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Read the latest news, research updates and trends in audiology and hearing care. Post comments and share with your colleagues!

Thursday, April 18, 2019

Hearing aid use is significantly low among Hispanics/Latinos in the United States with clinically significant hearing loss, finds a new study. Data on 1,989 Hispanic/Latino older adults with hearing loss showed that only 87 (4.7 %) used hearing aids—lower than what the researchers expected and lower than the already-low national estimate of hearing aid prevalence at 14.2 to 33.1 percent. Access to health insurance was found to play an important role in the adults' hearing aid use.

"The most significant finding was that health insurance was associated with greater odds of hearing aid use," said lead author Michelle L. Arnold, AuD, PhD, of the University of South Florida Sarasota. "This isn't too surprising though. Many previous studies also point to a lack of affordability and access being major barriers to hearing health care."

The participants were also given the Short Acculturation Scale for Hispanics (SASH) to assess their language use, media, and ethnic and social relations. The SASH scores suggested that the study participants tended to think and speak in Spanish and preferred social contacts from Hispanic/Latino backgrounds. While the SASH language scores did not significantly characterize hearing aid use, the researchers noted that language may have a secondary effect on the participants' overall health care access, including access to insurance.

"Anecdotally, I've noted that language barriers are a significant problem," Arnold told The Hearing Journal. "Even clinics that are located in areas with high concentrations of Spanish-speakers often don't provide culturally and linguistically appropriate services—whether that is having a translator available or documents translated into Spanish."

"It's odd to me when patients are referred from an outside provider, and they come in with instructions that this provider gave them that are in English, when it is clear that they don't speak English, let alone read it," Arnold cited from her experience. "These types of behavior from health care providers perpetuate health inequities. And they are unacceptable when you know that a linguistic minority resides in your practice location's geographic area."

When asked about the practical steps for hearing health care providers to help improve hearing aid use in this population, Arnold offered several ideas.

"First, if you are a health care provider who works in an area where you KNOW you will see people from a different cultural or linguistic background, do your due diligence to provide culturally and linguistically appropriate services to the best of your capabilities," Arnold noted. "Make noise if there aren't interpreters or translators available, make noise if materials in languages commonly spoken in your community aren't available. Do what you can to pressure administrators and the system to change, even if it's just for your individual clinic schedule. Don't perpetuate health inequities because 'this is the way we've always done it'."

"Second, addressing the under-utilization of hearing health care among people with hearing loss is a huge issue," she added. "Demographically, we are getting older and more diverse in the United States," she pointed.  The prevalence of clinically significant hearing loss is more than 50 percent among adults aged 65 years and older, and 80 percent among older adults between 75 and 80 years old. Hearing loss is associated with various negative outcomes that impact cost, general health—such as increased risk of falls, hospitalizations, mental health problems, and dementia—and overall quality of life. Arnold posed: "If you can't have a conversation, how good is your quality of life going to be?"

The authors stressed the need to change public health policy and clinical service provision to improve access to hearing care for this patient population. "We need to start taking a serious look at whether addressing untreated hearing loss can mitigate some of these other health conditions," Arnold added. "Part of that includes addressing the differential needs of people in the United States from culturally and linguistically diverse backgrounds."

Tuesday, April 16, 2019

A recent study[1] by researchers from Boys Town National Research Hospital shows that Oticon OpenSound Navigator™ (OSN) improves children's speech understanding in noisy environments when listeners directly face towards or face away from the principal talker, yet still preserves speech from other talkers in the environment. The ability of OSN to preserve speech coming from different locations allows access to other talkers in the background, which is fundamental to incidental learning in school-age children.

"Better speech recognition in noise even when the child is not facing the speaker is particularly important for children because spontaneous speech may come from any direction in typical learning environments and because children do not always turn in the direction of target speech," explained Maureen Doty Tomasula, AuD, senior product and marketing manager of Oticon Pediatrics. "Giving children access to other talkers in the environment provides opportunities for incidental learning in everyday life."

In the study, Boys Town researchers compared the signal-to-noise ratios required to achieve 50 percent recognition of speech in noise when OSN or omnidirectional setting (OMNI) was applied. Fourteen children (6-15 years of age) who were experienced hearing aid users listened to and repeated words presented from either directly in front of them or from the side. Competing noise or speech was presented from loudspeakers located to the back right and back left of the children.

The study results showed that OSN, relative to OMNI, improved speech recognition performance in competing noise by an average of 4.0 dB SNR (facing talker) and 3.8 dB SNR (facing away from talker). Similar performance was observed for OSN and OMNI in competing speech, indicating that OSN did not attenuate speech in the environment. These correspond to 20-30 percentage point improvements in speech recognition when comparing OSN to OMNI.

"The overall findings of the study were that children did benefit from OpenSound Navigator when the background noise was steady noise, and that was regardless of whether the children were facing the target talker of interest, or if the target was off to the side and they weren't facing it," said Jenna M. Browning, AuD, research audiologist at the Center for Hearing Research in Boys Town National Research Hospital. "Either way, they did benefit and their signal to noise ratio was improved on average by about 4dB compared to an omnidirectional microphone."

In a separate study[2] of listening effort for children with hearing loss (ages 12-16), researchers at VU University Medical Center, Amsterdam showed that OSN improves speech understanding with less effort compared to traditional OMNI. The results showed that OSN improved speech understanding across listening conditions by up to 5 dB SNR, compared to OMNI. Subjectively, the children perceived significantly less effort while listening to speech in noise with OSN activated.

