American Journal of Audiology最新文献

{"title":"Cervical and Masseter Vestibular Evoked Myogenic Potentials in Diabetes Mellitus Type 2.","authors":"Sujeet Kumar Sinha, Krishnapriya Moothedath Vipinan","doi":"10.1044/2024_AJA-24-00176","DOIUrl":"https://doi.org/10.1044/2024_AJA-24-00176","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes affects the peripheral auditory and vestibular systems. Research suggests that both cervical vestibular evoked myogenic potentials (cVEMP) and ocular VEMP (oVEMP) are affected in individuals with diabetes. Masseter VEMP (mVEMP) is a new tool that assesses the vestibulomasseteric reflex pathways. The study aimed to characterize the cVEMP and mVEMP latency and amplitude parameters in diabetes mellitus type 2.</p><p><strong>Method: </strong>The study included 21 participants with type 2 diabetes mellitus and 21 age- and gender-matched participants without diabetes aged 48-68 years. mVEMP and cVEMP were recorded using 500 Hz tone burst stimuli, presented at an intensity of 125 dB peSPL for both the groups.</p><p><strong>Results: </strong>The study suggests significantly prolonged P13 (<i>p</i> = .00) and P11 latencies (<i>p</i> = .00) in participants with diabetes (<i>M</i> for p11 = 15.81, <i>M</i> for p13 = 15.39) compared to participants without diabetes (<i>M</i> for p11 = 13.12, <i>M</i> for p13 = 14.19) for both cVEMP and mVEMP, respectively. No significant differences were observed in N23 (<i>p</i> = .4) and N21 latencies (<i>p</i> = .18) between the diabetes (<i>M</i> for N21 = 22.62, <i>M</i> for N23 = 22.61) and nondiabetes groups (<i>M</i> for N21 = 22.21, <i>M</i> for N23 = 22.40). Additionally, a significant reduction in cVEMP amplitude (P13-N23) was noted in the diabetes group (<i>M</i> for P13-N23 = 0.71, <i>p</i> = .00) than the nondiabetes group (<i>M</i> = 1.44), while mVEMP amplitudes (P11-N21) remained similar across groups (<i>M</i> for P11-N21 for diabetes = 0.72, (<i>M</i> for P11-N21 for nondiabetes = 0.77, <i>p</i> = .44). There were no significant correlations between the duration of diabetes and VEMP parameters, nor between cVEMP and mVEMP responses in either group.</p><p><strong>Conclusions: </strong>The findings revealed notable differences in cVEMP and mVEMP findings in diabetes individuals. These results suggest that diabetes may lead to neural and labyrinthine impairments. The degree of vestibular impairment varies and affects different reflex pathways. Even though mVEMP has a similar saccular origin as cVEMP, the results between the two do not correlate with each other.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Vestibular Function in Young Adult Musicians and Nonmusician Peers.","authors":"Alexandria W Greene, Ashley G Flagge, Nic S Stanley","doi":"10.1044/2024_AJA-24-00203","DOIUrl":"https://doi.org/10.1044/2024_AJA-24-00203","url":null,"abstract":"<p><strong>Purpose: </strong>The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and nonmusicians to determine the effects of music exposure on the vestibular system.</p><p><strong>Method: </strong>Young adult participants aged 18-27 years without any history of hearing loss, vestibular/balance disorder, otologic disorder, or nervous system disorder were included in this study. Participants were divided into musician (<i>n</i> = 19) and nonmusician (<i>n</i> = 18) groups. Vestibular function was assessed and compared via the cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), video head impulse test (vHIT), and modified clinical test of sensory interaction in balance (mCTSIB).</p><p><strong>Results: </strong>Musicians were found to produce significantly more saccades in the left horizontal semicircular canal during vHIT assessment compared to nonmusicians. Group differences were not found in the cVEMP, oVEMP, or mCTSIB.</p><p><strong>Conclusions: </strong>This study shows the effects of music exposure on the vestibular system in young adult musicians who show early-onset, subclinical findings on the vHIT that could develop into abnormal results on vestibular assessments if hearing protection use is not increased.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to Dizziness in Workers With Noise-Induced Hearing Loss in Brazil.","authors":"Danúbia Hillesheim, Renata Coelho Scharlach, Eduarda Dandolini da Silva, Bárbara Amaral Silva, Fernanda Zucki","doi":"10.1044/2024_AJA-24-00066","DOIUrl":"10.1044/2024_AJA-24-00066","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to describe the factors related to dizziness in workers with noise-induced hearing loss in Brazil.</p><p><strong>Method: </strong>A cross-sectional study was carried out with a sample from noise-induced hearing loss reports (2007-2019). The dependent variable in this study was dizziness, and the independent variables were sociodemographic characteristics, comorbidities, symptoms, and noise characteristics in the work environment. Logistic regression analysis was performed.</p><p><strong>Results: </strong>A total of 3,824 individuals with noise-induced hearing loss in Brazil were analyzed. The prevalence of dizziness was 23.4% in the sample. Factors associated with dizziness were women (odds ratio [<i>OR</i>]: 2.10; 95% confidence interval [CI] [1.64, 2.69]), hypertension (<i>OR</i>: 1.68; 95% CI [1.38, 2.06]), headache (<i>OR</i>: 6.31; 95% CI [5.26, 7.57]), tinnitus (<i>OR</i>: 3.46; 95% CI [2.82, 4.25]), and continuous noise at the work environment (<i>OR</i>: 1.54; 95% CI [1.22, 1.94]).