By Abram Bailey
This article is a part of the March/April 2017, Volume 29, Number 2, Audiology Today issue.
With smartphone apps that amplify speech (Mimi Hearing Test, 2016), and effective (Ear Machine, 2016) over-the-counter (OTC) hearing aids and personal sound amplification products (PSAPs) on the market, consumers may now obtain hearing devices from the comfort of home, completely bypassing the attention of an audiologist. Recent reports from the President’s Council of Advisors on Science and Technology (PCAST, 2015) and the Institute of Medicine (IoM, 2016) have called for greater access to affordable hearing aids, and the Over-the-Counter Hearing Aid Act of 2016 threatens to both legalize OTC hearing aids and remove the “burdensome requirement” that consumers obtain a medical evaluation or sign a waiver before purchasing an OTC hearing aid. With comparatively high hearing aid pricing, and inconsistent service delivery, our profession is poorly positioned to face such challenges. To remain relevant, we must defend our role as the gatekeepers of better hearing, and prove to consumers that audiologists can consistently deliver superior hearing outcomes and exceptional levels of consumer satisfaction.
Research Then and Now
As a profession, how can we achieve this ambitious goal? As it turns out, the answer has been sitting right in front of us—for at least a decade. In 2006, an extensive critical analysis of audiology research was performed by an American Academy of Audiology (the Academy) task force to identify the audiological services that are most likely to make a difference to hearing aid benefit and satisfaction. The resulting publication, Guidelines for the Audiologic Management of Adult Hearing Impairment (Guidelines) (Valente et al, 2006), identified strong evidence for the effectiveness of services like real-ear measurement (REM), electroacoustic verification of special hearing aid features, and the administration of formal self-assessments. Guidelines laid the foundation for audiological best practice in our profession, and is currently endorsed by the Academy as a practice guideline for adult rehabilitation and hearing aids.
More recently, in MarkeTrak VIII: The Impact of the Hearing Health-Care Professional On Hearing Aid User Success, Sergei Kochkin (2014) reported that hearing aid users with above average success (a composite of benefit, usage, utility, positive attitudes toward hearing aids, and quality of life changes) were more likely to have received an objective benefit measurement, a subjective benefit measurement, a patient satisfaction measurement, a loudness discomfort measurement, REMs, and testing in a sound booth. The study also reported that patients with below average success were less likely to have received personal counseling from a hearing-health professional.
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