Christopher G. Brennan-Jones

The relationship between hearing impairment and cognitive function: a meta-analysis in adults

Hearing loss affects over 1.23 billion people globally. It has been proposed that hearing impairment negatively impacts on cognition. Some studies have demonstrated a faster rate of decline in cognition, and increased risk of incident all‐cause dementia. This finding is not ubiquitous. This study used meta‐analysis to examine the evidence‐base regarding the relationship between hearing and cognition.

Prevalence and risk factors for parent-reported recurrent otitis media during early childhood in the Western Australian Pregnancy Cohort (Raine) Study

To describe the prevalence and risk factors of recurrent otitis media (rOM) in an urban Australian population at 3 years of age.

Hearing loss and cognition in the Busselton Baby Boomer cohort: An epidemiological study

To determine the relationship between peripheral hearing loss (HL) in baby boomers (better‐ear measure) and cognitive function, taking into account the impact of depression or cognitive reserve on this relationship and exploring binaural hearing.

Evaluating hearing aid handling skills: A systematic and descriptive review

Abstract Objective: To review and appraise the content and quality of surveys that evaluate hearing aid handling. Design: A systematic and descriptive review. Study sample: Twelve surveys were identified as containing at least one item evaluating hearing aid handling. Results: Fifteen aspects of hearing aid handling were evaluated. None of the surveys evaluated all aspects of handling skills identified. While the majority of studies reported some psychometric evaluation during survey development, the quality of the methodology used and extent of psychometric evaluation reported varied considerably. Conclusions: There is currently no single survey that evaluates handling skills comprehensively. In the absence of an ideal survey, the Practical Hearing aid Skills Test appears to be the most inclusive clinician-administered survey and the Hearing aid Users Questionnaire appears to be the most inclusive self-report survey evaluating hearing aid handling precision; however, there are limitations in the analysis of their psychometric properties. Nonetheless, use of these surveys in clinical practice could identify areas of handling that warrant additional training in order to improve hearing aid success. Research identifying the full range of hearing aid handling skills necessary for successful hearing aid use will further contribute knowledge to the complex construct of successful hearing aid-use.

Self-reported hearing loss and manual audiometry: A rural versus urban comparison

OBJECTIVE To examine whether self-reported hearing difficulty is an accurate measure of hearing loss compared with standard hearing screening with pure tone audiometry in rural and urban communities. DESIGN Convenience sampling. SETTING Urban and rural areas of Western Australia. PARTICIPANTS A total of 2090 participants (923 men; 1165 women; 2 unknown) aged 20-100 years presenting for community-based hearing screening in urban (982) and rural (1090) areas. INTERVENTIONS Self-reported hearing difficulty assessed with the Hearing Handicap Inventory for the Elderly - Screening questionnaire. Hearing loss defined as average hearing thresholds >25 dB in the better ear using screening audiometry conducted at 500, 1000, 2000 and 4000 Hz. MAIN OUTCOME MEASURES Nil. RESULTS The Hearing Handicap Inventory for the Elderly - Screening was sensitive (≥60 years = 76.69%; <60 years = 71.67%) but not specific (≥60 years = 45.15%; <60 years = 49.63%) for identifying hearing loss. The <60 age group had a hearing loss prevalence of 25.6%, and a false-positive rate of 67.12% compared with a prevalence of 69.12% and false-positive rate of 29.77% for the ≥60 age group. For all ages, rural participants were more likely to have a disabling hearing loss (odds ratio 2.04 (95% confidence interval, 1.55-2.67); χ(2)(1) = 27.28; P < 0.001), but there were no significant differences in hearing aid uptake. CONCLUSIONS Patients in rural areas presenting for hearing screenings are more likely to suffer hearing loss than adults in urban areas. We suggest rural health practitioners incorporate a self-reported hearing loss questionnaire into health check-ups for adults, particularly patients aged ≥60 years due to the high prevalence of hearing loss in this group.

Diagnosis of hearing loss using automated audiometry in an asynchronous telehealth model: A pilot accuracy study:

Introduction Standard criteria exist for diagnosing different types of hearing loss, yet audiologists interpret audiograms manually. This pilot study examined the feasibility of standardised interpretations of audiometry in a telehealth model of care. The aim of this study was to examine diagnostic accuracy of automated audiometry in adults with hearing loss in an asynchronous telehealth model using pre-defined diagnostic protocols. Materials and methods We recruited 42 study participants from a public audiology and otolaryngology clinic in Perth, Western Australia. Manual audiometry was performed by an audiologist either before or after automated audiometry. Diagnostic protocols were applied asynchronously for normal hearing, disabling hearing loss, conductive hearing loss and unilateral hearing loss. Sensitivity and specificity analyses were conducted using a two-by-two matrix and Cohen’s kappa was used to measure agreement. Results The overall sensitivity for the diagnostic criteria was 0.88 (range: 0.86–1) and overall specificity was 0.93 (range: 0.86–0.97). Overall kappa (k) agreement was ‘substantial’ k = 0.80 (95% confidence interval (CI) 0.70–0.89) and significant at p < 0.001. Discussion Pre-defined diagnostic protocols applied asynchronously to automated audiometry provide accurate identification of disabling, conductive and unilateral hearing loss. This method has the potential to improve synchronous and asynchronous tele-audiology service delivery.

