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Effectiveness of Signal Processing Strategies for the Pediatric Population: A Systematic Review of the Evidence

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A systematic review of literature addressing the question "Is there evidence pointing to optimal signal processing for pediatric hearing aid patients?" was conducted. Key words and authors were used as search terms in five databases, and one textbook appendix was reviewed for related references. The levels of evidence that were accepted comprised randomized controlled trials, nonrandomized controlled trials, cohort, and before/after designs with or without control groups. Two hundred twenty-six articles were identified during the preliminary search with 183 of these eliminated by review of abstracts because they did not meet the search criteria. Forty-three manuscripts were reviewed, with eight meeting the evidence levels and search criteria. The strengths and weaknesses of these studies are highlighted, and the systematic review question is answered in light of these studies. There is evidence to recommend wide dynamic range compression signal processing for pediatric hearing aid users with mild, moderate, and moderately severe sensorineural hearing loss when full-time and consistent audibility is the goal of the hearing aid fitting. Further, there is evidence that audibility across a wide frequency bandwidth as well as across a large range of input levels is essential for pediatric hearing aid users to recognize critical components of the spoken language.

Spanish
Se realizó una revisión de la literatura planteando la pregunta: "¿Existe evidencia que apunte al procesamiento óptimo de la señal para pacientes pediátricos con auxiliar auditivo?" Se utilizaron palabras clave y autores como términos de búsqueda en cinco bases de datos, y el apéndice de un libro de texto fue revisado buscando referencias relacionadas. Los niveles de evidencia que fueron aceptados incluyeron estudios aleatorios controlados, estudios controlados no aleatorios, diseños de cohorte y de antes/después, con y sin grupos control. Se identificaron doscientos veintiséis artículos durante la búsqueda preliminar y 183 de éstos fueron eliminados con la revisión de los sumarios, pues éstos no cumplían los criterios escogidos. Se revisaron cuarenta y tres manuscritos, con sólo ocho que cumplían los niveles de evidencia y los criterios de búsqueda. Se destacan las fortalezas y debilidades de estos estudios. No existe evidencia para recomendar el uso de procesamiento de la señal por medio de compresión de rango dinámico amplio, para usuarios pediátricos de auxiliar auditivo con hipoacusias sensorineurales leves, moderadas y moderadamente severas, cuando la meta de la adaptación del audífono es audibilidad consistente todo el tiempo. Más aún, existe evidencia de que la audibilidad a través de un ancho de banda amplio, así como de un rango amplio de niveles de estimulación es esencial para los usuarios pediátricos de auxiliar auditivo, cuando se trata de reconocer componentes críticos del lenguaje hablado.
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Keywords: AUDIBILITY; COMFORT; LINEAR; PEDIATRIC; SIGNAL PROCESSING; VERIFICATION; WIDE DYNAMIC RANGE

Document Type: Research Article

Publication date: June 1, 2005

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