Following the onset of the COVID-19 pandemic, a clinical practice guideline (CPG) around virtual hearing aid practices was developed to fill a knowledge gap within the field of audiology. Details outlining the development and mobilization of this draft guideline were outlined as Phase 1 (described in a paired paper).
This study describes Phase 2 of this project as part of the Knowledge-to-Action Framework, including an evaluation of the methodological quality of the guideline and the resulting tailored version of the document (v2.0).
The Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality and to guide revisions. Twenty-two clinicians, from a variety of clinical backgrounds, participated in the evaluation.
Findings reported across six domains suggest high mean scores, ranging from 78% to 81%, in order of scope and purpose (highest rated), stakeholder involvement, rigour of development, applicability, clarity of presentation, and editorial independence. Specific recommendations made by in international co-creation team during the evaluation informed the final version of the CPG. Future development and evaluation efforts should aim to include greater representation from nontraditional practice contexts to strengthen global applicability.

There is a growing demand for comprehensive, evidence-based, and accessible clinical practice guidelines (CPGs) to address virtual service delivery. This demand was particularly evident within the field of hearing healthcare during the COVID-19 pandemic, when providers were faced with an immediate need to offer services at a distance. Considering the recent advancement in information and communication technologies, the slow uptake of virtual care, and the lack of knowledge tools to support clinical integration in hearing healthcare, a Knowledge-to-Action Framework was used to address the virtual care delivery research-to-practice gap.
This paper outlines the development of a CPG specific to provider-directed virtual hearing aid care. Clinical integration of the guideline took place during the COVID-19 pandemic and in alignment with an umbrella project aimed at implementing and evaluating virtual hearing aid care incorporating many different stakeholders.
Evidence from two systematic literature reviews guided the CPG development. Collaborative actions around knowledge creation resulted in the development of a draft CPG (v1.9) and the mobilisation of the guideline into participating clinical sites.
Literature review findings are discussed along with the co-creation process that included 13 team members, from various research and clinical backgrounds, who participated in the writing, revising, and finalising of the draft version of the guideline.

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OBJECTIVE: This systematic review aimed to explore the recommended fall risk assessment practices in audiology, identify audiologists\' reported practices in fall risk assessment, and recognize the barriers and facilitators affecting fall risk assessment in clinical practice.
METHODS: This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
RESULTS: CINAHL, PubMed, and gray literature yielded 262 articles. A total of 27 full-text articles were included in this review article. An additional 16 scope of practice and guideline documents were also reviewed. Pertinent data and findings from the review were tabulated and analyzed using a qualitative, inductive approach.
CONCLUSIONS: Results revealed that despite fall risk assessment measures and protocols being mentioned, discussed, and reportedly implemented clinically in audiology literature, many audiologists are not conducting fall risk assessments clinically. The main challenges presented appear to be due to limited guidance within audiology documentation and inadequate training and knowledge of audiologists on fall risk factors and measures. This review article highlighted that all audiologists have an important role to play in reducing the global crisis of falls in older adults. However, without further research to aid in the development of standardization of documentation and training programs, we may continue to see a lack of awareness and education on fall risk and on the audiologist\'s role in the screening and early detection hereof.

OBJECTIVE: This document presents the fundamentals of speech audiometry in noise, general requirements for implementation and criteria for choice among the tests available in French according to the health-professional\'s needs.
METHODS: The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of doctors, audiologists and audioprosthetists from all over France. They are graded A, B, C or expert opinion according to decreasing level of scientific evidence.
RESULTS: Eight tests of speech audiometry in noise can be used in France.
CONCLUSIONS: To be complete, evaluation of hearing status requires testing understanding of speech in noise. The examination must begin with a minimum of two measurements familiarizing the subject with the test procedure. For initial diagnosis, adaptive procedures establishing the 50% speech reception threshold (SRT50) in noise are to be preferred in order to obtain a rapid and standardized measurement of perception of speech in noise. When the aim is to measure real-life speech comprehension, tests based on sentences, cocktail-party noise and free-field stimulation are to be preferred. Prosthetic gain is evaluated exclusively in free field. This is the only way to evaluate the contribution of binaurality and to measure perception in noise in an environment as close as possible to real life. In order to avoid acoustic interference in free field, at least five loudspeakers should be used, in particular for evaluating the effectiveness of directional microphones, CROS devices enabling sounds picked up in the damaged ear to be rerouted to the functional ear, or bimodal fitting (i.e., when hearing is enabled by two modalities: for example, hearing aid for one ear, cochlear implant for the other).

