Purpose This study describes the effects and costs of hearing screening and rehabilitation in residential care homes for the elderly. It was hypothesized that offering an in-house hearing screening and rehabilitation program would be an effective strategy to increase hearing aid ownership among the residents. Method All 705 residents of 8 residential care homes in the Netherlands were invited to participate in a hearing screening (pure-tone audiometry) and rehabilitation (hearing aids) program. Resident participation was analyzed, and the costs were calculated. Results A total of 243 residents (34%) participated in the screening, 222 (91%) of whom had hearing loss. Ninety-one (41%) of the screening participants with hearing loss started rehabilitation, which was successful for 50 (55%) of them. Hearing aid ownership among the residents with hearing loss increased from 28% at the start of the program to 33% at the end. The costs were €1,896 (US $2,480) per successfully rehabilitated resident. Hearing aid trials and hearing aids together accounted for 83% of the total costs. Conclusion The effectiveness of the program was limited, as hearing aid ownership increased only slightly. Cost reduction measures should focus on decreasing the number of unsuccessful hearing aid trials.

Objective: In the Netherlands, many children are surgically treated for OM. Recent publications question the need for surgical treatment in common uncomplicated OM, although there is certainly a subgroup of infants that do need further assessment and possible treatment. The present study explores the possibility of using known and presumed risk factors for OM as an instrument for selecting and routing an infant with OM to further care.Methods: Two questionnaires were used. A questionnaire embracing a wide range of OM-related factors was sent to 6531 children aged nine months that were routinely invited for the hearing screen at nine months. In a second stage, a structured history questionnaire regarding ear and/or hearing problems, subsequent referral and/or treatment, was sent to all parents of children at age 21 months, responding to the first questionnaire. Univariate analysis was performed for identification of potential predictors for surgical treatment of OM for the whole sample as well as for 4 different subsets. Multivariable regression analysis with stepwise backward deletion was applied to arrive at a model for optimal prediction of tube insertion. A ROC (receiver operating characteristic) curve and the accompanying sensitivity and specificity values were analyzed to determine cut off values.Results: Univariate analysis found 10 items predicting surgical treatment for OM. Multivariable regression analysis resulted in a model with a ROC curve having an area of 0.801 and estimated coefficients for risk factors which were used to calculate a OM-score for each case.Conclusion: The developed scoring sheet, e.g., to be used in combination with physical examinations and/or tympanometry looks promising as a predictor for those children that might benefit from further assessment and eventually surgically treatment for OM. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Hearing loss is the third most common condition affecting adults over 65 (Cruickshanks et al., 1998)[...]

Objective: Screening for hearing impairment in the Netherlands took place at the age of 9 months for many years but was recently moved to the neonatal period. Since otitis media has its highest prevalence at the age of 9 months, it might be that screening for hearing impairment at this age is linked to treatment of otitis media. We were interested in what the impact would be on the number of children treated with ventilation tubes or adenoidectomy when they were no longer screened at the age of 9 months.Methods: National birth rates, data regarding screening for hearing impairment at the age of 9 months and at the neonatal period, as well as data regarding adenoidectomy and tube placement were used to study treatment of otitis media in children aged 0-2 years in the Netherlands.Results: The percentage of children treated with ventilation tubes after implementation of neonatal screening for hearing impairment did not decline (OR 1.198-1.112), and more children were treated at a younger age. The number of children treated with adenoidectomy did however decline (OR 0.724-0.890).Conclusion: There seems to be an association between the implementation of neonatal screening for hearing impairment and the treatment of otitis media. During the whole studied period there was a slight but statistical significant increase in the odds for tube placement in all children aged 0-23 months. After implementation of the neonatal screen there was a distinct increase in the number of children aged 6-11 months treated with tubes. In the same period a statistical significant decline in the odds of undergoing adenoidectomy was observed. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

The present study examined the long-term consequences of otitis media (OM) on speech perception abilities in noise. 55 children with a prospective 3-monthly documented middle-ear status and hearing loss between birth and 24 months completed a ‘speech-in-noise’ (SPiN) test at the age of 7 years. Both hearing loss and the cumulation of uni- and bilateral OM incidents in early life were significantly correlated to the performance on the SPiN test at school age. Other background factors such as socio-economic status, language perception and cognitive development did not predict the performance on the SPiN test. Only the language production score at age 7 was also significantly related to the score on the SPiN test. The present study deals with the risk of OM in early life and its accompanied hearing loss on auditory processing, specifically speech perception in noise, up to school age.