REFERENCES:

[1] Ng, E., Goverts, T., Kramer, S., & Zekveld, A. (2019). Improved speech understanding with less effort in children: An OpenSound Navigator™ study. Oticon Whitepaper.

[2] Browning, J. M., Buss, E., Flaherty, M., & Leibold, L. J. (2017, March). Integrated directionality and noise reduction: Effects on children's masked thresholds. Poster session presented at the Annual Scientific and Technology Conference of the American Auditory Society, Scottsdale, AZ.

Friday, April 12, 2019

​Thirty-eight genes previously unsuspected to be involved in hearing are actually linked to hearing loss, and they could be useful targets for the development of hearing restoration drugs, according to a new study (PLoS Biol. 2019 Apr 11;17(4):e3000194). A team of researchers from King's College London and the Wellcome Sanger Institute conducted a large-scale screen of new targeted mouse mutant lines using the auditory brainstem response. Of the 1,211 genes tested, 38 genes with no prior association with deafness had raised thresholds for detecting a response to sounds—five showed severe or profound deafness, 10 had raised thresholds at high frequencies only, two showed raised thresholds at low frequencies only, seven had moderately raised thresholds across frequencies, and 14 showed a mild hearing impairment. The 38 genes are involved in a broad range of functions, including transcriptional and translational regulation, chromatin modification, splicing factors, cytoskeletal proteins, membrane trafficking, and more, and some of them have links to existing pathways involved in deafness. The authors therefore posited it is likely that therapies will need to be directed at common molecular pathways involved in deafness rather than individual genes or mutations. The authors added that over 600 more genes required for normal auditory thresholds have yet to be found. Added to the 362 already known and 38 reported in this study, this indicates that there may be as many as 1,000 genes involved in deafness, a very high level of genetic heterogeneity. 

Friday, April 5, 2019

​iHEAR Medical (https://www.ihearmedical.com/) has launched the next generation of iHEARhd, its home-programmable invisible hearing aid for mild to moderate hearing losses. The new iteration of the device features four new pre-set sound profiles with advanced sound processing for different environments. It will also have a more durable housing, and a secure, comfortable, and discreet fit inside the ear. Users can customize their iHEARhd anywhere with a computer with internet connection using the iHEARhd programming kit and iHEARtuner, an easy-to-use interactive online application. iHEARhd is currently available for $299 per ear at iHEAR's online store. Consumers can opt for devices with customized settings for $399 each. The customized settings option is available for consumers who submit a recent hearing test or take the iHEARtest with iHEAR's FDA-cleared home hearing screener before iHEARhd is delivered to the consumer's home.

Friday, April 5, 2019

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Innovation, research, continuity, reliability: these are the keys to MedRx’s success over the last 25 years. MedRx, Largo, Florida, was established in 1994 by Ron Buck. In 1994, Ron had worked in Florida for more than 10 years as a hearing aid dispenser. As a practice owner, he decided he needed a video otoscope but found the market solutions were too costly. Instead of giving in to the market, Ron decided to develop a video otoscope for his offices. Ron pulled an engineering friend out of retirement and they started development on his video otoscope ideas. By the time the project was complete, Ron had three of the most expensive video otoscopes known to man. At that point, Ron decided to take his video otoscopes to market. This was the birth of MedRx. The result was incredible: 5 million dollars in a single year with a team of three people.

MedRx-Otowizard.jpgMedRx continued its market leading innovation with the development of the Otowizard launched in 1997. The Otowizard was the first all-in-one computerized audiometer, real ear measurement and otoscope. The Otowizard was neatly packed onto a rolling cart which could be moved around the office. MedRx built the Otowizard with products required in the hearing aid retail model. MedRx was focused on the retail model and practice owners. They were determined to produce solutions that help clinics explain hearing loss easily to patients and visually show the benefits of hearing aids.

In 2005, MedRx introduced the portable Avant series of audiometers and real ear measurement products. The Avant series transformed what was thought of as an Audiometer. These products had a small lightweight design which allowed the owners to easily travel with the equipment. The Avant audiometer and real ear devices opened new opportunities for practice owners. This allowed clinicians to travel into nursing homes, retirement facilities, remote locations and even complete home testing and fitting.

By 2017, MedRx had rounded off its modern product line. Their products became easier to install and operate. The need for drivers has disappeared and the ultimate portable audiometer and real ear device was created in the Avant ARC. The Avant ARC is a device which contains both an audiometer and real ear device combined (hence the name) in a single unit. MedRx has since expanded into clinical units with a high frequency audiometer and the Tinnometer, a device designed specifically to assess and diagnose tinnitus.

MedRx as a company prides itself on a family atmosphere with a fun lively work environment. The MedRx customers benefit from very knowledgeable staff including a technical support team with over 50 years of MedRx experience combined. MedRx has many employees who have been with the company 15+ years and 3 having been with the company over 20 years. MedRx holds regular company events like painting, go kart racing and escape rooms which keeps everyone tight knit. This fun atmosphere keeps employees engaged and ensures they are always pushing the envelope on what can be accomplished in our industry.

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Today, MedRx is 25 employees and distributes its products in more than 60 countries worldwide. MedRx maintains their focus on helping the clinician explain and the patient understand their hearing loss. The MedRx product line has expanded to screening, diagnostic and clinical audiometers, tinnitus assessment devices, binaural and monaural real ear measurement, hearing instrument test boxes, hearing aid cleaning devices and of course a video otoscope.

MedRx is celebrating their 25th Anniversary and looks forward to another 25 years to come. MedRx would like to thank the industry for their support over the past 25 years and to celebrate all purchases in May will come with a 25-month warranty!