalker babble ) , and two signal-to-noise ratios ( + 5 and + 10 dB ) . Subjective outcome measures included magnitude estimation of listening effort ( MELE ) , the abbreviated form of the Hearing Aid Performance Inventory ( HAPI ) , and estimations of hearing-aid usage based on daily-use logs kept by the participants . All of these measures were used to evaluate the benefit provided by linear amplification and the benefit result ing from the experimental BILL processing . Participant preferences for the experimental BILL-processing scheme or linear processing were also examined by using a paired-comparison task at the end of the study . Results were analyzed separately for three subgroups of patients ( mild , moderate , severe ) formed on the basis of their average hearing loss at 500 , 1000 , 2000 , and 4000 Hz . In all three subgroups , significant improvement in performance was observed for linear amplification and for BILL processing when compared to unaided performance . There were no significant differences in aided performance , however , between linear processing and the experimental BILL processing Objective Subjective measures of performance were assessed on three different hearing aid circuits as part of a large clinical trial . These measurements included the Profile of Hearing Aid Performance and a subjective ranking of individual preference . Design A multi-center , double-masked clinical trial of hearing aids was conducted at eight VA Medical Centers .  Three hearing aid circuits , a linear peak-clipper , a linear compression limiter and a wide dynamic range compressor , were investigated . The experimental design was a three-period , three-treatment crossover design . Subjects ( N = 360 ) were stratified by site and r and omized to one of six sequences for the  hearing aid circuits  . All fittings were binaural and involved a 3-mo trial with each of the three circuits . All subjective measures were administered for unaided and aided conditions at the end of each trial period . Results While all of the circuits result ed in improved scores on the aided versus the unaided PHAP , there were few conditions in which one circuit outperformed the others . An exception was the aversiveness of sound subscale where the peak clipper frequently scored worse than either the compression limiter or the wide dynamic range compressor . In the subjective ranking scale the compression limiter received more first place rankings than the other two circuits , especially for one subgroup of patients with moderate flat hearing loss . Conclusions All circuits were perceived as beneficial by these subjects in most situations . The peak clipper scored worse on aversiveness of sound than did the other two circuits for most subjects , while the compression limiter seemed to have a slight advantage in subjective rankings . Most subjects perceived considerable aided benefit in situations involving background noise and reverberation , situations where hearing aid benefit is often question ed The purpose of this study was to determine whether periodic clinician-initiated telephone contact would reduce the number of unresolved complaints and increase satisfaction , use , and perceived benefit at 4 mo postfitting . Thirty subjects were contacted at 6 , 9 , and 12 wk postfitting to address questions and to encourage them to return to the clinic to resolve hearing aid-related problems . A control group of 30 subjects was encouraged to contact the center if problems arose at the time of dispensing only . All subjects were interviewed at 4 mo following receipt of the aids , and were sent the Hearing H and icap Inventory for the Elderly at the same time as well as at the time of dispensing . Results revealed a significant reduction in perceived h and icap in general , but no significant difference between groups on measures of satisfaction , use , or benefit . There was no significant difference between groups in the number of unresolved complaints at the time of the interview ; however , a trend toward fewer complaints in the experimental group was noted . A significantly greater number of complaints were raised for the first time in the control group than in the experimental group at the time of the interview , indicating that more problems remained unaddressed in the absence of clinician-initiated intervention . Therefore , the continued investigation of aggressive , and efficient , postfitting management schemes is warranted Abstract Objective : To assess ( 1 ) the feasibility of incorporating the Ida Institute ’s Motivation Tools into a UK audiology service , ( 2 ) the potential benefits of motivational engagement in first-time hearing aid users , and ( 3 ) predictors of hearing aid and general health outcome measures . Design : A feasibility study using a single-centre , prospect i ve , quasi-r and omized controlled design with two arms . The Ida Institute ’s Motivation Tools formed the basis for motivational engagement . Study sample : First-time hearing aid users were recruited at the initial hearing assessment appointment . The intervention arm underwent motivational engagement ( M+ , n = 32 ) , and a control arm ( M- , n = 36 ) received st and ard care only . Results : The M+ group showed greater self-efficacy , reduced anxiety , and greater engagement with the audiologist at assessment and fitting appointments . However , there were no significant between-group differences 10-weeks post-fitting . Hearing-related communication scores predicted anxiety , and social isolation scores predicted depression for the M+ group . Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group . Hearing sensitivity was not a predictor of outcomes . Conclusions : There were some positive results from motivational engagement early in the patient journey . Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users PURPOSE To screen hearing and evaluate outcomes in community-dwelling older adults . METHOD Three thous and and twenty-five adults responded to an  invitation to be screened by question naire , otoscopy , and pure-tone audiometry . Pure-tone average ( PTA ) > 35 dB HL in the worse ear , unilateral hearing loss , or otoscopic findings were the criteria for referral for services . A question naire related to compliance with referral recommendations was completed by telephone interview for 160 r and omly selected participants after 1 - 2 years from referral . RESULTS The referral rate for audiologic/hearing aid evaluation was 46 % , and referral for cerumen removal/medical evaluation was 17 % . Of the people referred for audiologic/hearing aid evaluation , 18 % tried a hearing aid ; 2 years later , 11 % were using a hearing aid . Screening recommendations affected participants ' decision to seek help . Study participants stated that the screening was helpful , it should be offered to everybody , and they would participate in future screenings . CONCLUSION Although adult hearing screening offered timely identification of hearing loss for adults seeking help , follow-up with hearing aid treatment was low OBJECTIVES ( 1 ) To conduct a contemporary analysis of historical data on short-term efficacy of a 3-year hearing conservation program conducted from 1992 to 1996 in Wisconsin , USA , with 753 high school students actively involved in farm work ; ( 2 ) to establish procedures for assessment of hearing loss for use in a recently funded follow-up of this same hearing conservation program cohort . METHODS We analyzed a pragmatic cluster-r and omized controlled trial , with schools as the unit of r and omization . Thirty-four rural schools were recruited and r and omized to intervention or control . The intervention included classroom instruction , distribution of hearing protection devices , direct mailings , noise level assessment s , and yearly audiometric testing . The control group received the audiometric testing . RESULTS Students exposed to the hearing conservation program reported more frequent use of hearing protection devices , but there was no evidence of reduced levels of noise-induced hearing loss ( NIHL ) . CONCLUSION Our analysis suggests that , since NIHL is cumulative , a 3-year study was likely not long enough to evaluate the efficacy of this intervention . While improvements in reported use of hearing protection devices were noted , the lasting impact of these behaviors is unknown and the finding merits corroboration by longer term objective hearing tests . A follow-up study of the cohort has recently been started Objectives Suboptimal hearing aid use extorts significant social , health , and economic costs . The aims of this study were to ( 1 ) test the novel hypothesis that the threat associated with being diagnosed with hearing loss could be ameliorated with a self‐affirmation manipulation and ( 2 ) gauge the feasibility of deploying the manipulation in routine clinical practice . Design Parallel groups r and omized controlled trial with 10‐week follow‐up . Method Fifty people , newly prescribed with a hearing aid , completed either a question naire that included a brief self‐affirming exercise or an identical question naire with no self‐affirming exercise . The main outcome measure was derived from data logging automatically stored by the hearing aid . Perceived threat ( ‘ anxiety about ageing ’ ) , behavioural intention , and self‐efficacy were measured as potential mediators . Results Objective ly measured hours of daily hearing aid use were marginally higher in the intervention group compared with the control group ( between‐group difference = 1.94 hr , 95%CI = −1.24 , 5.12 , d = 0.43 ) . At follow‐up , participants in the intervention group were significantly less anxious about ageing and more accepting of older people than were participants in the control group ( between‐group difference = 0.75 , 95%CI = 0.26 , 1.22 , d = 0.87 ) . There was no statistically significant effect of the intervention on behavioural intention or self‐efficacy . Conclusions Although not statistically significant , the magnitude of the effect of the intervention on hearing aid use ( d = 0.43 ) suggests that it would be worthwhile working towards a fully powered r and omized controlled trial . The ability to reduce anxieties about ageing with this brief intervention could have far‐reaching benefits for multiple patient and general population groups . Statement of contribution What is already known on this subject ? Hearing impairment is more disabling than diabetes , yet hearing aid use is suboptimal . Anxieties about ageing may undermine hearing aid use . What does this study add ? The study tests a brief theory‐based psychological intervention to reduce anxiety about ageing and promote hearing aid use . Results show that the brief psychological intervention  reduced anxiety and marginally increased objective hearing aid use . Further work is required to identify other situations in which anxieties about ageing undermine behaviour change efforts . The very brief , flexible nature of the intervention means it could be adapted and deployed in numerous other health care setting The primary aim of this research was to evaluate the validity , efficacy , and