{"title":"The Relationship between P300 and Central Auditory Processing Test Result.","authors":"Cem Yeral, Bulent Serbetcioglu","doi":"10.1055/s-0044-1789597","DOIUrl":"https://doi.org/10.1055/s-0044-1789597","url":null,"abstract":"<p><strong>Background: </strong> Central auditory processing (CAP) refers to the perceptual processing of auditory inputs in the central nervous system and includes a series of auditory skills such as sound localization, auditory pattern recognition, and temporal sequencing which is a component of temporal processing. This skill can be assessed by frequency pattern test (FPT) and duration pattern test (DPT). Auditory attention is another skill that contributes to the CAP and can be analyzed by the P300.</p><p><strong>Purpose: </strong> This study assesses the relationship between the P300 latency and the CAP test results of individuals with normal hearing.</p><p><strong>Research design: </strong> An experimental study was used in which the determined tests were applied to the participants.</p><p><strong>Study sample: </strong> Thirty-four individuals with normal hearing between the ages of 20 and 40 years were included in the study.</p><p><strong>Data collection and analysis: </strong> P300, FPT, and DPT were applied to the participants. The Spearman correlation test and Mann-Whitney U test were used for analysis.</p><p><strong>Results: </strong> There were significant moderate and strong-level negative correlations between P300 latency and the scores obtained from frequency pattern and DPT (<i>p</i> < 0.01). We also analyzed whether P300 latency and frequency pattern and DPT scores differed according to gender and, as a result, did not find significant relationship (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong> We observed that frequency pattern and DPT scores decreased as P300 latency increased. We propose that these results could contribute to the diagnosis and follow-up process of CAP disorder by allowing P300 and CAP tests to be cross-checked.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"34 3-04","pages":"65-69"},"PeriodicalIF":1.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523518","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":"Applied Research in Clinical Audiology with Spanish Speakers in the United States: A Scoping Review.","authors":"Karen Muñoz, Diana Ortiz, Guadalupe G San Miguel","doi":"10.1055/s-0043-1768058","DOIUrl":"10.1055/s-0043-1768058","url":null,"abstract":"<p><strong>Background: </strong> The Hispanic population is growing, and Spanish is the second most spoken language in the United States. When individuals experience a hearing problem, culturally and linguistically responsive services represent an important part of person-centered care, contributing to wellbeing and intervention outcomes.</p><p><strong>Purpose: </strong> The purpose was to identify research in clinical audiology conducted with Spanish speakers to illuminate gaps and inform future research.</p><p><strong>Research design: </strong> A scoping literature review.</p><p><strong>Data collection and analysis: </strong> A database search was completed in January 2022. Included research was conducted in clinical audiology, had Spanish-speaking deaf or hard-of-hearing (DHH) adults/parents of a DHH child in the United States, Spanish language data collection, and published in English in a peer-reviewed journal. Studies were categorized by the area of audiology and a narrative description provided.</p><p><strong>Results: </strong> The search identified 655 articles. Following screening, 11 studies met the inclusion criteria and 1 article was identified from the reference lists of included articles for a total 12 articles. The articles were published between 1997 and 2021. Most studies were conducted with adults and a few were with parents of DHH children. Research was conducted in four areas: hearing loss experiences, hearing aid experiences, hearing screening, and communication.</p><p><strong>Conclusions: </strong> There is limited research with Spanish-speaking DHH individuals and parents of DHH children. There is an urgent need for future research to inform culturally and linguistically responsive clinical practice, and to provide evidence-based interventions for effective hearing health care management.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"77-83"},"PeriodicalIF":1.