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Introduction Current literature does not provide strong evidence that remote programming of hearing aids is effective, despite its increasing use by audiologists. We tested speech perception outcomes, real-ear insertion gain, and changes in self-perceived hearing impairment after face-to-face and remote programming of hearing aids in a randomized multicentre, single-blind crossover study. Methods Adult experienced hearing aid users were enrolled during routine follow-up visits to audiology clinics. Hearing aids were programmed both face to face and remotely, then participants randomly received either the face-to-face or remote settings in a blinded manner and were evaluated 5 weeks later. Participants then received the other settings and were evaluated 5 weeks later. Results Data from 52 out of 60 participants were analysed. We found excellent concordance in performance of hearing aids programmed face to face and remotely for speech understanding in quiet (phonetically balanced kindergarten test – intraclass correlation coefficient of 0.92 (95% confidence interval: 0.87–0.95)), and good concordance in performance for speech understanding in noise (phonetically balanced kindergarten +5 dB signal-to-noise ratio – intraclass correlation coefficient of 0.71 (95% confidence interval: 0.55–0.82)). Face-to-face and remote programming took 10 minutes (±2.9) and 10 minutes (±2.8), respectively. Real-ear insertion gains were highly correlated for input sound at 50, 65 and 80 dB sound pressure levels. The programming type did not affect the abbreviated profile of hearing aid questionnaire scores. Conclusions In experienced hearing aid users, face-to-face and remote programming of hearing aids give similar results in terms of speech perception, with no increase in the time spent on patients’ care and no difference in self-reported hearing benefit. ClinicalTrials.gov Identifier NCT02589561

International audience; OBJECTIVE:Teleotoscopy requires the assistance of telehealth facilitators; but their training requirements remain to be determined. We evaluated the use of an otoscopy simulator to train facilitators to remote otoscopies sent via the Internet using a teleaudiology platform.DESIGN:Neurotologists experts were asked to identify images using the otoscopy simulator and to perform an identification task of significant anatomical landmarks. The experts were asked to repeat those tasks remotely, with the help of facilitators who either received basic training, or no training prior to the experiment.STUDY SAMPLE:Three experts, three trained facilitators and three untrained facilitators participated in this study.RESULTS:The use of an otoscopy simulator in addition to remote otoscopy yielded a good inter- and intrarater agreement (κ between 0.81-1, and 0.80-0.87, respectively). The accuracy of diagnosis was high on-site (11.7% error) and remotely (0% error). The time required for landmark identification task was not increased when performed remotely with a trained facilitator versus on-site otoscopy (9.3 versus 9.2 s/landmark). Conversely, the lack of training of facilitators increased significantly this time (15.6 s/landmark, p

L'echelle Doloplus® est un outil valide d'hetero-evaluation de la douleur chez la personne âgee presentant des troubles de la communication. Utilisee habituellement avec support papier, il est apparu interessant d'evaluer une saisie electronique de cette echelle sur support de type PalmOne®, afin de permettre un enregistrement facile de l'evaluation de la douleur, a tout moment et en tout lieu, collecter, centraliser et analyser rapidement ces donnees et optimiser l'evaluation de la douleur de chaque patient. Le suivi de 281 patients dans 20 centres investigateurs a conduit a l'enregistrement complet de 484 evaluations. L'outil electronique experimente a permis une valorisation de l'outil papier par les capacites d'analyse instantanee et de memoire qu'il propose pour chaque patient, grâce en particulier a la visualisation graphique des resultats obtenus. Au-dela de l'aide a la decision therapeutique lors de la prise en charge de la personne âgee douloureuse, cet outil presente un interet certain lors de la collection de donnees pour les etudes a visee epidemiologique.

Resume L’objectif de l’etude a ete d’utiliser une nouvelle version de l’echelle des visages, transposition de la FPS-R sur ordinateur de poche de type PalmTM et d’en apprecier le bon usage et la validite aupres d’enfants douloureux. L’esprit et la forme originelle de cette echelle ont ete respectes sur le support electronique. 3 groupes homogenes de 30 enfants hospitalises (4 a 12 ans) ont auto-evalue leur douleur a 10 min d’intervalle, avec les deux outils, papier puis PDA, ou inversement, suivant une randomisation pre-definie. Un test de comprehension a ete effectue apres les deux mesures. Sur ce premier effectif de 92 enfants, le coefficient de correlation (r de Spearman) global entre les paires de scores est de 0,86 (p

Background Assessment of pain in children is an important aspect of pain management and can be performed by observational methods or by self-assessment. The Faces Pain Scale-Revised (FPS-R) is a self-report tool which has strong positive correlations with other well established self-report pain intensity measures. It has been recommended for measuring pain intensity in school-aged children (4 years and older). The objective of this study is to compare the concordance and the preference for two versions, electronic and paper, of the FPS-R, and to determine whether an electronic version of the FPS-R can be used by children aged 4 and older. Methods The study is an observational, multicenter, randomized, cross-over, controlled, open trial. Medical and surgical patients in two pediatric hospitals (N = 202, age 4-12 years, mean age 8.3 years, 58% male) provided self-reports of their present pain using the FPS-R on a personal digital assistant (PDA) and on a paper version. Paper and electronic versions of the FPS-R were administered by a nurse in a randomized order: half the patients were given the PDA version first and the other half the paper version first. The time between the administrations was planned to be less than 30 minutes but not simultaneous. Two hundred and thirty-seven patients were enrolled; 35 were excluded from analysis because of misunderstanding of instructions or abnormal time between the two assessments. Results Final population for analysis comprised 202 children. The overall weighted Kappa was 0.846 (95%CI: 0.795; 0.896) and the Spearman correlation between scores on the two versions was rs = 0.911 (p < 0.0001). The mean difference of pain scores was less than 0.1 out of 10, which was neither statistically nor clinically significant; 83.2% of children chose the same face on both versions of the FPS-R. Preference was not modified by order, sex, age, hospitalization unit (medical or surgical units), or previous analgesics. The PDA was preferred by 87.4% of the children who expressed a preference. Conclusion The electronic version of the FPS-R can be recommended for use with children aged 4 to 12, either in clinical trials or in hospitals to monitor pain intensity.