Despite normal hearing thresholds in pure-tone audiometry, 0.5-1% of children have difficulty understanding what they hear. An auditory processing disorder (APD) can be assumed, which should be clarified and treated. In patients with hearing loss, this must first be compensated or resolved. Only hereafter can a suspected APD be confirmed or excluded. Diagnosis of APD requires that a clear discrepancy between the child\'s performance in individual auditory functions and other cognitive abilities be demonstrated. Combination of therapeutical modalities is considered particularly more beneficial in APD patients than a single modality. Treatment modalities should consider linguistic and cognitive processes (top-down), e.g., metacognitive knowledge of learning strategies or vocabulary expansion, but also address underlying auditory deficits (bottom-up). Almost 50% of children with APD also have a language development disorder requiring treatment and/or dyslexia. Therefore, each therapeutic intervention for a child with APD must be individually adapted according to the diagnosed impairments. Musical training can improve phonologic and reading abilities. Changes and adaptations in the classroom are helpful to support the weak auditory system of children with APD. Architectural planning of classrooms can be a means of ensuring that direct sound is masked by as little diffuse sound as possible. For example, acoustic ceiling tiles are suitable for reducing reverberant and diffuse sound.
UNASSIGNED: Bei 0,5–1 % aller Kinder bestehen Schwierigkeiten mit dem Verstehen von Gehörtem, obwohl ein regelrechtes Tonschwellenaudiogramm vorliegt. Hier kann eine auditive Verarbeitungs- und Wahrnehmungsstörung (AVWS) vermutet werden, die abgeklärt und therapiert werden sollte. Sollte eine Schwerhörigkeit vorliegen, muss diese zunächst ausgeglichen oder beseitigt werden. Erst danach kann untersucht werden, ob eine AVWS vorliegt oder nicht. Für die Diagnose einer AVWS muss eine deutliche Diskrepanz zwischen den Leistungen des Kindes in einzelnen auditiven Funktionen und anderen kognitiven Fähigkeiten nachgewiesen werden. Eine Kombination von Behandlungsmaßnahmen gilt beim AVWS gegenüber einer einzelnen Maßnahme als besonders vorteilhaft. Hierbei sollten sowohl linguistische und kognitive Prozesse (Top-down) berücksichtigt werden, z. B. metakognitives Wissen über Lernstrategien oder Wortschatzerweiterung, als auch zugrunde liegende auditive Defizite (Bottom-up). Fast 50 % der Kinder mit AVWS weisen zusätzlich eine behandlungsbedürftige Sprachentwicklungsstörung und/oder Lese-Rechtschreib-Störung auf. Daher muss jede therapeutische Intervention bei einem Kind mit AVWS gemäß den festgestellten Einschränkungen individuell angepasst werden. Mit musikalischem Training können phonologische und Lesefertigkeiten verbessert werden. Veränderungen und Anpassungen im Klassenraum sind für Kinder mit AVWS hilfreich, um ihr schwaches auditives System zu unterstützen. Durch bauakustische Planung von Klassenräumen kann bewirkt werden, dass der Direktschall durch möglichst wenig Diffusschall verdeckt wird. So sind z. B. akustische Deckenverkleidungen geeignet, um Nachhall und Diffusschall zu reduzieren.

Accessing educational and scientific material is key to improving otolaryngology care in developing countries. Yet current financial models of publishers restrict access to academic information. This article describes the author\'s experience with self-publishing 2 open access textbooks, Open Access Atlas of Otolaryngology, Head and Neck Operative Surgery and Open Access Guide to Audiology and Hearing Aids for Otolaryngologists, as well as the African Head and Neck Society (AfHNS) Clinical Practice Guidelines for Head and Neck Cancer in Developing Countries and Limited Resource Settings. The author outlines the simplicity, advantages, and popularity of this form of publication and why societies and individuals should embrace open access publishing to benefit especially those studying and practicing in developing countries. He discusses some of the challenges related to open access publishing and calls for medical societies to become involved in evaluating the quality of open access texts and videos for their members.

As a prerequisite for diagnosing auditory processing disorders (APD), differential diagnostic considerations are essential, especially with regard to language comprehension disorders, attention deficit hyperactivity disorder, specific cognitive impairments (e. g., in memory or multi-modal perception performance), specific learning disorders affecting reading and/or spelling, and autistic-type diseases. The current clinical management is presented in detail in the updated APD guidelines, as are the resulting conclusions for the interpretation of individual test results.

In accordance with international consensus papers, auditory processing disorders (APD) are defined as disorders of central processes of hearing. Following the establishment of a commission of experts from the German Society for Phoniatrics and Pediatric Audiology, the existing S1 guideline was revised and updated. In this chapter, a position is taken on the clinical diagnostics of APD as well as on the delimitation of similar disorders.

Observational studies often represent the best available evidence for surgical practice. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations were generated in 2007 with the aim of improving the quality of reporting. This study was designed to assess whether publication of STROBE guidelines has improved the quality of reporting in observational otology and audiology studies.
EMBASE and MEDLINE were searched using a comprehensive keyword search developed in conjunction with a scientific librarian.
English language papers from six Otorhinolaryngology journals during two 6-month periods (2005 and 2016) were evaluated.
Two reviewers independently analyzed papers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Percentage scores for the two periods were compared using Mann-Whitney U test.
Forty and 42 studies were returned for the 2005 and 2016 periods, respectively. The mean percentage of STROBE items that were met improved between 2005 and 2016 (58, 76%, respectively; p < 0.0001). Analysis indicated that improvements were greater in journals that endorsed STROBE guidelines (p = 0.02). This data suggests that STROBE has increased the reporting quality of observational studies; however, there are still significant further improvements to be met.