Purpose: This study aimed to map publication trends, topical focus, study designs, and institutional concentration in otology research in Saudi Arabia from 1978 to 2024 to deduce any topical, regional, institutional, or funding disparities in the field of otology in the country. Methods: We conducted a scoping review of studies on human ear diseases in Saudi Arabia, searching PubMed and the Cochrane Library from inception to 31 December 2024. Bibliometric characteristics were charted, topics were mapped to ICD-11 chapters, and temporal trends were modelled using negative binomial regression with a single data-driven breakpoint. Results: Of 2227 records identified, 510 studies were included. Annual output increased by 9.28% (95% CI 7.05-11.55). An inflection occurred around 2017, with slower growth before 2017 (7.2%/year, 95% CI 5.3-9.1) and faster growth from 2018 onward (23.9%/year, 95% CI 18.6-29.4). The institutional affiliation of first authors was concentrated in a small number of organizations, led by King Saud University. Observational studies predominated (441/510), whereas experimental studies were limited (16/510). ICD-11 mapping showed the greatest concentration in "Ear and mastoid" (189/510, 37.1%) and "Factors influencing health status or contact with health services" (179/510, 35.1%) chapters. Funding was reported in 75 studies. Conclusions: PubMed- and Cochrane-indexed otology and hearing health research output in Saudi Arabia has grown substantially, particularly since 2017, but remains concentrated by institution, region, study design, and topic. The dominance of cochlear implant and hearing impairment research, together with limited multicenter, experimental, vestibular, tinnitus, and rehabilitation-focused studies, identifies priorities for future audiology and neurotology research planning.
South Africa's speech-language therapy (SLT) and audiology professions face challenges in achieving linguistic and cultural integration (i.e., the meaningful incorporation of diverse linguistic and cultural perspectives into training and practice), a critical aspect for effectively serving the country's diverse population. Limited curriculum content on indigenous languages and cultural competence, along with low diversity of academic and clinical training staff (staff), may hinder students' preparedness for multilingual and multicultural clinical practice. This study explored undergraduate students' views and self-reported practices regarding linguistic and cultural integration during their professional training. To explore the views and practices of South African SLT and audiology undergraduate students concerning linguistic and cultural integration in their training. A cross-sectional convergent mixed-methods survey design was used to gather quantitative and qualitative data from a purposive sample of 48 third- and fourth-year SLT and audiology students across four South African universities. Data were collected using a structured online questionnaire, including Likert-scale items and open-ended questions. Quantitative data were analysed using descriptive and inferential statistics, while thematic analysis was applied to qualitative responses. Within this sample, participants recognised the importance of linguistic and cultural competence but report feeling inadequately prepared to implement these skills in clinical settings. Key barriers included insufficient curriculum coverage of cultural topics, reliance on untrained interpreters, and a lack of bilingual resources. Students from indigenous language backgrounds reported higher ratings of the importance of linguistic integration than their English-speaking peers (p < .05). Qualitative themes suggested a perceived need for greater curriculum responsiveness, increased staff diversity, and enhanced institutional support to facilitate culturally competent practice. These exploratory findings suggest that curriculum responsiveness, institutional support, and staff diversity may warrant further consideration within ongoing efforts aimed at improving student preparedness for practice in South Africa's multilingual and multicultural healthcare environment. These findings point to the need for ongoing educational transformation efforts to better serve the diverse needs of the South African population.
Social communication interventions to support autistic people are primarily developed and tested in Western countries with predominantly White, English-speaking participants. Although numerous frameworks have been developed to adapt these interventions for diverse ethnocultural groups, the quality of these adaptations is not well understood. This review used the Cultural Adaptation Checklist (CAC) to appraise the quality of cultural adaptations of social communication interventions for autistic children and adolescents. Searches across eight databases identified 16 studies involving 474 participants. Included studies reflected seven different culturally adapted interventions delivered across 12 countries in 11 languages. The methodological quality of the studies was assessed using QualSyst, and data were analyzed through narrative synthesis. All studies demonstrated at least adequate methodological quality, but only three reported using a specific framework to guide their cultural adaptations. The extent of adaptations varied, with fulfillment of CAC items across studies ranging from 44% to 91%. This review highlights the need for more comprehensively reported cultural adaptations to best support the global autistic community. The CAC offers a useful framework that researchers can use to facilitate this process. Future research should examine to what extent cultural adaptations are needed and which types of adaptations best support desired intervention outcomes.Lay AbstractMany programs have been designed in Western countries to support social communication skills such as understanding others, making friends, and building relationships in autistic people. Those who participate in these programs have mainly been English-speaking participants, so the suitability of these programs to other language, cultural, and ethnic backgrounds remains unknown. To make programs more culturally and linguistically relevant, researchers have adapted them in several ways. This study looked at how well programs for autistic children and adolescents have been adapted for various communities. Using the Cultural Adaptation Checklist (CAC), we examined 16 studies and found that the amount of adaptations varied widely. Only three studies mentioned using a framework that guided their adaptations. Our findings show that although all studies described some level of cultural adaptation, very few reported on ensuring stronger community involvement or making the programs more accessible for all. Using tools like the CAC can help researchers and clinicians make programs more inclusive and relevant for autistic individuals and their families worldwide.