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299736","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":"Comparison of Multifrequency Narrow-Band CE-Chirp and Tone Burst Evoked Cervical Vestibular Evoked Myogenic Potentials.","authors":"Anuj Kumar Neupane, Vidhi Lodha","doi":"10.1055/a-2036-0510","DOIUrl":"10.1055/a-2036-0510","url":null,"abstract":"<p><strong>Background: </strong> Cervical vestibular evoked myogenic potentials (cVEMPs) are inhibitory myogenic responses that have commonly been elicited using a variety of stimuli. Yet the comparison of the effects of multifrequency tone bursts and narrow-band Claus Elberling chirps (NB CE-chirps) on cVEMPs has never been studied in homogeneous age groups.</p><p><strong>Purpose: </strong> The present study focused on comparing the effect of multifrequency NB CE-chirps and tone bursts on the various parameters of cVEMP responses in normal-hearing younger adults.</p><p><strong>Research design: </strong> A within-group study design was applied, and purposive sampling was utilized for the collection of the data sample.</p><p><strong>Study sample: </strong> The present study involved the elicitation of NB CE-chirp and tone burst-evoked cVEMPs across four-octave frequencies in 25 normal-hearing younger adults.</p><p><strong>Results: </strong> NB CE-chirp and tone burst evoked cVEMPs were found to have a 100% response rate for all frequencies except 4,000 Hz. Across frequencies, P1 and N1 latencies were seen to be significantly shorter for NB CE-chirps than tone bursts at 500 Hz and 1,000 Hz stimulation. No differences were seen in the P1N1 amplitudes and interaural asymmetry ratio between the two stimuli across all four-octave frequencies. Furthermore, we found a significantly higher number of ears tuned to NB CE-chirps than tone bursts at 500 Hz.</p><p><strong>Conclusions: </strong> Comparative differences in the latencies of cVEMP responses between and within stimuli could be due to the variation in stimuli duration. Also, the difference in amplitudes across stimulation frequencies might have resulted due to the predominance of saccular responses at lower mechanical resonance frequencies. Thus, the tuning was also seen at 500 Hz and was relatively higher for NB CE-chirps than tone bursts.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"56-64"},"PeriodicalIF":1.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9512450","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":"American Academy of Audiology Position Statement on Early Identification of Cytomegalovirus in Newborns.","authors":"Maggie Kettler, Angela Shoup, Shelley Moats, Wendy Steuerwald, Sarah Jones, Stacy Claycomb Stiell, Jenni Chappetto","doi":"10.1055/s-0043-1768036","DOIUrl":"10.1055/s-0043-1768036","url":null,"abstract":"<p><p>The American Academy of Audiology recommends early identification of congenital cytomegalovirus (cCMV) through screening to allow for appropriate early diagnosis, intervention, and monitoring for congenital, progressive, and delayed-onset hearing loss in infants with cCMV.Early identification of cCMV is a valuable component in the diagnostic evaluation of infants with sensorineural hearing loss. The Academy recognizes the important role audiologists serve as clinical care providers and educators and advocates for early identification and audiological management of infants with cCMV.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"84-89"},"PeriodicalIF":1.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246969","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}
Ruby E Garbutt, Greg A O'Beirne, Michael R D Maslin
{"title":"A Comparison of Ocular Vestibular Evoked Myogenic Potentials via Audiometric and Nonaudiometric Bone Vibrators.","authors":"Ruby E Garbutt, Greg A O'Beirne, Michael R D Maslin","doi":"10.1055/s-0043-1764348","DOIUrl":"10.1055/s-0043-1764348","url":null,"abstract":"<p><strong>Background: </strong> There is limited evidence demonstrating the ability of audiometric bone vibrators to elicit ocular vestibular evoked myogenic potentials (oVEMPs). The RadioEar B71 bone vibrator has insufficient power output to reliably evoke oVEMPs, which has previously left nonaudiometric and nonmedically approved devices such as the Brüel & Kjær Mini-shaker 4810 as the only feasible alternative. The newer RadioEar B81 model has a higher power output than its predecessor, but evidence for its suitability for eliciting oVEMPs has so far been mixed. This variability may be due to factors other than simply the power output, such as whether sufficient static force is applied to hold the transducer in place and transfer vibratory energy into the bone.