Toward Development of a Mobile Assessment and Differential Diagnosis of Auditory Dysfunction: Hidden Hearing Loss and Central Auditory Processing Disorders
Abstract
Objectives and Rationale: Military Service members are at increased risk of damage to the auditory system due to exposures encountered during their service such as loud noise, toxic substances like jet fuel and burn pit fumes, and high-intensity explosive blast waves. Hearing impairment caused by exposure to these risk factors can greatly reduce an individuals ability to listen and understand speech without impacting their detection of soft sounds. The most widely used clinical tool for the assessment of hearing, the audiogram, is based on an individuals ability to detect soft tones and is not particularly effective at predicting the ability to understand speech at conversational levels. In addition, the tests used in the audiology clinic to assess speech understanding in background noise often fail to identify individuals who have deficits in certain aspects of auditory processing that make it difficult for them to understand speech in real-life situations. The objective of this study is to develop an efficient and easy-to-administer hearing test that can identify Service members who have listening difficulties that cannot be detected by currently available tests. This test will evaluate fitness for duty in operational environments and provide a preliminary diagnosis of the underlying cause of impairment. What persons with auditory injury will it help, and how will it help them? Since 2001, more than 41,000 Veterans have been diagnosed with auditory dysfunction unrelated to hearing loss or tinnitus at VA facilities (Corporate Data Warehouse data pull, August 2018). While it is likely that many of these deficits began during active military service, there are currently no readily accessible screening measures to identify those individuals who are having communication difficulty in the field. This study will develop a screening measure that both assesses operational readiness and facilitates clinical referrals to ensure appropriate treatment and rehabilitation. What are the potential clinical applications, benefits, and risks? The information obtained will be used to develop a diagnostic screening tool that could be used by non-specialists in an operational environment to quickly evaluate suprathreshold auditory function as a complement to typical audiological assessment. Risks associated with participation in this study are minimal. What is the projected time it may take to achieve a patient-related outcome? At the end of the funding period, it is anticipated that there will be a version of the test ready for evaluation with an active-duty population. Following validation with this target population, the test would be available for implementation on a number of testing platforms, including mobile applications. What are the likely contributions to advancing the field of hearing restoration research? Currently, there is little evidence-based guidance for audiologists on how to address the communication difficulties of patients with clinically normal hearing who nevertheless report difficulty understanding speech in challenging listening situations. Suprathreshold hearing impairments often go undiagnosed and unremediated because the clinical diagnostic tools are limited. A reliable measure of speech perception in complex listening environments would identify individuals experiencing listening difficulties, and could be used to monitor the effectiveness of future rehabilitation approaches. What is the likely impact on operational performance, medical readiness, and/or quality of life of Service members, Veterans, and the American public? There is currently no forward operations screening for suprathreshold auditory function. Improved methods of monitoring hearing changes in military Service members that extend beyond the pure tone audiogram are necessary for early detections of auditory damage that may negatively impact communication ability. Early detection of auditory deficits will facilitate preventative measur
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910367
Entities
People
- Michelle Molis
Organizations
- United States Army
- Veterans Affairs Medical Center (Oregon)