The problem of hearing impairment in children remains of high medical and social significance, as it negatively affects speech development, social adaptation, and quality of life. Early rehabilitation plays a crucial role, and parental involvement is a key factor in success. In the Russian Federation, ear diseases account for 5% of the structure of childhood disability, necessitating the development of accessible regional rehabilitation programs with active family involvement. To present a comprehensive regional rehabilitation program for children with hearing impairments in the Ivanovo region, developed with the support of the National Medical Research Center for Otorhinolaryngology of the FMBA of Russia, and to describe its main modules aimed at actively involving parents in the process of hearing restoration, speech development, and social adaptation of the child. This work is based on an analysis of the experience of implementing the regional program at the audiology department of the Ivanovo Regional Clinical Hospital with the participation of the Department of Otorhinolaryngology of Ivanovo State Medical University. The description is based on program documentation, session protocols, and interviews with participants (specialists and parents). A qualitative and descriptive analysis was conducted, identifying key modules, rehabilitation stages, and the roles of specialists. The program includes comprehensive diagnostics (audiological, speech therapy, psychological), an individualized rehabilitation plan, and a differentiated approach for users of hearing aids and cochlear implants. Educational modules for parents have been developed: psychological education, training in device handling, communication strategies, parental coaching, psychological support, social navigation, monitoring, and supervision. Innovative components include theater therapy and vocal lessons, which contribute to the development of prosody and strengthen parent-child relationships. The program is implemented by a multidisciplinary team (audiologist, ENT physician, speech-language pathologist, psychologist, social worker, coordinator) in accordance with a calendar model (0-1 month, 1-6 months, 6-24 months, preschool and school stages). Distance learning formats are provided for families from remote areas. The regional program of the Ivanovo region represents an example of a comprehensive family-centered approach that integrates modern evidence-based rehabilitation methods. This experience can serve as a model for the development of similar programs in other regions. Further research will be aimed at quantitative evaluation of the effectiveness of the described modules. Нарушения слуха у детей имеют большое социально-медицинское значение, поскольку негативно влияют на речевое развитие, социальную адаптацию и качество жизни. Ранняя реабилитация играет решающую роль, а участие родителей является ключевым фактором успеха. В Российской Федерации заболевания уха составляют 5% в структуре детской инвалидности, что обусловливает необходимость создания доступных региональных программ реабилитации с активным вовлечением семьи. Представить комплексную региональную программу реабилитации детей с нарушениями слуха в Ивановской области, разработанную при поддержке НМИЦО ФМБА России, и описать ее основные модули, направленные на активное вовлечение родителей в процесс восстановления слуха, развития речи и социальной адаптации ребенка. В основу работы положен анализ опыта реализации региональной программы на базе сурдологического кабинета Ивановской областной клинической больницы при участии кафедры оториноларингологии ФГБОУ ВО «Ивановский ГМУ» Минздрава России. Описание основано на документации программы, протоколах занятий и интервью с участниками (специалистами и родителями). Проведен качественный и описательный анализ с выделением ключевых модулей, этапов реабилитации и роли специалистов. Программа включает комплексную диагностику (аудиологическую, логопедическую, психологическую), индивидуальный план реабилитации и дифференцированный подход для пользователей слуховых аппаратов и кохлеарных имплантов. Разработаны образовательные модули для родителей: психологическое образование, обучение обращению с техникой, коммуникативные стратегии, родительский коучинг, психологическая поддержка, социальная навигация, мониторинг и супервизия. Инновационными компонентами выступают театральная терапия и вокальные занятия, способствующие развитию просодики и укреплению детско-родительских отношений. Программа реализуется мультидисциплинарной командой (аудиолог, врач-оториноларинголог, логопед-дефектолог, психолог, социальный работник, координатор) в соответствии с календарной моделью (0—1 мес, 1—6 мес, 6—24 мес, дошкольный и школьный этапы). Предусмотрены дистанционные формы работы для семей из отдаленных районов. Региональная программа Ивановской области представляет собой пример комплексного семейно-центрированного подхода, интегрирующего современные научно обоснованные методы реабилитации. Опыт может служить моделью для создания аналогичных программ в других регионах. Дальнейшие исследования будут направлены на количественную оценку эффективности описанных модулей.
