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Thread: Best Practices?

  1. #1
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    Default Best Practices?

    It seems like a lot of issues I read about could be greatly improved by a set of Best Practices in audiology. I've seen some articles on best practices, but they have tended to be more marketing oriented. From my reading and limited experiences with hearing aids, some of the things that I think would be included would be:
    1) frequencies tested for audiogram 2) bone conduction frequencies tested 3) Real Ear measurement compared to NAL-2 fitting formula and guidelines for how close a fit is desired

    That's not a complete list, but it seems like if people had a set of best practices or clinical guidelines they would know what to expect and have something to judge their care by. It would also give brick and mortar businesses an advantage because there is no way online businesses could offer real ear measurements. Has anybody seen a set standards of what to expect from hearing testing and hearing aid fitting? As mentioned, I've seen some stuff labelled best practices and clinical guidelines, but they seem "soft."
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  2. #2

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    Best practice standards for audiology already exist. Just google it. All the professional bodies for audiologists have them for example.
    Carol

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  3. #3
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    Default

    I've googled and read much of them. As I mentioned before, much of them are "soft" or not very specific. Perhaps I'm using wrong terminology. Perhaps Quality Checklist is more appropriate. Something a consumer could use to determine if he/she got an adequate evaluation and fitting. A lot of people seem to believe that verifying with real ear measurements is important, but I haven't seen any standard of how close one should try to get. I think if there were widely agreed upon quality standards it could improve user satisfaction and also help audiologists compete with online sales.
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  4. #4

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    You want a consumer guide to ensuring quality care. That is not the same. Not everyone has the same knowledge and understanding to assess their care so the guides tend to keep it simple. Not really what you are looking for. You would be better off finding the quality guidelines for audiologists but you will have to hunt through the less interesting stuff to find what you want.
    Carol

    Linx 961>Linx2 961> Phonak Audeo V90 312T L&R
    Hz 250 500 1K 2K 3K 4K 5K 6K 8K
    L 25 25 15 35 40 40 60 60 55
    R 25 25 15 30 40 35 35 55 50
    Speech
    L 83% 40dB, 100% 50dB
    R 80% 40dB, 97% 50dB

  5. #5
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    Default

    Several years ago Consumer reports did a study.

    They used 48 purchases and determined that 2/3rd of them were not set up properly.

    https://youtu.be/5lMuHQT2NtU
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  6. #6
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    Thanks. Further poking and I've found some useful stuff. An Oticon white paper was useful on REM. They suggested + or- 5db at 500, 1000 and 2000 and + or-8db at 3000 and 4000. Also sounds like their software facilitates making adjustments when doing REM. I do find fascinating the disconnect between recommendations and reality.

    [QUOTE=Psocoptera;147611]You want a consumer guide to ensuring quality care. That is not the same. Not everyone has the same knowledge and understanding to assess their care so the guides tend to keep it simple. Not really what you are looking for. You would be better off finding the quality guidelines for audiologists but you will have to hunt through the less interesting stuff to find what you want.[/QUOT
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  7. #7

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    I suspect much of the poor quality fits are the consumers not knowing how things should work. Having had aids for 30+ years I am pretty demanding, but grandpa going in for his first fitting isnt going to know how something should fit/work.

  8. #8
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    Gary, I believe the point being made was the the fitter wasn't competent enough to fit to prescription.
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  9. #9

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    In Australia when fitting hearing aids to patients who fall within the government subsidy system, we have a set of guidelines to follow which includes REM / LSM verification measurement at fitting to ensure aids are set up correctly. That being said, I have seen plenty of people who's file shows a great target 'match', however they have not been correctly shown how to use their hearing devices, or their hearing devices are not suitable for them resulting in poor usage outcomes. Verification is important in my opinion, but it's more important to spend the time with the patient making sure they know all of the ins and outs of their hearing aids and are being given personalised information so that they can manage them effectively and understand limitations etc. A perfectly verified hearing aid is useless in a drawer!

  10. #10
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    Thoroughly agree.
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