Editor's Message: Putting a Human Face on Research

Author: Brian Taylor, Au.D.

Eleven years ago a special issue of the Journal of the American Academy of Audiology was devoted to the topic of evidence-based practice. The issue was edited by Robyn Cox and it featured several articles by other prominent audiologists. Maybe you have some familiarity with evidence-based practice (EBP) and how it can be used to make clinical decisions. Better yet, maybe some actually rely on it in their decision making process with patients. But, if my observations are accurate, most audiologists don’t know too much about EBP, much less use it.

If EBP is unfamiliar to you, or it’s been several years since you studied it, EBP thinking is a regimented approach, relying on a systematic analysis of published peer-reviewed research, to make clinical decisions. The approach starts with a question. For example, what level of hearing aid technology provides optimal benefit for a specific patient population? After you find, read and analyze the relevant studies related to your question, you can use the approach to make a better clinical decision for your patient. The challenge, of course, is this process is relatively complex and very time consuming when you have to conduct it on your own. It’s easy to want to take shortcuts or not to even bother with it.

Using EBP decision making is especially pertinent in this era of PSAPs and other direct-to-consumer hearing technology. The question we should all we asking about theses devices: Are they effective? Emerging evidence is beginning to reveal that a few high quality PSAPs might be comparable to conventional hearing aids. Here are four studies suggesting that some PSAPs offer many of the same acoustic characteristics (and potential benefits) of a high fidelity hearing aid:
  • Mamo, S., Reed, N.S., Nieman, C.L., Oh, E.S. & Lin, F.R. (2016). Personal sound amplifiers for adults with hearing loss. American Journal of Medicine, 129(3), 245-50
  • Sacco, G., Gonfrier, S., Teboul, B et al. (2016). Clinical evaluation of an over-the-counter hearing aid (TEO First®) in elderly patients suffering of mild to moderate hearing loss. BMC Geriatrics, 9(16), 136
  • Smith, C., Wilber, L.A., Cavitt, K. (2016). PSAPs vs hearing aids: An electroacoustic analysis of performance and fitting capabilities. Hearing Review, 23(7), 18.
  • Xu, J., Johnson, J., Cox, R., & Breitbart, D. (2015). Laboratory comparison of PSAPs and hearing aids. Paper presented at the annual meeting of the American Auditory Society, Scottsdale, AZ. Retrieved from: http://www.harlmemphis.org/files/9814/2593/1864/XuAAS2015_PSAPs.pdf (accessed on November 30th, 2016).
On the other hand, there are comparative studies which indicate hearing aids significantly outperform PSAPs. One example of this is from a recent study by Ronne & Rossin, published in the December 2016 Hearing Review. Their study indicated one hearing aid significantly outperformed two PSAPs on speech intelligibility tasks.

The lessons are twofold: One, audiologists must be responsible consumers of the research. We need to understand how the design of the study can affect its results, and how the results of any study must be interpreted in relation to the patient you are trying to help. After all, it is easy to design a laboratory study that leads to a clear “winner” in a study. Thus, audiologists must look for blinded studies with a real world component, which is more reflective of everyday patient experiences.

Two, research seldom provides us with clear, black and white answers to common clinical questions. No matter how automated hearing technology becomes there will always be a demand for someone who can interpret research findings and communicate their nuances for the individual sitting in front of them: A professional who doesn’t ignore science, but one who puts a human face on it.