JDVAC Highlights

Victor Bray

 A hearing test is a screener for cardiovascular health. Individuals who present with an
unexplainable, low-frequency hearing loss (>= 40dB PTA) are at risk for a cardiovascular event
and should be referred to a cardiologist.
 Because HOH individuals are at an increased risk of depression, clinicians are urged to
administer a two item depression screener such as the PHQ-2 or PHQ-9. Compare results pre-
and post-fitting, and if no change, then refer.
 Untreated hearing loss is associated with accelerated cognitive decline, and the decline
increases with the severity of hearing loss. However, randomized studies are needed before we
can say that amplification slows decline or reduces the risk of falls.

Lisa Guillery

 Clinicians are urged to begin offering APD testing sooner rather than later. We will never have a
gold standard for APD testing, and we shouldn’t wait for a universal protocol to feel comfortable
offering this service. Take the plunge, offer testing, and modify your approach over time as new
information comes to light. Read and follow AAA guidelines for types/categories of tests to
administer and for pass/fail criteria.
 Electrophysiology (FFR, P300), may become useful to understand more about speech
understanding in the population undergoing APD testing.

Bob Margolis

 Consider using automated audiometry to avoid introducing bias. One bias is seeing what we
expect to see. Ex: we might expect the normal population to have small or no ABGs, and then
that’s what we’re more inclined to find on a hearing test. We’re artificially reducing the natural
variance in our results. This has consequences such as biasing others’ expectations for what’s
normal. Then, folks like ENT docs might think that a hearing test is erroneous when it’s actually
reflecting normal variance. FUN FACT: The probability of having an audiogram with 0dB ABGs
across frequencies is something like 1 in 260,000.
 The 4kHz ABG is a result of a calibration issue. The RETFL (reference value/calibration standard)
is incorrect. A false value was introduced into the standard (human error), and it has not been
corrected. Solutions: 1) recalibrate with correct RETFL or 2) apply a correction factor. Email
4kabgap@gmail.com to voice your opinion to correct the RETFL value for 4kHz.
 ABGs tend to increase with the severity of hearing loss. It relates to the noise floor. As hearing
approaches normal, people are more affected by the noise floor, resulting in smaller ABGs.

Cognition lady

 The MoCA is best for mild cognitive impairment whereas the MMSE is better for detecting
moderate to severe Dementia.
 Cognitive screening is within Audiologists’ scope of practice! We might think that PCPs
would administer a cognitive screener, but if the patient has multiple complaints and PCPs
have short appointment times, cognitive ability isn’t being assessed.
 It’s not necessary to administer a full cognitive screener. Although, if a full screener isn’t
administered, understand that you’re not evaluating multiple cognitive abilities. A single
 screening item, such as the “draw the clock” question, is enough to: confirm patient/family
concerns, help the audiologist structure appointments (amt. of content, required
attendance of family members), and provide a referral. A screener isn’t valuable in isolation,
but it’s a useful tool to understand how to modify the patient’s care.

Signia training

 Highlight: own voice processing (OVP) feature. It results in a more natural/less

“amplified” sound quality of people’s own voices. The intended use: instead of fitting
with open domes, close up the ear canal and then run OVP. Now, individuals have more
access to speech-in-noise features such as noise reduction and directionality with the
closed fitting, and the perceptual consequences of closing up the ear are eliminated
with OVP. Consider using when a person with an open fit feels that the hearing aids
aren’t providing much benefit.

Phonak Training

 Highlight: Roger select. It’s a direct to Marvel accessory that can function as a table mic,
remote mic, and tv streamer.