The Military Audiology Short Course (MASC) for 2006 was held 13-15 February in Tampa, Florida. In this entry we offer a content overview from this course.
Presentation abstracts from the meeting
Each year MAA invites ex-military or prominent non-military affiliated speakers to address our organization.
Early Hearing Detection and Intervention (EDHI) National Center On Birth Defects & Developmental Disabilities Centers for Disease Control and Prevention
John Eichwald, CDC, LT Anne Jarrett, USN, Craig Mason, Ph.D., U of Maine
With approximately 90,000 military-births a year, the combined US Military Forces have more births than approximately three-fourths of any individual state. Complicating the coordination between screening, diagnosis, and intervention, these births occur in a mobile population (with almost 20% of these births occurring to active duty mothers) and they occur in every state and in over 20 different countries. The largest portion of births involve Army families (40%), with 25% of births involving Navy families, 25% involving Air Force families, and 10% involving Marine families. Consequently, coordination of newborn hearing services for families is an issue that crosses all branches of the military. An informal survey of state/territory EHDI programs suggested that less than half of military hospitals may be reporting child-level data to state EHDI programs, and 30% may be reporting no data at all. This pattern varies from hospital to hospital, and appears to vary with changes in the command structure at military hospitals.
AudBase Audiology Database Management Software
Brian King, Biocoustics Instruments Inc.
This one hour session will demonstrate how to simplify audiogram input to AHLTA using AudBase. AudBase is an Audiometric Database package that electronically transfers data from audiometers and tympanometers and stores the information to a database. From the database, end users can print a detailed report to any number of compatible AHLTA files (currently using .wmf). That file is then attached to the AHLTA record for printing and/or future reference.
Computer/Electronic Accommodations Program (CAP)
Michael Young, CAPTEC Manager
The Department of Defense Computer/Electronic Accommodations Program (CAP) is the federal governmentâ€™s centrally funded program to provide assistive technology devices and services to employees with disabilities and to Wounded Service Members. Information will be shared on the CAP assessment process, acquisitions process, and technologies for auditory, visual, dexterity and cognitive issues. Attendees will receive information on supporting Wounded Service Members and employees with disabilities throughout the Employment Life Cycle.
Outcome Measures and Quality of Life Issues
Harvey Abrams, PhD., Terry Chisholm Ph.D.
Patients, families, insurers, HMOs and government agencies are increasingly requiring evidence that our treatments make a difference. This presentation will familiarize audiologists with the options available to the practicing clinician to measure the outcomes of audiologic intervention with a focus on hearing instruments. Outcome measures in the impairment, activity and participation, satisfaction, health-related quality of life, and economic domains will be critically reviewed utilizing audiology-specific examples throughout the session. Evidence-based audiologic practice will also be discussed as a means of increasing the likelihood of positive treatment outcomes.
Extending Military Hearing Conservation Practices to NASA Strategies
Col(ret) John Allen, Ph.D. and COL(ret) Richard Danielson, Ph.D
The negative impact of noise on military missions has produced well-designed hearing conservation programs and noise control standards in materiel development within the Department of Defense. Similarly, the National Aeronautics and Space Agency (NASA) has developed programs and policies for hearing loss prevention and noise control engineering for employees working in noise-hazardous jobs at its twelve centers. However, NASA also has a unique concern for the impact of noise on space missions conducted by members of its astronaut corps. Long-duration flights present challenges in determining damage risk criteria, methodology for conducting periodic audiometric testing (some of which is conducted aboard the International Space Station) and strategies for reducing the impact of noise on habitability. This discussion will describe unique concerns about noise in space operations, NASAâ€™s efforts for monitoring and mitigating audibility and acoustics onboard space vehicles and practices in aerospace-based audiology that could be applied to conventional practices.
Presentation abstracts from the Army include the following:
Binaural Amplification: Risks and Opportunities
Therese C. Walden, Au.D. and Brian E. Walden, Ph.D
Clinical standards hold that patients with aidable hearing in both ears should be fit with bilateral amplification. Recent research conducted at the Army Audiology and Speech Center (AASC) suggests, however, that some patients may not always perform better with two hearing aids in background noise. This seems to be especially true for older patients. A concurrent line of research at the AASC is studying binaural hearing aid fittings in which directional microphone processing is provided to one ear and omnidirectional microphone processing to the other ear. Such â€œasymmetricâ€ fittings seem to offer certain advantages over both manually-switchable and automatic omnidirectional/directional hearing aids. In addition to the research findings, this presentation will discuss the clinical implications of both lines of research, including clinical protocols for assessing the risks and opportunities provided by binaural amplification.
Hearing Handicap and SPRINT Results in Army Soldiers
LTC Lynnette B. Bardolf
Predictive validity of the Speech Recognition in Noise Test (SPRINT) has not yet been determined. Part one of this study, utilizing a data set of 109 audiograms and SPRINT test results obtained from various Army installations, explored five hypothesized relationships between the SPRINT and other measures. Significant correlations were found between hearing thresholds and SPRINT scores. Part two of this study, utilizing a questionnaire sent to 18 Army audiology clinics, was designed to assess H-3 categorized soldiersâ€™ self-perceived hearing handicap in relation to speech recognition in noise, use of hearing protection, and hearing loss. Sixty-one questionnaires from 6 sites were returned. SPRINT scores significantly correlated (r = -0.365, p< 0.005) with perceived hearing handicap, identifying a component of hearing handicap not identified by the soldier’s average hearing thresholds or word recognition in quiet.
Results are discussed in terms of the SPRINT as a measure of speech perception ability.
Comparison of Four Attenuation Devices and an Open Ear Canal using the HINT Test
CPT Leanne M. Cleveland and David A. Eddins, Ph.D
Noise induced hearing loss is the most preventable type of hearing loss. In spite of this fact, several million dollars are distributed every year to veterans of the US Armed Forces as compensation for hearing loss sustained as a result of military service. Recent numbers indicate that noise induced hearing loss has increased exponentially for our active duty soldiers involved in GWOT and OIF. Soldiers are reluctant to use hearing protective devices because they think that earplugs will impair their communication and word recognition abilities, thus reducing their awareness and safety in a combat environment. The Combat Arms earplug is a passive, non-linear earplug available for issue to soldiers of the US Army which addresses these awareness issues. The Combat Arms earplug uses a perforated acoustic filter. The resistance properties of the filter increase non-linearly as the velocity of air particles increase. This allows acoustic sound pressure to enter the ear canal unimpeded up until a level of 110 dB peak pressure. Thus the high frequency peak pressure levels associated with impulse noise are attenuated, and the cochlea is protected from acoustic trauma.
MHS Standards of Practice for Audiology/Hearing Conservation Documentation and Coding
Thomas M Helfer, Ph.D
Over the past 8 years Military Audiologists have worked to establish uniform documentation and coding practices across the Military Health System (MHS). The forces driving the requirements for such standards have recently started to reach critical mass. Absent documentation and coding data quality assurance standards Audiology/Hearing Conservation (HC) are at a significant disadvantage when it comes to
1. quantifying Audiology/HC workload and resource requirements to do the mission
2. accurate data quality for public health and Force Health Protection (FHP) surveillance metrics
3. support evidence-based FHP and
4. re-imbursement for reimbursable services.
Since 1999 standard coding guidelines have been published in refereed scientific journals, in superbill spreadsheets and in 2005 in the official MHS coding guidelines. These guidelines for paper records and CHCS-ADM documentation and coding are currently being used as requirements for 2 categories of medical content in the emerging MHS e- health record (e-HR):
1. standard clinical statements in e- documents
2. standard healthcare codes for public health surveillance and healthcare administration.