The development of a Self-Rated ICF-based questionnaire (HEAR-COMMAND Tool) to evaluate Hearing, Communication, and Conversation disability: Multinational experts’ and patients’ perspectives

ObjectiveAn instrument that facilitates the advancement of hearing healthcare delivery from a biomedical model to a biopsychosocial one that underpins the International Classification of Functioning, Disability, and Health framework (ICF) brief and comprehensive Core Sets for Hearing Loss (CSHL) is currently unavailable. The objective is to describe the process of developing and validating a new questionnaire named the HEAR-COMMAND Tool created by transferring the ICF CSHL into a theory-supported, practically manageable concept.DesignA team from Germany, the USA, the Netherlands, and Egypt collaborated on development. The following ICF domains were considered; “Body Functions” (BF), “Activities and Participation” (AP), and “Environmental Factors” (EF). The development yielded English, German, and Arabic versions. A pilot validation study with a total of 109 respondents across three countries, Germany, Egypt, and the USA was conducted to revise the item terminology according to the feedback provided by the respondents.ResultsThe questionnaire included a total of 120 items. Ninety items were designed to collect information on the functioning and 30 items inquiring about demographic information, hearing status, and Personal Factors. Except for the “Body Structures” (BS) domain, all the categories of the brief ICF CSHL were covered (a total of 85% of the categories). Moreover, the items covered 44% of the comprehensive ICF CSHL categories including 73% of BF, 55% of AP, and 27% of EF domains. Overall, the terminology of 24 ICF-based items was revised based on the qualitative analysis of the respondents' feedback to further clarify the items that were found tod be unclear or misleading. The tool highlighted the broad connection of HL with bodily health and contextual factors.ConclusionsThe HEAR-COMMAND Tool was developed based on the ICF CSHL and from multinational experts' and patients' perspectives with the aim to improve the execution of audiological services, treatment, and rehabilitation for adult patients with HL. Additional validation of the tool is ongoing. The next step would be to pair the tool with BS categories since it was excluded from the tool and determine its effectiveness in guiding hearing health care practitioners to holistically classify categories influencing hearing, communication, and conversation disability

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Investigating Differences in Preferred Noise Reduction Strength Among Hearing Aid Users

Even though hearing aid (HA) users can respond very differently to noise reduction (NR) processing, knowledge about possible drivers of this variability (and thus ways of addressing it in HA fittings) is sparse. The current study investigated differences in preferred NR strength among HA users. Participants were groups of experienced users with clear preferences (“NR lovers”; N  = 14) or dislikes (“NR haters”; N  = 13) for strong NR processing, as determined in two earlier studies. Maximally acceptable background noise levels, detection thresholds for speech distortions caused by NR processing, and self-reported “sound personality” traits were considered as candidate measures for explaining group membership. Participants also adjusted the strength of the (binaural coherence-based) NR algorithm to their preferred level. Consistent with previous findings, NR lovers favored stronger processing than NR haters, although there also was some overlap. While maximally acceptable noise levels and detection thresholds for speech distortions tended to be higher for NR lovers than for NR haters, group differences were only marginally significant. No clear group differences were observed in the self-report data. Taken together, these results indicate that preferred NR strength is an individual trait that is fairly stable across time and that is not easily captured by psychoacoustic, audiological, or self-report measures aimed at indexing susceptibility to background noise and processing artifacts. To achieve more personalized NR processing, an effective approach may be to let HA users determine the optimal setting themselves during the fitting process

Effect of Hearing Aid Directionality and Remote Microphone on Speech Intelligibility in Complex Listening Situations

Remote microphones (RMs) have been developed to support hearing aid (HA) users in understanding distant talkers. In traditional clinical applications, a drawback of these systems is the deteriorated speech intelligibility in the near field. This study investigates advantages and disadvantages of clinical RM usage and the effects of different directionality settings of the HAs in complex listening situations in the laboratory. Speech intelligibility was investigated in 15 experienced severely hearing impaired participants in a noisy environment using a dual-task test paradigm where the tasks were presented from either a near field or a far field loudspeaker. Primary and secondary tasks were presented simultaneously so attention had to be shared on both tasks. In a second experiment, two speech intelligibility tests were presented from either the near field or the far field loudspeaker. The tests were interleaved to simulate a complex listening situation with shifting attention. Directional HA microphones yielded better performance than omnidirectional microphones (both combined with a RM) in near field when analyzing both tasks of the dual-task experiment separately. Furthermore, the integrated dual-task test results showed better performance with directional HA microphones compared with the omnidirectional setting (both cases in combination with a RM). These findings were confirmed by the results of the interleaved speech intelligibility test

The French digit triplet test: A hearing screening tool for speech intelligibility in noise

A French speech intelligibility screening test in noise that applies digit triplets as stimuli has been developed and evaluated for both telephone and broadband headphone use. After optimizing the speech material based on the intelligibility of the individual digits, norms for normal-hearing subjects were established. speech reception thresholds (SRTs) of -6.4 +/- 0.4 and -10.5 +/- 0.3 dB SNR, and slopes of 17.1 and 27.1 %/dB were obtained for telephone and broadband headphone presentation, respectively. The French digit triplet test by telephone was then implemented as an automatic self-screening test by home telephone, and further evaluated in normal-hearing and hearing-impaired listeners. A test-retest variability of 0.7 dB was found and the correlation between SRT and pure-tone average (PTA(0.5,1,2,4)) was 0.77. One month after launching the test, 20,000 calls were registered. It can be concluded that both versions of the newly developed test have steep slopes and small SRT differences across normal-hearing listeners. The screening test by telephone is highly reliable and proves to fulfill the need for an easily accessible and objective hearing screening.status: publishe

What Keeps Older Adults With Hearing Impairment From Adopting Hearing Aids?

The aim of this study was to compare elderly individuals who are hearing impaired but inexperienced in using hearing aids (hearing aid non-users; HA-NU) with their aided counterparts (hearing aid users; HA-U) across various auditory and non-auditory measures in order to identify differences that might be associated with the low hearing aid uptake rate. We have drawn data of 72 HA-NU and 139 HA-U with a mild-to-moderate hearing loss, and matched these two groups on the degree of hearing impairment, age, and sex. First, HA-NU and HA-U were compared across 65 auditory, cognitive, health-specific, and socioeconomic test measures as well as measures assessing technology commitment. Second, a logistic regression approach was performed to identify relevant predictors for using hearing aids. Finally, we conducted a sensitivity analysis for the matching approach. Group comparisons indicated that HA-NU perceive their hearing problem as less severe than their aided counterparts. Furthermore, HA-NU showed worse technology commitment and lower socioeconomic status than HA-U. The logistic regression revealed self-reported hearing performance, technology commitment, and the socioeconomic and health status as the most important predictors for using hearing aids