generalization of principles underlying a sound therapy-based treatment for promoting expansion of the auditory dynamic range ( DR ) for loudness . The basic sound therapy principles , originally devised for treatment of hyperacusis among patients with tinnitus , were evaluated in this study in a target sample of unsuccessfully fit and /or problematic prospect i ve hearing aid users with diminished DRs ( owing to their elevated audiometric thresholds and reduced sound tolerance ) . Secondary aims included : ( 1 ) delineation of the treatment contributions from the counseling and sound therapy components to the full-treatment protocol and , in turn , the isolated treatment effects from each of these individual components to intervention success ; and ( 2 ) characterization of the respective dynamics for full , partial , and control treatments . Thirty-six participants with bilateral sensorineural hearing losses and reduced DRs , which affected their actual or perceived ability to use hearing aids , were enrolled in and completed a placebo-controlled ( for sound therapy ) r and omized clinical trial . The 2 × 2 factorial trial design was implemented with or without various assignments of counseling and sound therapy . Specifically , participants were assigned r and omly to one of four treatment groups ( nine participants per group ) , including : ( 1 ) group 1-full treatment achieved with scripted counseling plus sound therapy implemented with binaural sound generators ; ( 2 ) group 2-partial treatment achieved with counseling and placebo sound generators ( PSGs ) ; ( 3 ) group 3-partial treatment achieved with binaural sound generators alone ; and ( 4 ) group 4-a neutral control treatment implemented with the PSGs alone . Repeated measurements of categorical loudness judgments served as the primary outcome measure . The full-treatment categorical-loudness judgments for group 1 , measured at treatment termination , were significantly greater than the corresponding pretreatment judgments measured at baseline at 500 , 2,000 , and 4,000 Hz . Moreover , increases in their " uncomfortably loud " judgments ( ∼12 dB over the range from 500 to 4,000 Hz ) were superior to those measured for either of the partial-treatment groups 2 and 3 or for control group 4 . Efficacy , assessed by treatment-related criterion increases ≥ 10 dB for judgments of uncomfortable loudness , was superior for full treatment ( 82 % efficacy ) compared with that for either of the partial treatments ( 25 % and 40 % for counseling combined with the placebo sound therapy and sound therapy alone , respectively ) or for the control treatment ( 50 % ) . The majority of the group 1 participants achieved their criterion improvements within 3 months of beginning treatment . The treatment effect from sound therapy was much greater than that for counseling , which was statistically indistinguishable in most of our analyses from the control treatment . The basic principles underlying the full-treatment protocol are valid and have general applicability for exp and ing the DR among individuals with sensorineural hearing losses , who may often report aided loudness problems . The positive full-treatment effects were superior to those achieved for either counseling or sound therapy in virtual or actual isolation , respectively ; however , the delivery of both components in the full-treatment approach was essential for an optimum treatment outcome PURPOSE To evaluate teleconsultation 's efficacy for hearing aid fitting . METHODS Fifty hearing impaired individuals with ages ranging from 39 to 88 years and mean audiometric thresholds between 30 and 68.75 dBHL participated in this study . Participants were divided into two groups ( stratified r and omization ) : control group ( n=25 ) , su bmi tted to face-to-face procedures , and experimental group ( n=25 ) , su bmi tted to synchronous teleconsultation with interactive video and remote applicative control . The hearing aids were programmed and verified ( with microphone probe ) , and the subjects received instructions regarding use and care for the device . Time taken for the procedures was measured . Following the consultations , an evaluator ( blind to the groups ) applied the Hearing in Noise Test ( HINT-Brazil ) . Approximately one month after consultations , the daily time of hearing aid use was verified , and the International Outcome Inventory for Hearing Aids ( IOI-HA ) was administered . RESULTS A greater time for programming and verification and a smaller time for orientation were observed for the experimental group . No difference was found between groups for the total consultation time . The real ear measures ' matching to their respective targets was similar for both groups . No difference was observed between groups for the HINT results ( silence and noise ) , the daily amount of use of hearing aids in hours , and the IOI-HA scores . CONCLUSION Teleconsultation is an efficient procedure for hearing aid programming , verification and fitting when face-to-face services are not available
Satisfaction and speech perception were frequent secondary outcomes .
There was diversity in measures used to report patient outcomes .
Outcome categories other than patient health status and behavior were rarely reported .
This review has highlighted considerable diversity in patient-reported outcome measurements in r and omized control trials in the context of adult auditory rehabilitation .
OBJECTIVES This review documented the range and nature of reported outcome measures in the context of adult auditory rehabilitative research .