OBJECTIVE: To explore the experiences, current approaches, opinions and awareness of healthcare professionals (HCPs) caring for adults with traumatic brain injury (TBI) regarding the audio-vestibular consequences.
METHODS: Cross-sectional online survey study.
METHODS: HCPs with experience of caring for adults with TBI, who were not ENT (ear nose throat) specialists or audiologists.
METHODS: The study was conducted from May 2022 to December 2022. The online survey consisted of 16 closed and open-text questions in English and Turkish about clinical experience, current approaches and awareness of audio-vestibular consequences following TBI. Frequencies of responses to closed questions and associations between variables were analysed using SPSS V.28. Open-text responses were summarised in Microsoft Excel.
RESULTS: Seventy HCPs participated from 17 professions and 14 countries, with the majority from the UK (42.9%). HCPs stated that \'some\' to \'all\' of their patients had auditory problems such as \'inability to understand speech-in-noise\' (66%), \'tinnitus\' (64%), \'hyperacusis\' (57%) and balance problems such as \'dizziness\' (79%) and \'vertigo\' (67%). Usually, HCPs asked about the balance status of patients at appointments and when they observed dizziness and/or balance disorder they used screening tests, most commonly finger-to-nose (53%). For auditory impairments, HCPs preferred referring patients with TBI to audiology/ENT services. However, 6% of HCPs felt that audio-vestibular conditions could be ignored on referral because patients with TBI struggled with many impairments. Additionally, 44% would suggest hearing aids to patients with TBI with hearing loss \'if they would like to use\' rather than \'definitely\'.
CONCLUSIONS: Many audio-vestibular impairments are observed by HCPs caring for patients with TBI. The assessment and intervention opinions and awareness of HCPs for these impairments vary. However, non-expert HCPs may not be aware of negative consequences of untreated audio-vestibular impairments following TBI. Therefore, developing a simple framework for screening and indications of audio-vestibular impairments for referral may be helpful for non-audiological specialists regularly seeing these patients.

Introduction  Permanent education in health aims to ensure that professionals are constantly learning in the workplace and in the last few years institutions resorted to the technology-mediated education modality and new teaching possibilities were explored. In Brazil, between 2017 and 2021, only six articles and five monographs were published about listening effort. Objective  The objective of this study was to develop a website with scientific content on the topic listening effort for Speech -Language Therapist and Audiologist with free online access. Methods  The study was carried out in five stages: Analysis, contemplating the search for scientific materials to prepare the material. Design, in which the writing and design of the website was carried out. Development, carrying out the adequacy of the online material. Implementation, a stage in which professionals in the area evaluated the quality of the material after consenting to participation through a free and informed consent term. Review, stage in which the researcher analyzed the evaluators\' responses. Results  The five stages of elaboration of the website were carried out, which was evaluated by professionals in the area. The average of responses to all applied questions rated the website as \"superior\". Conclusion  The website development was validated for online availability.

BACKGROUND:  Healthcare professionals are required to work effectively together to deliver the best healthcare services. Without awareness of other healthcare professionals\' roles and responsibilities, interprofessional practice (IPP) cannot be optimally achieved.
OBJECTIVE:  This study aimed to investigate healthcare professionals\' awareness of audiology and speech-language pathology (SLP) services in Saudi Arabia.
METHODS:  This cross-sectional descriptive study consisted of two parts. The content of a 20-item paper questionnaire was firstly validated. The full-scale study addressed the aim through distributing questionnaire items among potential participants. Descriptive statistics and chi-square test were used.
RESULTS:  A total of 403 participants completed the questionnaires for the main study. Most of the participants were Saudi citizens (84.1%), aged 18 years - 40 years (84.8%) years, and lived in Riyadh region (76.2%). Allied health professionals (40.2%), physicians (22.6%), nursing (15.4%) and dentistry (11.2%) were the main group of participants working mainly at governmental hospitals (69.2%). Of the total participants, 92.6% and 95.3% reported being fully aware of the services provided by audiologists and SLPs, respectively. No statistically significant association between the specialty of participants and their familiarity with the scope of practice for SLPs and audiologists was determined.
CONCLUSIONS:  Our study examined healthcare professionals\' awareness of audiology and SLP services and revealed a high level of awareness.Contribution: The existed level of awareness is expected to facilitate IPP and enhance the quality of care. Still, awareness campaigns about audiology and SLP services are needed to address the existing lack of knowledge among some healthcare professionals.