Work time management is an important aspect in organizing medical care. Current regulations do not establish recommended time limits for audiologists. To determine the time spent on audiologist's appointments and performing various diagnostic and rehabilitation procedures. At the City Audiology Center for Adults (St Petersburg), a time estimate was conducted for 10 audiologists who performed various medical diagnostic and rehabilitation audiology services. The advisability of standardizing audiologist's appointment duration to 30 minutes was established (for adult patients, without an instrumental audiological assessment or 60 minutes if an assessment (pure tone audiometry, acoustic impedance, otoacoustic emissions) is included). The results of medical appointments for diagnostic tests (acoustic impedance, speech audiometry, nasopharyngeal endoscopy, otoacoustic emissions, auditory brainstem response (ABR), ASSR, central auditory processing disorders tests, and vestibular tests) and rehabilitation interventions (hearing aid issuance, selection, or fitting of hearing aids) are determined. The obtained data can be used for inclusion in specialized regulatory documents governing the activities of audiologists and otolaryngologists. Нормирование труда является важным аспектом при организации оказания медицинской помощи. Действующими нормативно-правовыми актами не установлены рекомендованные нормы приема врача — сурдолога-оториноларинголога. Определить временные затраты на прием врача — сурдолога-оториноларинголога и выполнение различных диагностических и реабилитационных мероприятий. На базе Городского сурдологического центра для взрослых СПб ГБУЗ «Городской гериатрический медико-социальный центр» проведен хронометраж рабочего времени 10 врачей — сурдологов-оториноларингологов, которые оказывали различные медицинские диагностические и реабилитационные услуги сурдологического профиля. Целесообразно установить нормированное время базового приема врачом — сурдологом-оториноларингологом взрослого пациента без проведения инструментального аудиологического обследования в объеме 30 мин, а с проведением обследования (тональная пороговая аудиометрия, акустическая импедансометрия и регистрация отоакустической эмиссии) — 60 мин. Представлены результаты хронометража врачебных приемов по проведению диагностических исследований (акустической импедансометрии, речевой аудиометрии, эндоскопии носоглотки, регистрации отоакустической эмиссии и коротколатентных слуховых вызванных потенциалов (КСВП, ASSR-тест), проведения тестов для диагностики центральных слуховых расстройств, исследования вестибулярного анализатора) и реабилитационных мероприятий (выдача слуховых аппаратов, подбор или настройка имеющихся слуховых аппаратов). Полученные данные могут быть использованы для включения в профильные нормативные документы, регулирующие деятельность врача — сурдолога-оториноларинголога.
Justice-involved youth (JIY) represent a vulnerable population with a well-documented elevated risk for language disorder compared to their nonoffending peers. Research also suggests that JIY with language disorder are more likely to reoffend after release. Despite this, the involvement of speech-language pathologists (SLPs) in JIY rehabilitation in South Africa remains limited. This study explored the perceptions of South African SLPs regarding their potential roles in youth correctional facilities. A cross-sectional, mixed-method online survey design was used. Participants were recruited by means of nonprobability purposive sampling through various social media platforms. A total of 35 complete data sets were collected. Most participants were unfamiliar with the current role of SLPs in youth correctional facilities (n = 25, 86.2%). Despite this, most viewed SLP involvement as potentially beneficial to JIY rehabilitation (n = 26, 74.3%) and agreed with the need for increased advocacy for the involvement of SLPs in JIY rehabilitation programs (n = 23, 79.3%), although fewer than half reported feeling comfortable working in youth correctional settings (n = 15, 42.9%). Roles such as supporting literacy development and acquisition (n = 29, 100%) and communication assessment (n = 29, 100%) received the highest priority scores. Participants generally held positive attitudes toward the potential role of SLPs in youth correctional facilities, supporting the profession's role in rehabilitation teams. Despite a small sample size, the study offers valuable insights into South African SLPs' perspective on the context, highlighting the need for further research on the topic. https://doi.org/10.23641/asha.32692002.