Protective benefit of predominant breastfeeding against otitis media may be limited to early childhood: results from a prospective birth cohort study.

To examine the long‐term effects of predominant breastfeeding on incidence of otitis media.

Clinical validation of automated audiometry with continuous noise-monitoring in a clinically heterogeneous population outside a sound-treated environment

Abstract Objective: Examine the accuracy of automated audiometry in a clinically heterogeneous population of adults using the KUDUwave automated audiometer. Design: Prospective accuracy study. Manual audiometry was performed in a sound-treated room and automated audiometry was not conducted in a sound-treated environment. Study sample: 42 consecutively recruited participants from a tertiary otolaryngology department in Western Australia. Results: Absolute mean differences ranged between 5.12–9.68 dB (air-conduction) and 8.26–15 dB (bone-conduction). A total of 86.5% of manual and automated 4FAs were within 10 dB (i.e. ±5 dB); 94.8% were within 15 dB. However, there were significant (p < 0.05) differences between automated and manual audiometry at 250, 500, 1000, and 2000 Hz (air-conduction) and 500 and 1000 Hz (bone-conduction). The effect of age (≥55 years) on accuracy (p = 0.014) was not significant on linear regression (p > 0.05; R2 =  0.11). The presence of a hearing loss (better ear ≥26 dB) did not significantly affect accuracy (p = 0.604; air-conduction), (p = 0.218; bone-conduction). Conclusions: This study provides clinical validation of automated audiometry using the KUDUwave in a clinically heterogeneous population, without the use of a sound-treated environment. Whilst threshold variations were statistically significant, future research is needed to ascertain the clinical significance of such variation.

Associations between cardiovascular disease and its risk factors with hearing loss—A cross-sectional analysis

To investigate the relationship between hearing loss and cardiovascular disease risk factors.

The speech intelligibility benefit of a unilateral wireless system for hearing-impaired adults.

Abstract Objective: This study measured the effects of two previously untested practical considerations—venting and transmission delays—on speech intelligibility in a simulated unilateral wireless system, where a target signal in background noise was transmitted wirelessly to the hearing-impaired (HI) listener. Design: Speech reception thresholds (SRTs) relative to the signal-to-noise ratio (SNR) were measured by varying the surrounding babble noise level. The target signal was presented at 0° azimuth in the soundfield and unilaterally via an insert earphone, using open and closed fittings with simulated-wireless delays ranging between 0–160 ms. SRTs were also measured unaided and with participants’ current hearing aid(s). Study sample: Thirty-three mild-to-moderate sensorineural HI adults participated in the experiment. Results: For an open fitting, the results showed a 5-dB SNR benefit in SRT compared to unaided performance at shorter delays. For a closed fitting, the majority of participants could accurately recognize speech below − 20 dBSNR across delays. Conclusions: These results highlight the efficacy of wireless systems with HI adults. Speech-intelligibility benefits are affected by transmission delays only when the delay is greater than 40 ms and the coupling is vented. Sumario Objetivo: Este estudio midió los efectos de dos condiciones prácticas que no han sido probadas con anterioridad – ventilación y retardos en la transmisión – sobre la inteligibilidad del lenguaje en un sistema unilateral inalámbrico simulado, en el que la señal objetivo en ambiente ruidoso fue transmitida en forma inalámbrica a la persona con hipoacusia (HI). Results: Diseño: Los umbrales de recepción del habla (SRT) relativos al ratio señal/ruido (SNR) fueron medidos variando el nivel de ruidobalbuceante circ undante. La señal objetivo fue presentada a 0° azimut en el campo libre y por medio de un audífono de inserción, utilizando adaptaciones abiertas y cerradas con retardo simulado inalámbrico entre 0 y 160 ms. Los SRT también fueron medidos sin auxiliar y con los auxiliares propios de los participantes. Muestra: Treinta y tres adultos con hipoacusia sensorineural leve a moderada participaron en el experimento. Resultados: Cuando se utiliz la adaptación abierta, los resultados mostraron un beneficio de 5dB en el SRT comparado con el desempe o sin auxiliar con un retardo más corto. Con la adaptación cerrada, la mayoría de los participantes pudieron reconocer acertadamente el lenguaje a − 20 dB SNR en todas las condiciones de retraso. Conclusiones: Estos resultados resaltan la eficacia de los sistemas inalámbricos para los adultos con hipoacusia. Los beneficios en la inteligibilidad del lenguaje son afectados por los retrasos en la transmisión, sólo cuando el retraso es mayor a 40 ms y el molde tiene ventilación.