BACKGROUND: Pathway innovation using smartphone otoscopy and tablet-based audiometry technologies to deliver ear and hearing services via trained audiologists may improve efficiency of the service. An ENT-integrated-community-ear service (ENTICES-combining community audiology management, remote ENT review and novel technologies) was piloted. We aimed to assess the efficiency and safety of ENTICES.
METHODS: ENTICES was a community-based and audiologist-led pathway. Patients with otological symptoms were self-referred to this service. Smartphone otoscopy and tablet-based audiograms were performed. Two otologists reviewed all decisions made in the community by audiologists based on video-otoscopy, hearing tests and chart reviews. Data on the first 50 consecutive new patients attending either consultant-led hospital otology clinics (HOC), audiologist-led hospital advanced audiology diagnostics (AAD) or ENTICES clinics were collected between 1 August 2021 and 31 December 2021. Data were collected through chart reviews and questionnaires to compare the three pathways with respect to efficiency, patient satisfaction, technology utility and safety.
RESULTS: No audiology-led ENTICES decisions were amended by hospital otologists following remote review. Remote review of video-otoscopy with history was sufficient for a diagnosis in 80% of cases. Adding hearing tests and standardised history increased the diagnostic yield to 98%. Patient satisfaction scores showed 100% service recommendation. The cost per patient, per visit, was £83.36, £99.07 and £69.72 for AAD, HOC or ENTICES, respectively.
CONCLUSIONS: ENTICES provides a safe ear and hearing service that patients rated highly. Thirty-two per cent of hospital otology patients were eligible for this service. For those patients, ENTICES is 20% more cost-effective and can reduce the number of clinic visits by up to 60% compared with HOC.

BACKGROUND: Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical practice, as they capture the functional impacts of hearing loss on individuals. However, little research has evaluated the prevalence or factors associated with self-reported hearing difficulty. Therefore, the purpose of this study was to determine the prevalence of self-reported hearing difficulty, measured by the Revised Hearing Handicap Inventory (RHHI), and associated factors.
METHODS: This study was conducted in a community-based cohort study based in Charleston, SC. We determined the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and evaluated associated factors with logistic regression models. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals (95% CI).
RESULTS: There were 1558 participants included in this study (mean age 63.7 [SD 14.4], 56.9% female, 20.0% Minority race). The prevalence of RHHI self-reported hearing difficulty was 48.8%. In a multivariable model, older age (per + 1 year; OR 0.97 [95% CI 0.96, 0.98]), Minority (vs. White) race (OR 0.68 [95% CI 0.49, 0.94]), and speech-in-noise scores that are better than predicted (OR 0.99 [95% CI 0.98, 1.00]) were associated with lower odds of RHHI self-reported hearing difficulty. Furthermore, female (vs. male) sex (OR 1.39 [95% CI 1.03, 1.86]), higher PTA in the worse ear (per + 1 dB; OR 1.10 [95% CI 1.09, 1.12]), more comorbid conditions (vs. 0; 1 condition: OR 1.50 [95% CI 1.07, 2.11]; 2 conditions: OR 1.96 [95% CI 1.32, 2.93]; 3 + conditions: OR 3.00 [95% CI 1.60, 5.62]), noise exposure (OR 1.54 [95% CI 1.16, 2.03]), bothersome tinnitus (OR 2.16 [95% CI 1.59, 2.93]), and more depressive symptoms (OR 1.04 [95% CI 1.01, 1.07]) were associated with higher odds of RHHI self-reported hearing difficulty.
CONCLUSIONS: The prevalence of RHHI self-reported hearing difficulty is high, and associated factors included demographics, audiometric hearing and other hearing-related factors, and physical and mental health. The RHHI likely captures functional impacts of hearing loss that are not captured by audiometry alone. Study findings can support the correct interpretation of the RHHI in research and clinical settings.