</p><p><strong>Purpose: </strong> This study aimed to test the hypothesis that bone-conducted oVEMPs can be obtained with the B81 that are equivalent to those from the Mini-shaker, the de facto gold-standard transducer for this response, when the outputs of the two transducers are matched and they are coupled with sufficient static force.</p><p><strong>Research design: </strong> oVEMPs elicited by both transducers were recorded in a counterbalanced within-groups design.</p><p><strong>Study sample: </strong> Sixteen healthy adults (12 female; 22-47 years) with no history of hearing, balance, or neurological disorders were included in the study.</p><p><strong>Data collection and analysis: </strong> One-cycle alternating tone-burst stimuli at 500 Hz were delivered to the mastoid from each transducer. The vibratory force levels were matched at 127 dB peak-to-peak equivalent force levels, and both were held in place with a static force around 10 N. oVEMP waveforms were gathered from the contralateral eye using the belly-tendon montage and were assessed for statistical equivalence.</p><p><strong>Results: </strong> There was an absence of any statistically significant difference in N10 and N10-P15 amplitudes in oVEMPs from each transducer.</p><p><strong>Conclusions: </strong> Our results indicate that B81 can elicit oVEMPs with no meaningful differences to those from the Mini-shaker, provided effective stimulus levels are matched and static force is sufficient. Although further work is necessary to investigate equivalence at other stimulus frequencies and stimulation sites, the results support the use of the B81 to elicit 500Hz oVEMPs at the mastoid in a clinical setting.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"49-55"},"PeriodicalIF":1.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331362","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":"Validation of the Mandarin Chinese Translation of the \"Meaning of Life\" in Patients with Hearing Loss or Tinnitus.","authors":"Yufei Xie, Yu Wang, Tao Pan, Richard Tyler","doi":"10.1055/a-1996-1227","DOIUrl":"10.1055/a-1996-1227","url":null,"abstract":"<p><strong>Background: </strong> There is an increasing need to evaluate the quality of life of individuals who are hearing impaired. However, most of the generic \"quality of life\" questionnaires do not include communication-related questions. Recently, a new \"Meaning of Life\" (MOL) questionnaire was developed to measure quality of life based on everyday issues, enabling a comprehensive evaluation of tinnitus patients and cochlear implant users. A Mandarin Chinese version of this questionnaire for the Mandarin-speaking population is needed. Many of the existing Mandarin Chinese questionnaires currently in use are not effectively assessing hearing-related conditions.</p><p><strong>Purpose: </strong> We aimed to translate and validate the MOL questionnaire into Mandarin Chinese to make it applicable as a tool for measuring quality of life in patients with hearing loss or tinnitus.</p><p><strong>Research design: </strong> For this study, the original version of the MOL questionnaire was translated into the Mandarin Chinese language. A prospective cohort study was then performed on adults with hearing loss or tinnitus to preliminarily examine the reliability and validity of the Mandarin Chinese version.</p><p><strong>Study sample: </strong> A total of 206 Mandarin-speaking subjects with hearing loss or tinnitus were included in the study and divided into three groups according to their chief complaints: group B included patients suffering from both hearing loss and tinnitus (<i>N</i> = 113), group T contained patients with tinnitus alone (<i>N</i> = 49), and group H was composed of patients with hearing loss alone (<i>N</i> = 44).</p><p><strong>Data collection and analysis: </strong> The Mandarin version of the MOL (C-MOL) was administered to the participants. The reliability of the C-MOL was evaluated using Cronbach's α and item total correlation coefficients. Exploratory factor analysis was performed to examine the relationships among the questions. Correlations between the patient characteristics and total scores were tested.