With age-related hearing loss on the rise and a large bilingual (BI) population in the United States, there is an increasing need for effective assessment tools for Spanish-speaking and BI older adults. Research in this area is limited. The AzBio Sentence Test (AzBio) is used to assess speech perception in challenging listening environments. A Spanish version was recently developed to address the needs of Spanish-speaking patients, and opens new opportunities for research with BI individuals to better understand speech perception processes in both the native and the second language. This preliminary study aims to explore the characteristics of speech recognition among older BI adults by examining the performance of younger and older proficient Spanish-English BIs on the AzBio in quiet and noisy conditions. Preliminary quasi-experimental group design. Twenty-one participants were divided into three groups: eight young American English monolinguals (M = 28.12 years, range: 24-32), eight young Spanish-English BIs (M = 28.38 years, range: 23-33), and five older Spanish-English BIs (M = 58 years, range: 55-62). The AzBio was used to assess speech perception in quiet and noisy conditions in both English and Spanish, with two signal-to-noise ratios: 0 and -3 dB. Independent and paired sample statistical tests were conducted. In quiet conditions, older BIs outperformed younger ones on the Spanish version, whereas younger BIs performed better in English. However, for the older group, the linguistic advantage observed in quiet conditions disappeared in noisy environments, because performance differences with the younger group diminished when background noise was introduced. Young monolinguals and BIs showed no difference in performance on the English version. Aging poses challenges for speech recognition in noisy environments. For BIs, these difficulties extend to both languages, including the dominant one. The combined effects of bilingualism and aging negatively impact speech recognition in both languages. Understanding how individuals perform on the AzBio and other BI sentence recognition tools is essential for improving clinical assessment and intervention for those impacted by language background and age-related hearing changes.
Clinical care for patients who report substantial hearing difficulties despite having little or no hearing loss is a topic of great debate within and beyond audiology. Building on our previous retrospective review of veterans evaluated for auditory processing disorders across the Veterans Health Administration (VHA), the current work presents five such case studies. The goal is to work toward improved patient care by providing a more in-depth view highlighting both strengths and weaknesses of approaches to care for veterans whose hearing difficulties are not explained by hearing loss. Five case studies were selected for review with the goal of identifying individuals with a wide range of etiologies and experiences receiving care for auditory complaints across the VHA. All information provided is taken directly from chart notes available from VHA and Defense Health Agency sources. Etiologies included traumatic brain injury, jet fuel exposure, and nonspecific origins. Some patients experienced well-coordinated care across medical departments, while others experienced repeated barriers and high burdens of self-advocacy while trying to navigate the health care system. Furthermore, differences in the approach of audiologists and speech-language pathologists are highlighted, including differing emphasis on diagnostic tests versus self-report measures and use of top-down versus bottom-up rehabilitation tools. This work highlights several options likely to improve care for veterans with auditory processing deficits, including greater emphasis on addressing patient-specific needs and goals, improved communication and collaboration between audiology and other medical disciplines, and the potential role for auditory device-based rehabilitation options, even among patients with minimal hearing loss.