BACKGROUND: Tinnitus diagnosis poses a challenge in otolaryngology owing to an extremely complex pathogenesis, lack of effective objectification methods, and factor-affected diagnosis. There is currently a lack of explainable auxiliary diagnostic tools for tinnitus in clinical practice.
OBJECTIVE: This study aims to develop a diagnostic model using an explainable artificial intelligence (AI) method to address the issue of low accuracy in tinnitus diagnosis.
METHODS: In this study, a knowledge graph-based tinnitus diagnostic method was developed by combining clinical medical knowledge with electronic medical records. Electronic medical record data from 1267 patients were integrated with traditional Chinese clinical medical knowledge to construct a tinnitus knowledge graph. Subsequently, weights were introduced, which measured patient similarity in the knowledge graph based on mutual information values. Finally, a collaborative neighbor algorithm was proposed, which scored patient similarity to obtain the recommended diagnosis. We conducted 2 group experiments and 1 case derivation to explore the effectiveness of our models and compared the models with state-of-the-art graph algorithms and other explainable machine learning models.
RESULTS: The experimental results indicate that the method achieved 99.4% accuracy, 98.5% sensitivity, 99.6% specificity, 98.7% precision, 98.6% F1-score, and 99% area under the receiver operating characteristic curve for the inference of 5 tinnitus subtypes among 253 test patients. Additionally, it demonstrated good interpretability. The topological structure of knowledge graphs provides transparency that can explain the reasons for the similarity between patients.
CONCLUSIONS: This method provides doctors with a reliable and explainable diagnostic tool that is expected to improve tinnitus diagnosis accuracy.

BACKGROUND: ChatGPT has been tested in many disciplines, but only a few have involved hearing diagnosis and none to physiology or audiology more generally. The consistency of the chatbot\'s responses to the same question posed multiple times has not been well investigated either. This study aimed to assess the accuracy and repeatability of ChatGPT 3.5 and 4 on test questions concerning objective measures of hearing. Of particular interest was the short-term repeatability of responses which was here tested on four separate days extended over one week.
METHODS: We used 30 single-answer, multiple-choice exam questions from a one-year course on objective methods of testing hearing. The questions were posed five times to both ChatGPT 3.5 (the free version) and ChatGPT 4 (the paid version) on each of four days (two days one week and two days the following week). The accuracy of the responses was evaluated in terms of a response key. To evaluate the repeatability of the responses over time, percent agreement and Cohen\'s Kappa were calculated.  Results: The overall accuracy of ChatGPT 3.5 was 48-49%, while that of ChatGPT 4 was 65-69%. ChatGPT 3.5 consistently failed to pass the threshold of 50% correct responses. Within a single day, the percent agreement was 76-79% for ChatGPT 3.5 and 87-88% for ChatGPT 4 (Cohen\'s Kappa 0.67-0.71 and 0.81-0.84 respectively). The percent agreement between responses from different days was 75-79% for ChatGPT 3.5 and 85-88% for ChatGPT 4 (Cohen\'s Kappa 0.65-0.69 and 0.80-0.85 respectively).
CONCLUSIONS: ChatGPT 4 outperforms ChatGPT 3.5 both in accuracy and higher repeatability over time. However, the great variability of the responses casts doubt on possible professional applications of both versions.

