PP1328 - Development of the BiCROS Candidacy and Benefit Evaluation

Abstract: This study aimed to design a BiCROS candidacy and benefit assessment tool using a structured approach, incorporating input from both BiCROS users and clinicians. In a previous study, a structured brainstorming process involved BiCROS hearing aid users providing statements in response to the prompt 'one benefit of wearing my BiCROS transmitter rather than just the hearing aid on my better ear.' This resulted in 11 unique statements, which served as the framework for the BCaBE tool. To follow appropriate Knowledge-to-Action methodology, clinician focus groups were conducted to gather input regarding the tool's formatting and content.

Summary:

Background:

Limited Usable Hearing Unilaterally (LUHU) refers to a unilateral hearing loss characterized by a degree of severity ranging from severe to profound and/or poor speech recognition abilities (Picou et al., 2020). This type of hearing loss cannot be effectively treated with conventional hearing aids and can pose significant challenges audiologically and socially.Contralateral Routing of Signals (CROS) technology is one of the primary solutions available to individuals with LUHU. This involves placing a CROS transmitter microphone on the weaker, unaidable ear, and routing the signal to the CROS receiver on other, better ear. The primary purpose of this device is to act as a remote microphone positioned on the unaidable ear, sending the signal to the better ear. In cases where the better ear has a hearing loss which is aidable, the signal is transmitted to a hearing aid on the better ear, with appropriate amplification. This approach is known as Bilateral Contralateral Routing of Signals (BiCROS) (Dillon, 2006).While much research has been conducted investigating the benefits of CROS/BiCROS technology and its advantages/disadvantages in different listening environments (Beck & Ramachandran, 2019; Stewart & Woodward, 2021), the subjective BiCROS experience is relatively understudied. The CROS/BiCROS subjective user experience can be assessed through subjective questionnaires and rating scales such as the Bern Benefit in Single-Sided Deafness Questionnaire (BBSS) and the Speech, Spatial and Qualities of Hearing Scale benefit measure (SSQ-b). These questionnaires, however, were not designed with a focus on CROS/BiCROS devices, nor validated with users of these devices. To understand what drives BiCROS users to want to wear their BiCROS devices, 18 BiCROS users were presented with the brainstorming prompt “One benefit to using my hearing aids in both ears (CROS) rather than just one hearing aid on my better ear is…” and asked to complete the statement with as many ideas as possible. This resulted in 45 unique statements which, when compared to the SSQ-b and BBSS, resulted in 11 statements representing ideas not found in either of the aforementioned questionnaires (these statements were presented on a poster at AAA2023).

Methods

The aim of this study is to use these 11 statements as a framework for a questionnaire aimed at assessing candidacy for potential BiCROS users and, after fitting and acclimatization, assessing benefit from the BiCROS.

Currently, the tool is in its draft stage, but its development will involve consulting a focus group of clinicians and/or BiCROS users to ask about recommended changes in content or format. Following this, a validation project will be conducted, in which the questionnaire will be distributed by Qualtrics to individuals with LUHU to determine reliability, validity, and factor structure.  

Importance of work

This work will provide us with a novel tool developed specifically with BiCROS users in mind. Currently, the available hearing aid benefit questionnaires may not capture all important aspects of the BiCROS hearing aid user experience. This tool will allow us to better tailor our in-clinic services and decisions to this relatively less-understood group.