The cochlear microphonic (CM) primarily reflects the composite receptor potential of outer hair cells (OHCs), providing an objective assessment of OHC mechanoelectrical transduction (MET) capacity. However, systematic studies on CM in basic research remain scarce, and baseline CM values for CBA/CaJ mice have not yet been established. Moreover, whether CM can functionally differentiate between auditory neuropathy (AN) and noise-induced hearing loss (NIHL) has not been systematically addressed. This study aimed to establish normative CM reference values for CBA/CaJ mice and to explore the utility of CM as an objective electrophysiological tool for assessing OHC function across different pathophysiological conditions. CM was recorded from the round window in three mouse models: wild-type (WT) CBA/CaJ mice (1, 2, and 7 months), Aifm1 p.R450Q knock-in AN mice, and NIHL models of permanent threshold shift (PTS) and temporary threshold shift (TTS). Input-output (I/O) nonlinearity and frequency-specific were analyzed. In WT mice, CM amplitude exhibited an approximately linear relationship with stimulus intensity at levels ≤90dB SPL. When the intensity exceeded 90dB SPL, the amplitude saturated and subsequently declined, demonstrating nonlinear characteristics under high-intensity stimulation. Compared to 1- and 2-month-old WT mice, CM amplitude was reduced at 7 months of age. In AN mouse models, CM waveforms remained generally normal, but amplitude increased at 1 month and declined by 7 months. In noise-exposed mice, CM amplitude significantly decreased in the PTS group, while only a slight reduction was observed in the TTS group. This study establishes normative CM values for CBA/CaJ mice and demonstrates that CM profiling provides a functional differentiation between AN and two types of NIHL. These findings support CM as a robust, objective tool for assessing OHC function in murine models and encourage broader implementation of CM testing in both preclinical research and clinical diagnostics.
Financial toxicity (FT), encompassing objective and subjective impacts of cancer care costs, is linked to poorer quality of life, reduced treatment adherence, and higher mortality. While patient-level risk factors have been examined, a system-level perspective incorporating socioeconomic context is needed to understand global variation in FT. MEDLINE, CINAHL, Embase, and Web of Science were searched from inception to 06/27/2025 for peer-reviewed, English-language studies describing self-reported FT outcomes among adults with cancer. Reviewers extracted study characteristics, FT prevalence, predictors, and measurement tools. Financial, physical, and social asset measures from the World Bank were merged with FT data by study country and year of data collection. Focusing on studies reporting Comprehensive Score for Financial Toxicity (COST) scores, multilevel random effects meta-analysis was performed. Univariate and multivariate multilevel meta-regression evaluated relationships between country-level assets and COST. One hundred thirty-two studies from 22 countries were included, with FT prevalence ranging from 4.0% to 100.0%. Three-level meta-analysis of 75 COST-based studies (15 countries; 83,623 patients) yielded a pooled mean COST score of 21.2 (95% CI: 19.1-23.3; 95% prediction interval: 13.3-32.4), though substantial heterogeneity (I2 = 99.2%) and a predominance of studies from the US (55%) limited its standalone interpretability. Variance decomposition showed that 46% of heterogeneity was attributable to between-country differences. Higher log GDP per capita was associated with higher COST (β = 4.44, 95% CI: 2.90-5.98), explaining 43.1% of between-country variance. Higher out-of-pocket health expenditure, population-level financial hardship, and vulnerable employment were associated with worse FT. GDP associations were robust to sensitivity analyses excluding US-based studies. FT among cancer patients is linked to structural conditions governing access to education, employment, and financial systems, although expanded research in low-resource settings is needed. These findings highlight the roles of economic development strategies and investment in human capital in helping to safeguard against population-level FT.
To translate, cross-culturally adapt, and validate the Voice Handicap Index into the Tulu language and to compare outcomes between individuals with and without voice problems. Cross-sectional study METHODS: The study included 156 participants: 78 individuals without voice problems (Group I) and 78 with voice problems (Group II). The Voice Handicap Index was translated into Tulu following standard cross-cultural adaptation procedures, including forward translation, backward translation, expert review, and pilot testing. The adapted Voice Handicap Index-Tulu was administered to all participants. Internal consistency was assessed using Cronbach's α, test-retest reliability using the intraclass correlation coefficient, and construct validity using independent-samples t tests. Participants with voice problems reported significantly higher Voice Handicap Index-Tulu scores across all domains compared to those without voice problems (P < 0.001), with large to very large effect sizes. VHI-Tulu demonstrated good to excellent internal consistency (Cronbach's α = 0.82 in Group I; Cronbach's α = 0.94 in Group II). Test-retest reliability was excellent (intraclass correlation coefficient = 0.97). Subscale reliability ranged from acceptable to excellent in Group II. The Voice Handicap Index-Tulu is a reliable and valid tool for assessing the voice-related quality of life in the Tulu-speaking community and can be used in clinical practice and research.