</p><p><strong>Results: </strong> The Cronbach's α coefficient of C-MOL was 0.921. Four factors were identified by exploratory factor analysis: (1) mental state and positive outlook; (2) friendship; (3) physical health; and (4) hearing and negative experience. The total scores of groups B, T, and H were 76.4 (standard deviation [SD] = 13.5), 81.3 (SD = 10.6), and 82.4 (SD = 12.5), respectively. The total score was correlated with the affected ears (<i>r</i> = 0.179, <i>p</i> < 0.05), age (<i>r</i> = 0.179, <i>p</i> < 0.05), hearing of the better ear (<i>r</i> = 0.188, <i>p</i> < 0.01), and educational background (<i>r</i> = 0.181, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong> The Mandarin Chinese version of the MOL questionnaire showed good reliability. It can be used to quantify the quality of life of patients with hearing loss or tinnitus.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9139948","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":"JAAA CEU Program.","authors":"","doi":"10.1055/s-0044-1792045","DOIUrl":"10.1055/s-0044-1792045","url":null,"abstract":"","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"34 1-02","pages":"45-47"},"PeriodicalIF":1.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479240","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}
Elizabeth Tobener, Ashlee Searer, Steven Doettl, Patrick Plyler
{"title":"Oculomotor Findings in Videonystagmography across the Lifespan.","authors":"Elizabeth Tobener, Ashlee Searer, Steven Doettl, Patrick Plyler","doi":"10.1055/s-0042-1760437","DOIUrl":"10.1055/s-0042-1760437","url":null,"abstract":"<p><strong>Background: </strong> When performing oculomotor testing during standard videonystagmography (VNG), the vestibular system is not actively stimulated. Therefore, responses are generated from the cerebellum, brainstem, and oculomotor tract. Many patients seen for vestibular testing fall outside of the standard age norms, making it difficult to determine whether an abnormal finding is due to age or oculomotor dysfunction.</p><p><strong>Purpose: </strong> The purpose of this study was to further evaluate the effect of age on a standard clinical VNG oculomotor test battery consisting of saccades, smooth pursuit, and optokinetic (OPK) testing.</p><p><strong>Research design: </strong> This is a cross-sectional, between-group prospective study comparing oculomotor tests between age groups.</p><p><strong>Study sample: </strong> Twenty-one older adults between the ages of 60 and 90 years with no history of central or peripheral vestibular dysfunction were included in the study. Previously collected data from 29 children aged 4 to 6 years and 33 adults aged 20 to 60 years were also included.</p><p><strong>Data collection and analysis: </strong> Participants completed oculomotor testing using infrared goggles consisting of saccades, smooth pursuit, and OPK. Statistical analyses were completed using multivariate analysis of variance and analysis of variance and follow-up analysis when indicated.</p><p><strong>Results: </strong> Significant group differences were noted for saccade latency and speed, smooth pursuit gain, and OPK gain and speed. Children and older adults demonstrated longer saccade latencies compared with the controls, and older adults exhibited slower saccade speed than the controls and children. These results also indicated that smooth pursuit gain was reduced for children and older adults compared with controls, and gain decreased across all groups as frequency increased. Analyses of OPK results indicated older adults had reduced gain and speed compared with the children and control group.</p><p><strong>Conclusions: </strong> The findings of prolonged saccade latencies and reduced smooth pursuit gain in both children and older adults suggest possible cerebellar rather than attentional effects. However, other findings such as reduced saccade speed and reduced OPK gain were noted only in the older adults, which suggests oculomotor degeneration and/or insufficient coverage of the visual field during testing, respectively. These results also indicate the importance of age-specific normative data for use in clinical oculomotor testing.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"11-18"},"PeriodicalIF":1.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299739","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}
Daniel Demian, Michelle Petrak, Glen Zielinski, Shelly Massingale, Amy Alexander, Liz Fuemmeler, Chia-Cheng Lin