</p><p><strong>Conclusions: </strong>The factors associated with the outcome-dizziness-were gender (female), systemic arterial hypertension, headache, tinnitus, and continuous exposure to workplace noise. Such findings demonstrate the importance of promoting a multifactorial approach to understanding dizziness among workers exposed to occupational noise.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1135-1143"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefit-Cost Analyses of Hearing Aids, Over-the-Counter Hearing Devices, and Hearing Care Services.","authors":"Anna Marie Jilla, Carole E Johnson, Jonathan D Baldwin, Nick Huntington-Klein","doi":"10.1044/2024_AJA-23-00262","DOIUrl":"10.1044/2024_AJA-23-00262","url":null,"abstract":"<p><strong>Purpose: </strong>Limited accessibility to hearing health care threatens healthy aging in place for older adults with hearing loss. A willingness-to-pay (WTP) approach was used to determine benefits and value of prescription advanced digital technology (ADT) hearing aids, over-the-counter (OTC) hearing devices, and rehabilitative services using benefit-cost analyses.</p><p><strong>Method: </strong>This study was a cross-sectional survey with chart review of hearing aid users at two independent audiology practices. Seventy hearing aid users (response rate: 15.6%) provided their WTP for ADT prescription hearing aids, OTC hearing devices, and hearing rehabilitative services. Benefit-cost ratios and net social benefit were calculated using deterministic and exploratory approaches. Point estimates for benefit-cost ratios and net social benefit were derived using bootstrap sampling with replacement (<i>N</i> = 5,000).</p><p><strong>Results: </strong>Median WTP for ADT prescription hearing aids and rehabilitative services were $2,000 and $250, respectively. WTP was lowest for OTC devices (<i>Mdn</i> = $0; maximum = $500). Benefit-cost ratios and net social benefit for ADT prescription hearing aids, OTC devices, and hearing rehabilitative services favored these interventions when out-of-pocket costs remained low. Benefit-cost analyses also produced results favoring prescription ADT hearing aid intervention with costs as high as $1,530 per device.</p><p><strong>Conclusions: </strong>WTP results indicated that all interventions under study have a measurable consumer-perceived benefit. Results of benefit-cost analyses favored the interventions but only when costs were lower than market prices. The benefit-cost analysis results for hearing care services underscore their value when provided as part of a comprehensive rehabilitative plan that may inform future health policy changes.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1316-1330"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Peripheral Vestibular Impairment Among Adults With Chronic Moderate-Severe Traumatic Brain Injury.","authors":"Jessica J Feller, Melissa C Duff, Sharice Clough, Gary P Jacobson, Richard A Roberts, Daniel J Romero","doi":"10.1044/2024_AJA-24-00058","DOIUrl":"10.1044/2024_AJA-24-00058","url":null,"abstract":"<p><strong>Purpose: </strong>Traumatic brain injury (TBI) is a leading cause of death and disability among adults in the United States. There is evidence to suggest the peripheral vestibular system is vulnerable to damage in individuals with TBI. However, there are limited prospective studies that describe the type and frequency of vestibular impairment in individuals with chronic moderate-severe TBI (> 6 months postinjury).</p><p><strong>Method: </strong>Cervical and ocular vestibular evoked myogenic potentials (VEMPs) and video head impulse test (vHIT) were used to assess the function of otolith organ and horizontal semicircular canal (hSCC) pathways in adults with chronic moderate-severe TBI and in noninjured comparison (NC) participants. Self-report questionnaires were administered to participants with TBI to determine prevalence of vestibular symptoms and quality of life associated with those symptoms.</p><p><strong>Results: </strong>Chronic moderate-severe TBI was associated with a greater degree of impairment in otolith organ, rather than hSCC, pathways. About 63% of participants with TBI had abnormal VEMP responses, compared to only ~10% with abnormal vHIT responses. The NC group had significantly less abnormal VEMP responses (~7%), while none of the NC participants had abnormal vHIT responses. As many as 80% of participants with TBI reported vestibular symptoms, and up to 36% reported that these symptoms negatively affected their quality of life.</p><p><strong>Conclusions: </strong>Adults with TBI reported vestibular symptoms and decreased quality of life related to those symptoms and had objective evidence of peripheral vestibular impairment. Vestibular testing for adults with chronic TBI who report persistent dizziness and imbalance may serve as a guide for treatment and rehabilitation in these individuals.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1118-1134"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Psychometric Properties of the Short Form of the Speech, Spatial and Qualities of Hearing Scale in Swedish: Online Versus Paper-and-Pen.","authors":"Sandra Ahlberg, Jonas Brännström, Marie Öberg, Elisabet Thorén","doi":"10.1044/2024_AJA-24-00131","DOIUrl":"10.1044/2024_AJA-24-00131","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the psychometric properties of the Swedish short form of the Speech, Spatial and Qualities of Hearing Scale (SSQ12) and investigate whether the paper-and-pen and online formats could be used interchangeably.