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Should i get a hearing aid now - HEARing CRC PhD presentation
Title of poster
Gradual improvements in hearing aids have allowed clinicians to
successfully provide hearing aids to individuals with mild to moderate
hearing loss. However, usage rates remain low (Hartley et al., 2010).
To develop a patient decision aid (PDA) with an individualised prediction
of success to support the decision to adopt hearing aids.
First we used an online survey of older adults and Audiologists. Would
use a patient decision aid (PDA) for the uptake of amplification? Then, an
existing data set with pure tone audiograms and outcomes from 317
hearing aid fittings was re-analysed. Finally, a systematic search of the
evidence base for hearing aids was carried out. This search focussed on
the client factors that predict successful hearing aid outcomes. The
useful factors were incorporated into a prototype patient decision aid.
The survey of 120 older adults used a hypothetical health scenario. 90%
of respondents prefer to be told their chance of success with hearing
aids before deciding whether to obtain them. They were more likely to
take up amplification with a higher prediction of success. Audiologists
responded to a similar survey and hypothetical health scenario. (n=209
response rate=9.5%). Although the scenario described the PDA as an
adjunct to professional opinion, less than half of the surveyed
audiologists would share an evidence based prediction that was more
negative than their own opinion.
The reanalysis of the data set tested the hypothesis that pure tone
audiogram data from subjects with mild to moderate hearing loss can
predict successful outcomes on International Outcomes Inventory
(IOIHA) measures. Even after the data was modelled to represent the
expected improvement in speech discrimination in quiet from prescribed
amplification there were no correlations with IOIHA benefit or usage.
The systematic review of the literature yielded 34 papers from 2009 to
2015 that were graded. Evidence summary. 1. Device usage increases
for subjects with best ear 4F PTA > 45 dB HL. 2. Device usage increases
with greater than 2 people living in the home. 3. Pensioners living alone
who report poor general health also report poorer hearing aid outcomes.
4. Subjects who are fitted with open fit hearing aids do not show speech
discrimination improvements as a group.
An online patient decision aid was developed from the main findings of
the literature review. A focus on Australian findings was reflected in the
patient decision aid to ensure relevance to the Australian context.
It is possible to develop an evidence based patient decision aid to
support the uptake of hearing aids. Implementation within an industry
context is considered desirable to align with modern evidence based
practice and shared, informed, health decision making.
References Hartley, D., Rochtchina, E., Newall, P., Golding, M.,
Mitchell, P., 2010. Use of Hearing Aids and Assistive Listening Devices in an
Older Australian Population. Journal of the American Academy of Audiology 21
Christopher Whitfeld, PhD Candidate, Macquarie University, North Ryde,
NSW 2109, Australia email: Chris.Whitfeld@mq.edu.au
Associate Professor Dr Catherine McMahon, Centre for Language Sciences,
16 University Drive, Macquarie University, North Ryde, NSW 2109, Australia
Dr Harvey Dillon, National Acoustic Laboratories, Australian Hearing Hub, 16
University Drive, Macquarie University, North Ryde, NSW 2109, Australia.
Should I get a hearing aid now?
Developing a patient decision aid for the uptake of amplification.
Chris Whitfeld* Catherine McMahon* Harvey Dillon*
Success not likely
Success likely (75%) Almost certain success
Hypothetical Hearing Aid Uptake.
Based on an evidence based estimate of likely success.
Use the tool? Share positive
Use Tool and Share Tool Result?
Yes%. Adjacent differences significant p<0.05
Patient Decision Aid Sample