Sodium thiosulfate (STS) has recently been approved as an otoprotectant for systemic use in pediatric cancer patients receiving cisplatin treatment for localized, nonmetastatic solid tumors by the Food and Drug Administration, European Medicines Agency, and Medicines and Healthcare Products Regulatory Agency. While incorporating STS into the current standard of care pediatric practice, questions about uniform, timely, and safe administration are raised that may benefit from additional guidance. Recognizing that advancing clinical practice presents multiple challenges, an international onco-ototoxicity prevention task force, including experts in pediatric oncology, audiology, and pharmacology, was established to identify potential barriers to the implementation of otoprotection and to offer practical solutions for clinical services for children exposed to cisplatin, based on available evidence, as well as consensus where data are less robust. This task force held several online meetings and a working group session at the annual SIOPE meeting in Milan in May 2024, where the challenges for implementing STS were outlined and addressed. Nine key challenges were identified, including, for example, the timing of both cisplatin infusion and STS administration, the optimal integration of STS into existing treatment protocols, potential drug interactions, and relevant economic considerations. In this article, we propose practical steps to address these challenges, informed by the existing literature and expert opinion, incorporating recommendation statements from the international onco-ototoxicity prevention task force on behalf of the SIOP Supportive Care Network, to facilitate the implementation of STS in children with localized, nonmetastatic disease.
Language development is influenced by biological and environmental factors, including infant hormonal status and maternal mental health. Previous research on the role of infant sex hormones in language development focused on estradiol and testosterone, yet first evidence indicates that dehydroepiandrosterone (DHEA), the dominant fetal steroid hormone, may be a more sensitive biomarker for language development by shaping the organization of the developing brain. Concerning infants' language-learning environment, maternal well-being is a key factor, with maternal depressed mood postpartum, even at subclinical levels, negatively affecting language development, as depressed mothers engage less with their children and use less infant-directed speech. The present study examined the interplay of fetal DHEA levels and maternal mood at eight weeks postpartum on receptive language abilities at 12 months in boys and girls. Fetal DHEA levels were extracted from hair samples collected two weeks after birth (n = 58; 28 girls), allowing fetal hormone milieu quantification in the third trimester. Maternal mood in the subclinical depression range was assessed using the Edinburgh Postnatal Depression Scale. Children's receptive language abilities were assessed using the German version of the Bayley Scales of Infant and Toddler Development. Stepwise multiple linear regression analysis revealed fetal DHEA to predict language development in boys, with the effect depending on maternal mood. Only when mothers experienced better mood postpartum were higher DHEA levels related to lower language ability. By contrast, in girls, only maternal mood significantly contributed to language ability, with better mood relating to higher language outcome. Our findings suggest that the effect of infant sex hormones on language development follows sex-specific patterns and appears to be modulated by the learning environment. Moreover, our results emphasize the importance of mental support during the early stages of language development.
Hearing loss can have direct adverse effects on the significant others (SOs) of individuals with hearing loss. The term "third-party disability" is used to refer to the difficulties faced by family members because of the health conditions of their SOs. The "Hearing Impairment Impact-Significant Other Profile (HII-SOP)" is a tool designed to measure hearing loss-related quality of life among spouses of English speakers with hearing loss. In the present project, we have sought to translate the HII-SOP questionnaire into Kannada, a southern Indian language spoken by 43.7 million people, and validate it. In the first phase, we translated the questionnaire into Kannada following a structured protocol. In the second phase, we evaluated the psychometric properties by administering the translated version (HII-SOP-K) to 57 SOs of individuals with hearing loss. The sample included spouses, children, and other caregivers of individuals with hearing loss who were native speakers of Kannada (mean age: 47.96 years). The HII-SOP-K showed excellent internal consistency (Cronbach's α=0.90) and strong test-retest reliability (intraclass correlation coefficient: 0.914). Exploratory factor analysis revealed that the five factors accounted for 58.3% of the variance. Most SOs reported mild-to-moderate third-party disabilities. The relationship between SOs (spouses, children, and others) and individuals with hearing loss had no significant effect on HII-SOP-K scores. The Kannada version of the HII-SOP is a valid and reliable tool for assessing third-party disabilities among the SOs of individuals with hearing loss. Assessment of third-party disabilities will facilitate patient- and family-centered audiological care and may enable the inclusion of SOs in the aural rehabilitation of individuals with hearing loss and facilitate a comprehensive understanding of third-party disability among Kannada speakers; thus, HII-SOP-K is suitable for use in clinical and research contexts among Kannada speakers.