Phenomenon: This study explored experiences of simulation-based clinical education in the Speech-Language Pathology and Audiology professions in South Africa, a Global South context where research on this topic is limited. In this context, the COVID-19 pandemic brought simulation to the forefront of clinical education as a training solution when in-person encounters were impossible. As these simulation-based training approaches gain traction, with continued use post-pandemic, it is important to understand how they are currently being used so that appropriate support can be offered to ensure their efficiency and success in the future. Approach: We distributed a survey to South African university departments offering Speech-Language Pathology and Audiology training, inviting participation from students across years of study and clinical educators. Data were collected between October 2022 and February 2023. Twelve responses were received: three from clinical educators and nine from students. We analyzed the responses using descriptive statistics and a domain summary approach. Findings: Simulated activities were implemented as options for clinical education in South African Speech-Language Pathology and Audiology (SLP/A) programs during the pandemic, albeit in a somewhat haphazard way depending on available resources, often with limited preparation or guidance. Some universities have continued using aspects of simulation training post-pandemic. Insights: Our findings, although preliminary, are somewhat consistent with Global North literature, particularly regarding barriers and challenges to implementing these approaches in clinical education. We offer suggestions for enhancing the support of simulation-based clinical education in our context.

UNASSIGNED: Autism is a significant concern because of the increase in the prevalence of the disorder. University healthcare students might not all be adequately prepared to serve autistic individuals. Hence, there is a need in the South African context for information on healthcare practitioners\' knowledge of general aspects, diagnosis and management of autism.
UNASSIGNED: To determine current knowledge on autism among speech-language pathology and audiology (SLP & A) students at a South African Higher Education Institution.
UNASSIGNED: The study was conducted among 65 second, third and fourth year students at the SLP & A Department of a South African Higher Education Institution.
UNASSIGNED: A descriptive quantitative design utilising an online questionnaire was used to gather the quantitative and, to a lesser extent, qualitative data. Descriptive measures were used to analyse and summarise the data.
UNASSIGNED: Participants mainly understood autism\'s fundamental symptoms and comorbidities, early intervention, team management and speech-language therapist (SLT) duties. Students were found to have little awareness of autism\'s prevalence, causes, diagnosing experts, intervention methods and treatment. Participants felt uncomfortable treating autistic people owing to a lack of clinical exposure. Participants want further training.
UNASSIGNED: Students reported the need for additional training on autism, including its identification, diagnosis, assessment and treatment. It is recommended that the study be replicated at other institutions to impact other curricula.
UNASSIGNED: This research article provides input for enhancing the curriculum for Health Science Departments in Higher Education Institutions.

OBJECTIVE: To investigate the risk for sensorineural hearing impairment (SNHI) in preterm infants, and to what extent the risk is attributed to perinatal morbidities and therapies.
METHODS: Population-based cohort study using data from several nationwide registries.
METHODS: Norwegian birth cohort 1999-2014, with data on SNHI until 2019.
METHODS: 60 023 live-born preterm infants, divided in moderate-late preterm (MLP) infants (32-36 weeks), very preterm (VP) infants (28-31 weeks) and extremely preterm (EP) infants (22-27 weeks), and a reference group with all 869 797 term-born infants from the study period.
METHODS: SNHI defined by selected ICD-10 codes, recorded during minimum 5-year observation period after birth.
RESULTS: The overall SNHI prevalence in the preterm cohort was 1.4% compared with 0.7% in the reference group. The adjusted risk ratios (95% CIs) for SNHI were 1.7 (1.5-1.8) in MLP infants, 3.3 (2.8-3.9) in VP infants and 7.6 (6.3-9.1) in EP infants. Among EP infants, decreasing gestational age was associated with a steep increase in the risk ratio of SNHI reaching 14.8 (7.7-28.7) if born at 22-23 weeks gestation. Among the VP and MLP infants, mechanical ventilation and antibiotic therapy had strongest association with increased risk of SNHI, but infants not receiving these therapies remained at increased risk. Among EP infants intracranial haemorrhage increased the already high risk for SNHI. We found no signs of delayed or late-onset SNHI in preterm infants.
CONCLUSIONS: Preterm birth is an independent risk factor for SNHI. Invasive therapies and comorbidities increase the risk, predominantly in infants born after 28 weeks gestation.