{"title":"Clinical Saccadometry: Establishing Evaluative Standards Using a Simplified Video Oculography Protocol in the Adult Population.","authors":"Daniel Demian, Michelle Petrak, Glen Zielinski, Shelly Massingale, Amy Alexander, Liz Fuemmeler, Chia-Cheng Lin","doi":"10.1055/s-0043-1772582","DOIUrl":"10.1055/s-0043-1772582","url":null,"abstract":"<p><strong>Background: </strong> Saccadometry is an advanced ocular motor test battery that allows for the functional evaluation of the varied brain regions and circuits involved in the generation of fast, purposeful, and accurate saccadic eye movements. The test battery is composed of prosaccade (PS) and antisaccade (AS) tests that progressively increase cognitive demand. Existing saccadometry protocols qualitatively describe trends across the lifespan, but have not been widely adopted by clinicians.</p><p><strong>Purpose: </strong> The aims of this study are to design an efficient and simplified clinical saccadometry protocol using video oculography (VOG) equipment and establish associated evaluative standards across the lifespan.</p><p><strong>Study sample: </strong> Data were reported on 273 adults ages 18 to 69 years.</p><p><strong>Results: </strong> Evaluative data on four measures: directional error rate (DE), latency (Lat), peak velocity (Vel), and accuracy (Acc) during PS and AS measurements were provided. Age-group differences were found in Lat (<i>p</i> < 0.01) and Vel (<i>p</i> = 0.04) during PS and age-group differences were found in DE (<i>p</i> = 0.04), Lat (<i>p</i> < 0.01) and Vel (<i>p</i> < 0.01) during AS. Gender differences were found in DE (<i>p</i> = 0.01) and Lat (<i>p</i> < 0.01) during AS.</p><p><strong>Conclusions: </strong> This study established a standardized and time-efficient protocol with evaluative standards for individuals ages 18 to 69 years old to enable the use of saccadometry as an objective measure in the clinic. Saccadometry allows clinicians to look beyond the traditional saccade test and evaluate complex oculomotor and cognitive functions that will better help clinicians differentiate between peripheral and central diagnoses.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":" ","pages":"19-27"},"PeriodicalIF":1.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292219","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 a Proposed Direct-to-Consumer (DTC) Model of Hearing-Health Care.","authors":"Jasleen Singh, Karen A Doherty","doi":"10.1055/s-0044-1789598","DOIUrl":"10.1055/s-0044-1789598","url":null,"abstract":"<p><strong>Background: </strong> The introduction of over-the-counter hearing aids (HA) has resulted in a new hearing-health-care pathway.</p><p><strong>Purpose: </strong> The aim of this study was to assess if individuals could navigate four steps in a direct-to-consumer (DTC) HA delivery model, which include self-identification of hearing difficulties and risk for ear disease, self-selection of device, self-fitting and programming of device, and self-management.</p><p><strong>Research design: </strong> Fifty-two participants self-reported their degree of hearing loss and risk for ear disease. Participants were provided with three preselected DTC-HA Web sites and asked to select a device. Using the manufacturer's instructions, they then self-fit and programmed the device they chose. Participants' HA use and handling skills were evaluated using the Practical HA Skills Test-Revised (PHAST-R) and the Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (MARS-HA). Real-ear verification was completed to determine how closely they programmed their device to NAL-NL2 targets. Agreement between self-reported degree of hearing loss and ear disease was determined from an audiological and ear disease risk assessment, respectively.</p><p><strong>Results: </strong> Seventy-five percent of participants reported that their perceived hearing loss was in the mild-to-moderate range. Ninety-three percent of participants who were identified to be at risk for ear disease did not self-report being at risk. PHAST-R scores ranged from 45 to 100% and were significantly impacted by manufacturer instructions. Only 24% of fittings were within the accepted tolerances for prescriptive targets.</p><p><strong>Conclusions: </strong> No participant was able to successfully navigate all four steps in the proposed DTC-HA model. Participants with hearing thresholds ≤ 25 dB HL and participants who were identified as being at risk for ear disease, but did not self-report the risk, both said they would purchase a DTC-HA as a treatment option. Manufacturer instructional materials can impact setup and programming of a DTC device. DTC models of hearing-health care may require additional consumer support.</p>","PeriodicalId":50021,"journal":{"name":"Journal of the American Academy of Audiology","volume":"34 1-02","pages":"28-37"},"PeriodicalIF":1.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479239","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}