Benign paroxysmal positional vertigo (BPPV) is the most prevalent vestibular disorder in clinical practice, yet its diagnosis and management remain challenging for trainees due to their procedural and interpretation-dependent nature. Existing teaching approaches are often variable, lack standardisation, and provide limited support for skill acquisition. While multimedia learning is increasingly adopted in medical education, few resources are systematically developed and rigorously validated, particularly in vestibular training. This study aimed to develop and validate the content and face validity of the SMART-BPPV multimedia learning tool for BPPV education. This methodological study followed the ADDIE instructional design framework. After completion of the analysis, design, and development phases, the module underwent structured content and face validation. Seven experts in otorhinolaryngology and audiology assessed content relevance and clarity using a 4-point scale. Item- and scale-level Content Validity Indices (I-CVI, S-CVI/Ave) and chance-corrected agreement statistics were calculated. Face validity was evaluated by 30 medical officers assessing clarity, usability, and relevance. The module demonstrated excellent content validity (S-CVI/Ave = 0.987; I-CVI = 0.857-1.000; k* = 0.848-1.000). Interrater agreement using Gwet's AC1 was near-perfect (0.976), while Fleiss' κ (- 0.01) reflected the known paradox associated with highly uniform ratings. Face validity was similarly high (S-FVI/Ave = 0.999; I-FVI = 0.967-1.000). Qualitative feedback consistently highlighted clarity, logical organisation, and effective visual design, with minor refinements incorporated. SMART-BPPV demonstrated excellent content and face validity, supporting its suitability as a structured educational resource for introductory BPPV education. Future studies should evaluate its impact on knowledge acquisition and procedural performance.
This study explores the extent to which commonly used tinnitus questionnaires align with relevant International Classification of Functioning, Disability and Health (ICF) domains. The aim is not to establish the superiority of any tool, but rather to identify potential gaps in domain coverage and to support more intentional questionnaire selection. A rapid review was conducted to identify validated tinnitus questionnaires used in clinical practice. Each questionnaire was systematically linked to ICF categories employing established frameworks. The study compared the domain coverage of the ICF-based international inventory for tinnitus (ICF-TINI) with that of other commonly used questionnaires and mapped overlapping and unique ICF codes to determine the breadth of coverage. While ICF-TINI addressed a wide range of ICF domains, no single questionnaire provided complete coverage, particularly for the domains of environmental factors and participation. Other tools such as the Tinnitus Functional Index and Tinnitus Handicap Inventory also demonstrated broad but incomplete domain representation. The findings underscore the importance of strategically combining tinnitus questionnaires based on ICF domain mapping, rather than relying solely on familiarity or tradition. The study proposes an evidence-informed approach to tool selection that may enhance person-centered tinnitus assessment. Further research is required to determine whether broader ICF coverage leads to improved outcomes.
This review aims to identify the key barriers to clinical application of Machine Learning (ML) in multi-class voice disorder classification. Scoping Review. A comprehensive scoping review of research published between 2013 and May 2025 in seven clinical and engineering databases was conducted. Articles that applied ML techniques to classify voice disorders were examined, excluding publications limited to binary classification (e.g., healthy vs. pathological). Data were extracted from the included articles to analyze patterns in the specific voice disorder classification classes, database selection, the input data attributes, vocal tasks, diagnostic labelling, and the applied ML classification techniques. In total, 10,401 articles that addressed voice disorder classification were screened from which 80 used ML techniques for multi-class classification. Results revealed considerable variation in selection of databases, voice disorder diagnostic labels, amount and type of input data (e.g., voice tasks and demographics questionnaire), and classification techniques. These inconsistencies prevent robust comparisons and therefore identification of state-of-the-art solutions, which would typically mature to clinical applications. Variations in classification tasks make it difficult to compare results across studies. The inconsistency found in terms of class imbalance, sample size, and total number of classes investigated, means there is no baseline for comparing and exploring various classification techniques. Finally, variations in testing methods such as using different test set types and sizes or using cross validation limit comparisons across articles. This review identified considerable variations in the diagnostic labels associated with voice disorder classification, data availability per selected label, and testing methodology. Such variation limits comparability and undermines the generalization of ML models. The lack of consensus across the automated classification pipeline - from selection of which disorders should be classified using ML systems, to constructing test sets and measuring performance - are likely to be critical barriers to clinical application. These barriers must be addressed to realise the potential for using voice as a biomarker of other systemic diseases.
