Rapid, Multileveled Assessment of Hearing Dysfunction in Operational and Postdeployment Environments
Abstract
Rationale: Military fitness-for-duty requires good hearing and speech communication ability, especially in complex and noisy environments. Unfortunately, nearly every individual serving in our armed forces will be exposed to hazardous noise levels at some point, often leading to hearing loss or other listening problems. Any impairment that affects on-the-job performance, for instance, tactical communications and maintaining situational awareness, threatens the safety and effectiveness of the individual and the entire unit. So to ensure combat readiness, medical and support personnel must have a way to assess auditory fitness, often in forward remote settings, and often without the benefit of elaborate clinical equipment or highly trained staff. For this profound and urgent military operational need, no assessment tool exists. Furthermore, after deployment, over a million Veterans with Service-related hearing disability, many of whom are older as well, struggle to understand speech in noisy environments such as work meetings or family gatherings, leading to a cascade of physical and mental/emotional health decline. In this setting, too, clinicians lack the tools to diagnose why individual Service members fail to perform adequately and therefore how to guide treatment to improve their quality of life. Our present inability to diagnose hearing problems as relevant to real-life reflects the fact that listening relies not just on the ear, but on how each individual s brain processes sound. Typical audiological measures simply cannot detect these processes. Even time-honored measures such as hearing quiet tones (which for decades have informed the U.S. fitness-for-duty profile) utterly fail to predict speech comprehension and military job performance. We need a new approach to differential diagnosis of fitness. We need to reveal this "hidden" hearing loss as it impacts real life for our Service members. Objective: This proposal validates a powerful new diagnostic that uses brain waves (electroencephalography or EEG, easily recorded on the scalp) to assess hidden hearing loss and other listening problems (Patent pending PCT/US15/40629). Our rapid ~10-min brain-behavior assessment uses uniquely engineered speech sounds in an operationally relevant comprehension task, to characterize the entire hearing-speech brain simultaneously. This will enable quick screening of Service members in the field for auditory combat-readiness. The method has already been developed and vetted in over 200 listeners with healthy hearing and hearing loss across the lifespan, so the following Specific Aims will position it for immediate clinical/field testing: Aim 1: In 120 Veteran participants, we will relate objective measures of hearing ability, from the ear to higher brain function, to behavioral measures of operational performance and readiness (comprehension, ignoring distractions). This will, for the first time, connect real-world ability to individualized, evidence-based brain-behavior "profiles." Aim 2: Show that the diagnostic is reliable in individual listeners over long time periods (years), so listening ability can be tracked effectively upon enlistment (before any service-related auditory injury), pre-deployment, in active duty, and post-deployment. We will also identify an "Early Warning" brain-behavior profile to flag likely performance declines before listening problems put individuals and teams at risk. Aim 3: With an intuitive, largely automated processing framework, we will show that non-specialists can use the diagnostic to classify fitness-for-duty with durable equipment and minimal training in austere environments. Impact: Few health matters related to military service affect so many individuals, in such profound daily ways, usually for the rest of their lives. By enabling the first performance-relevant auditory fitness-for-duty assessment, this research will improve active Service member saf
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010485
Entities
People
- Lee Miller
Organizations
- United States Army
- University of California, Davis