</p><p><strong>Method: </strong>Individuals with and without hearing problems were invited to participate in this study. The participants (<i>N</i> = 125) were randomized into four groups: paper-paper, online-online, paper-online, and online-paper. All participants completed the Swedish SSQ12 twice.</p><p><strong>Results: </strong>Principal components analysis revealed one component. Statistical analysis revealed good psychometric properties. Administration formats were compared using repeated-measures analysis of variance, which revealed no statistically significant differences.</p><p><strong>Conclusions: </strong>The results indicate that the Swedish SSQ12 is possible to use in paper-and-pen and online formats interchangeably. The questionnaire has potential to be used by Swedish audiologists seeking to understand the individual experience of hearing loss or to evaluate hearing rehabilitation. To further understand the possible differences and to broaden the use and understanding of the SSQ12, future studies should aim to determine the minimal clinically important difference for the SSQ12.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1176-1183"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Tinnitus Clinical Care in the Veterans Health Administration and Department of Defense: Overview of Survey Results.","authors":"Amy Boudin-George, Erin Cesario, Catherine Edmonds, Emily J Thielman, James A Henry, Khaya Clark","doi":"10.1044/2024_AJA-24-00060","DOIUrl":"10.1044/2024_AJA-24-00060","url":null,"abstract":"<p><strong>Purpose: </strong>In 2021, the Veterans Health Administration (VHA) and Department of Defense (DOD) Tinnitus Working Group conducted a survey of DOD and VHA clinicians to evaluate clinical services provided for tinnitus.</p><p><strong>Method: </strong>The online survey included a mix of multiple-choice and open-ended questions. Respondents included VHA and DOD health care providers in audiology, otolaryngology, mental health, and primary care, as well as DOD hearing conservation technicians. Quantitative and qualitative methods were used to analyze the data.</p><p><strong>Results: </strong>A total of 669 providers responded to this combined survey. Results indicated that compared to DOD and VHA providers in other fields, audiologists tended to be more confident and more aware of their role in tinnitus management. In terms of confidence and scope of practice, DOD mental health care providers were the group least familiar with tinnitus care. Other results explored herein include barriers to tinnitus care, facilitators for progressive tinnitus management programs, interventions and patient materials offered, new patient materials wanted, and respondents' preferred information sources and training methods.</p><p><strong>Conclusion: </strong>Survey results indicated that more directed education and support are needed to increase DOD and VHA clinicians' awareness of the need for tinnitus services and their roles in providing that care.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27229215.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1184-1201"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alignment of Audiologists' Values With Best-Practice Standards: Insights From a National Survey.","authors":"Katherine N Menon, Eric C Hoover","doi":"10.1044/2024_AJA-24-00102","DOIUrl":"10.1044/2024_AJA-24-00102","url":null,"abstract":"<p><strong>Objectives: </strong>Previous research documented the values of audiology through a qualitative content analysis of documents representing traditional, best-practice hearing health care. The primary objective of this study was to validate the existing list of audiology values. Through a nationwide survey, this study aimed to elicit the values of practicing audiologists, with a specific focus on the prescription and dispensing of amplification devices, to ensure a comprehensive understanding of their priorities. Additionally, this study sought to identify any values missing from the original list and determine the rank order importance of these values, comparing this to the prioritization of values found in best-practice audiology documents. This comparison aimed to assess the alignment of recommended guidelines and real-world practices in hearing health care.</p><p><strong>Design: </strong>An online survey was distributed to audiologists to elicit the prioritization of values from hearing health care providers. Participants were tasked with sorting and ranking 18 items, each representing a specific value in hearing health care, based on importance. Respondents were encouraged to suggest and rank the importance of additional values not included in the list. Audiologists were recruited from professional association mailing lists and direct contact. Respondent demographics were representative of U.S. audiologists. Qualitative content analysis was used to interpret values suggested by audiologists. Kendall's rank distance test was used to compare values prioritization between audiologists and best-practice audiology documents.</p><p><strong>Results: </strong>After filtering out incomplete or disqualifying responses, data from 289 audiologists across 46 states were analyzed. Additional values suggested by respondents aligned with existing values from best-practice documents; thus, no new values were added as a result of this study. A ranked list of values based on mean order of importance was elicited from U.S.