To compare personal listening device (PLD) listening behaviours, leisure noise exposure, audiometric outcomes, hearing protection (HP) usage and self-reported hearing loss (HL) symptoms at Time 1: 2009/2010 and Time 2: 2022/2023. Mean hearing thresholds (HTs), pure-tone average HL prevalence, PLD volume levels, durations, earbud/headphone tightness, and sex among matched pairs, at Time 1 and 2, were compared. Longitudinal design. Questionnaire evaluating PLD listening behaviours, leisure noise exposure and HL symptoms. Multivariate regression analysis used to determine relationship between variables and audiometry. 59 Participants, aged 22-30, of original cohort (n = 237, aged 10-17) were re-tested (Time 2). Over time, tinnitus following leisure noise tripled, HP doubled and higher average PLD listening time was observed (7 vs. 18 h/week); longer durations for males. High volume listening was 20% at both timepoints. Leisure noise exposure and HL prevalence were similar across time, however mean HTs were higher at Time 1. Among matched pairs, more Time 2 participants created tight-fitting earbuds/headphones and responded affirmatively to some HL symptom questions. Subtle auditory changes, such as hidden HL, may be occurring over time. Educational outreach regarding HL prevention would be beneficial. Further longitudinal research needed due to the small follow-up sample.
Integrating auditory and visual information can improve intelligibility and neural tracking of the speech envelope. Speech-relevant tactile information also improves tracking, yet effects on intelligibility are mixed, possibly due to no regular exposure to speech-relevant tactile information. We used short-term audio-tactile training to advance understanding of audio-tactile integration during speech perception. 64 younger adult participants (aged 18-29) took part over five days, during which electroencephalography was recorded. Participants completed a speech-in-noise task, with audio-tactile and audio-only stimuli. They then received training with either tactile information that was congruent with sentences heard (trained group) or incongruent (pseudo-trained group). After three training sessions, participants completed the speech-in-noise task again. Two weeks later, participants returned for a follow-up. Effect of session (pre- or post-training) on speech intelligibility was significant, with no significant effect of group (trained, or pseudo-trained) or stimulus (audio-only, or audio-tactile). Before training, there was a significant increase in speech-envelope tracking accuracy with audio-tactile stimuli, suggesting enhanced neural representation of audio-tactile stimuli. However, there was no benefit of congruent training to audio-tactile tracking. There was an enhancement of audio-only speech-envelope tracking following incongruent training. This suggests that speech intelligibility and tracking of audio-tactile speech are not enhanced by short-term training. This work challenges prevailing assumptions by demonstrating increased speech-envelope tracking accuracy that was not linked to enhanced speech intelligibility. However, these findings are limited to short-term, bottom-up audio-tactile training. Alternate training approaches and further controls, such as tactile-only sentences or audio-only training groups, should be explored in future research.
Assigning individuals with hearing impairment to auditory profiles can support a better understanding of the causes and consequences of hearing loss and facilitate profile-based hearing-aid fitting. However, the factors influencing auditory profile generation remain insufficiently understood, and existing profiling frameworks have rarely been compared systematically. This study therefore investigated the impact of two key factors-the clustering method and the number of profiles-on auditory profile generation. In addition, eight established auditory profiling frameworks were systematically reviewed and compared using intrinsic statistical measures and manifold learning techniques. Frameworks were evaluated with respect to internal consistency (i.e., grouping similar individuals) and cluster separation (i.e., clear differentiation between groups). To ensure comparability, all analyses were conducted on a common open-access dataset, the extended Oldenburg Hearing Health Record (OHHR), comprising 1,127 participants (mean age = 67.2 years, SD = 12.0). Results showed that both the clustering method and the chosen number of profiles substantially influenced the resulting auditory profiles. Among purely audiogram-based approaches, the Bisgaard auditory profiles demonstrated the strongest clustering performance, whereas audiometric phenotypes performed worst. Among frameworks incorporating supra-threshold information in addition to the audiogram, the Hearing4All auditory profiles achieved the lowest normalized Davies-Bouldin (DB) score, while the BEAR auditory profiles performed better on the other intrinsic measures. In conclusion, separability should be considered a primary criterion in auditory profile generation, as it directly determines how meaningfully different profiles can be distinguished in practice. Manifold learning and intrinsic measures enable systematic comparisons of auditory profiling frameworks and identify the Hearing4All auditory profile as a promising approach for future research.