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Title of poster
Background
Gradual improvements in hearing aids have allowed clinicians to
successfully provide hearing ai...
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Should i get a hearing aid now - HEARing CRC PhD presentation

Developing a patient-decision aid for the uptake of amplification (hearing aids).

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Should i get a hearing aid now - HEARing CRC PhD presentation

  1. 1. Title of poster Background 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). Aim To develop a patient decision aid (PDA) with an individualised prediction of success to support the decision to adopt hearing aids. Methods 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. Results 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. Conclusions 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 (10), 642-653. *Authors 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* 29 74 84 Success not likely (25%) Success likely (75%) Almost certain success (95%) HearingAidUptake% Hypothetical Hearing Aid Uptake. Based on an evidence based estimate of likely success. 67 82 60 47 Use the tool? Share positive result? Share negative result? Share conflicting advice? Use Tool and Share Tool Result? Yes%. Adjacent differences significant p<0.05 Patient Decision Aid Sample

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