Background: The assessment of impact and evaluation of treatment effects in chronic otitis media (OM) calls for a much broader approach than just examining the presence of middle ear effusion or hearing loss. It is increasingly recognised that this condition may result in a comprised quality of life. Several studies have used proxy completed questionnaires to objectify the illness experience associated with chronic OM.Objective of review: To review questionnaires which have been developed to describe the effects of chronic OM on the daily functioning of children. Psychometric properties have been evaluated, in addition to discriminative and evaluative qualities.Type of review: A systematic review of publications pertaining to developed questionnaires related with chronic OM.Search strategy: Systematic literature searches of PubMed (1966–January 2007) and EMBASE (1989–January 2007) were conducted, supplemented by using free text words to identify publications after January 2005.Results: The included 15 questionnaires were developed for children with recurrent or persistent OM, describing functional health status (FHS), while two questionnaires also evaluate the effect of tympanostomy tubes insertion. The questionnaires generally cover six impact areas (physical symptoms, child development, educational performance, emotional/practical burden and general health status) with physical symptoms being the most prominant.Conclusions: The OM8‐30, OMO‐22 and OM‐6 adequately reflect the multidimensional aspects of FHS in chronic OM. The OMO‐22 and OM8‐30 show the best psychometric properties for the discrimination of impact severity between children, while the OM‐6 was found to have the best qualities for the evaluation of clinical change. Clinical applicability is crucial for the assessment of FHS in chronic OM, but requires a trade‐off with necessary psychometric properties.

In the present study, the effects of hearing aid use by hearing-impaired older individuals on different aspects of cognitive function, such as memory, attention, executive functioning, and processing speed, were investigated. Fifty-six participants (mean age = 72.5) who were fitted with hearing aids were compared with 46 control participants (mean age = 74.5) with an equivalent hearing impairment, but who were not fitted with a hearing aid. After a dual baseline measurement and fitting of the hearing aids, all participants were assessed again with neurocognitive tests after 12 months. While the participants with hearing aids had improved aided hearing thresholds, they did not demonstrate an improved performance on the cognitive tests compared to the controls. Thus improved hearing did not improve cognitive functioning. These findings may suggest that hearing aid use only restores impairments at the level of the sensory organ, but does not affect the central nervous system and, as a consequence, cognitive functioning.

Reason for the study: Response shift is the change in the meaning of one's self-evaluation of a target construct, like quality of life (QOL). The objective of this study was to investigate whether response shift in the measurement of generic and specific QOL occurred in persons with a relatively mild health condition. For this purpose hearing impairment was used as a research model. Major findings: Response shift effects were observed in the scores on the dimensions of hearing related QOL. In the scores on overall hearing related QOL, and in the scores on the generic control items, no response shift occurred. Conclusions: This study showed that response shift effects can take place in a relatively mild condition as well. The occurrence of response shift in QOL ratings over time could have large implications for the estimation of the effectiveness of medical interventions and for the use of these estimations in cost-effectiveness analyses. After a successful treatment the conventional change could be an underestimation of the effectiveness of the treatment, although it has also been argued that psychological adaptation is a welcome capacity of human beings, and that then-test changes do no justice to this capacity.

Introduction. Validity research into the OM-6 for a Dutch population, quality of life after grommets1 and the influence of ‘response shift bias’ was undertaken. Methods. Parents of 77 children with otitis media (OME) (age 12–36 months) completed the OM-6 (six items, seven-point scale). Quality of life domains concern physical suffering, hearing loss, speech impairment, emotional distress, activity limitations and caregiver concerns. The ‘global quality of life’ rating is performed on a 10-point visual analogue scale. The OM-6 is completed after the first visit to the ear, nose and throat (ENT) surgeon (pre-test 1) and around the time of surgery (pre-test 2). The post-test and the retrospective pre-test are scheduled 6 weeks after the intervention. Results. ‘Global quality of life’ and OM-6 ratings show a good correlation (R = −0.77, P < 0.01). Internal consistency of the OM-6 is satisfying (α = 0.79), responsiveness to clinical change is large (standardized response mean >0.8). Response shift bias is expressed by a difference between pre-test 1 and the retrospective pre-test (T = −3.3, P < 0.01). Before surgery, parents underestimate the seriousness of hearing loss (Z = −3.3, P < 0.05) and overestimate quality of life in general (Z = −3.6, P < 0.05). Conclusion. The OM-6 is valid for a Dutch population. Reported quality of life improves as a consequence of the intervention. The presence of response shift could be explained through adaptation to symptoms before surgery and changes in symptoms as a result of surgery, as well as an increase in knowledge of the consequences related to OME and hearing loss.

We studied to what extent immediate and delayed recall in an auditory verbal learning paradigm was affected by basic information processing speed (digit copying) and hearing acuity (average hearing acuity at 1, 2 and 4 KHz at the better ear). A group of 453 individuals in the age between 23 and 82 years with no overt hearing pathology was recruited from a larger study of cognitive aging (Maastricht Aging Study, MAAS). After controlling for age, sex, educational level, and processing speed it was found that a mild to moderate hearing loss predicted lower verbal memory performance. Auditory administered verbal memory tests can underestimate true memory performance, particularly in older individuals with unknown hearing status.

Click-evoked oto-acoustic emissions (CEOAE) are acoustic responses produced by the inner ear, reflecting functional auditory integrity. We studied both the success rate of the CEOAE method and the CEOAE presence in preterm infants during their stay at the Neonatal Intensive Care Unit (NICU), by analysis of the results of longitudinal CEOAE measurements in 19 preterm infants. The CEOAE method proved to be feasible in the majority of the population under study; the CEOAE measurement failed in 8% of the total of 226 attempts. Within the range of 30–40 weeks post-conceptional age (PCA) the CEOAE presence increased from about 50% to 80%. These results show the possible clinical application of CEOAE in a NICU for the monitoring of cochlear function during treatment of preterm infants.