-based audiologists. There was substantial agreement between survey results and the rank order of values found in best-practice audiology documents. A demographic subgroup analysis revealed a broad agreement among audiologists in the rank order of values.</p><p><strong>Conclusions: </strong>This study validated a comprehensive list of values in audiology and identified the rank order of values among a nationally representative sample of audiologists. The findings provide a foundation for future investigations into how these values influence decision-making processes for individuals with hearing difficulty. Addressing values conflicts as potential barriers to hearing health care usage can lead to solutions aligned with values of specific populations, ultimately improving the adoption and effectiveness of hearing health care interventions.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27478149.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1291-1305"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular and Balance Considerations in Type 2 Diabetes: A Tutorial on Pertinent Areas and Issues.","authors":"Zakaria Enayati, Anthony T Cacace","doi":"10.1044/2024_AJA-24-00075","DOIUrl":"10.1044/2024_AJA-24-00075","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to describe the effects of diabetes mellitus (DM) on vestibular and balance system functions in humans. Because Type 2 diabetes (T2D) represents the majority of individuals affected by this condition, this subgroup is the main focus of this tutorial.</p><p><strong>Method: </strong>Evidence of dysfunction is based on epidemiological, anatomical, physiological, neuroimaging, and clinical findings. Preventative measures, therapeutic interventions, and other mitigating factors are also given consideration.</p><p><strong>Results: </strong>Experimental and clinical findings support the notion that T2D damages vestibular and balance systems to the extent that these effects are more prevalent in patients with higher blood glucose levels and longer duration of the disease. Evidence indicates that T2D increases the occurrence and re-occurrence rates of benign paroxysmal positional vertigo, particularly when it occurs in conjunction with hypertension, osteoarthritis, and otologic disorders like Ménière's disease. Type 2 diabetes also impairs vestibular compensation, which is exacerbated by disease duration. Investigational and clinical studies suggest that galvanic stimulation of the vestibular system can be effective in reducing blood glucose levels and improving rehabilitation outcomes.</p><p><strong>Conclusion: </strong>Because DM is a chronic metabolic condition affecting cochlear, vestibular, and balance system functions, lowering blood glucose levels through diet, pharmacological interventions, and exercise can be effective in mitigating dysfunction.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1092-1103"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voices From the Field: A Quality Improvement Project for Progressive Tinnitus Management 2.0.","authors":"Khaya Clark, Suheily Lovelace, John C Moring, Emily J Thielman, Kassander A Thompson, James A Henry, Tara Zaugg","doi":"10.1044/2024_AJA-23-00167","DOIUrl":"10.1044/2024_AJA-23-00167","url":null,"abstract":"<p><strong>Purpose: </strong>Tinnitus is a common health condition in the general population, with increased prevalence among military Veterans. Tinnitus is, in fact, the most prevalent military service-connected disability. There is no cure for tinnitus, but interventions are available to help patients manage their reactions to tinnitus and reduce its functional impact. Progressive tinnitus management (PTM) is a stepped-care protocol that involves coordinated audiological and behavioral health clinical services. PTM was endorsed by national Veterans Affairs (VA) audiology leadership in 2009. Given new clinical insights and research findings since the initial rollout of PTM, it remains necessary to improve and update the protocol in response to feedback from clinicians and patients.</p><p><strong>Method: </strong>This two-phase quality improvement project captured quantitative and qualitative feedback from VA and Department of Defense (DOD) clinicians and patients concerning PTM materials. A convergent parallel mixed-methods design was used to integrate the quantitative and qualitative data, and a consensus method was used to adjudicate any discrepant findings.</p><p><strong>Results: </strong>In Phase 1, 21 VAs and DOD clinicians and patients completed semistructured interviews and quantitative measures on the PTM handbook and workbook revisions. Phase 1 findings were recommendations to modify content, format, and adaptations of content (e.g., electronic formats with a clickable index). In Phase 2, six non-Veteran patients assisted in pilot testing PTM PowerPoint slides used by clinicians for PTM skills education sessions. Phase 2 findings indicated that the revised PTM PowerPoint slides were useful and clinically acceptable.</p><p><strong>Conclusions: </strong>Findings from this study are being used to revise and update materials in the PTM skills education sessions. More generally, the study demonstrates the necessity of end-user input to inform and implement clinical updates.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.27057691.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1077-1091"},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}