Dr. McCreery is associate director of audiology and staff scientist at Boys Town National Research Hospital in Omaha, NE.
In all the discussions about hearing aid signal processes for children, data logging is often overlooked.
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Here, I'm using the term “data logging” generically to refer to any system in the hearing aid that keeps track of the duration of hearing aid use or the different listening environments the wearer encounters daily. Data logging varies considerably across hearing aid manufacturers, as well as within different products from the same manufacturer.
Some products simply report a total or average number of hours of hearing aid use when the device is connected to the programming software, whereas others track which programs or memories are used or even the characteristics of the listening environment itself, such as quiet, noise, and speech in noise.
Figure. Ryan McCreer...Image Tools
Data logging potentially represents a powerful tool to help clinicians understand how often hearing aids are worn and in what types of listening environments. However, we should consider what we know about the accuracy of data logging and the practical issues associated with using this information to counsel parents and caregivers.
IS DATA LOGGING ACCURATE?
We don't have a lot of direct evidence about the accuracy of data logging. A study by Elizabeth Walker and colleagues that I mentioned in my June column http://journals.lww.com/thehearingjournal/Fulltext/2013/06000/Building_Blocks___Asking_the_Right_Questions_about.5.aspx found that, on average, parent reports of the amount of hearing aid use strongly agreed with results from data logging in a group of infants and young children with hearing aids (Lang Speech Hear Serv Sch 2013;44:73-88 http://lshss.asha.org/cgi/content/abstract/44/1/73).
However, for parents who reported an average of 12 hours of hearing aid use per day, data-logging values ranged from two to 15 hours. This finding suggests that although data logging approximated parent reports of average daily hearing aid use, there was significant variability. The study's observational design does not allow us to determine if the discrepancy was due to inconsistent parent reports or problems with data logging.
Evidence for the classification of listening environments by data logging is even more limited. While a classification of speech in noise seems straightforward, criteria might differ across hearing aids and manufacturers.
Classifiers often use multiple acoustic characteristics of the signal entering the hearing aid to categorize the environment, making these systems complex to understand and study.
As a result, it's important to keep the limitations of the current evidence base in mind when considering data logging.
INFORMING PATIENTS AND FAMILIES
Many audiologists question whether or not data logging should be discussed with patients and their families or caregivers.
While there are numerous opinions and perspectives on the issue, I feel that children and their families should be made aware of data logging as part of promoting transparency between patients and professionals.
Informing our patients and their families about data logging also means that we must respect their preferences if they choose not to have the tool activated.
The type of information aggregated by the hearing aid, as well as why the information is important for supporting the child's success with amplification, should be discussed.
Once families realize that the information is averaged over time and that we are only collecting the information to help identify challenges, most are willing to have it activated.
While it may seem outlandish to those of us who work with hearing aids on a daily basis, some families express concern that data logging might include GPS data or audio recordings. Reassurance about what data logging can and cannot do at this time can help allay these worries.
Inevitably, clinicians who access the results of data logging in their patients’ hearing aids will encounter the uncomfortable situation that occurs when what the patient is telling us does not match data logging.
Managing these situations requires a careful balance. We should never suggest to children or their families that their estimation of hearing aid use or the situations where they are using the hearing aid is inaccurate because it does not match what was reported by data logging.
We simply don't have enough evidence to trust that data logging is 100-percent accurate. Also, we know that data logging can be affected by things like forgetting to take out the hearing aid battery or to take hearing aids to school.
The worst possible outcome is to create the perception that you do not trust the child, parent, or caregiver, as we need their engagement to ensure a successful outcome.
However, that does not mean we simply ignore the results of data logging. Use discrepancies between data-logging values and child or parent feedback as an opportunity to discuss the types of situations where the hearing aids are most helpful, as well as the situations where they might not be enough.
These discussions can lead to the use of other hearing assistive technologies or hearing aid signal processes, like digital noise reduction or directional microphones, that might provide better access than a hearing aid alone.
Approaching these discussions in a supportive way, rather than making the child and parent feel as though they are being interrogated by the Federal Bureau of Hearing Aid Compliance, will result in solutions.
Data logging is an important hearing aid feature that will continue to expand our understanding of the amount of time and types of listening environments where our patients use their hearing aids. The tool can be particularly informative in situations with children, who may not be able to report the extent of their hearing aid use.
© 2013 by Lippincott Williams & Wilkins, Inc.