Journal of allied healthBasem Marie, Celia Zhang, Fadi Najem
PURPOSE: The current study aimed to identify the ethical sensitivity of audiologists in Arabic-speaking countries of the Middle East and North Africa (MENA) and compare it with audiologists in the United States (U.S.) as reported in the 2002 and 2006 studies by Hawkins and colleagues. METHODS: In a cross-sectional survey, 123 audiologists from different countries in the MENA region were surveyed on their ethical perspectives regarding 18 ethical situations. An online survey was designed and posted in Arabic using the Qualtrics platform. The link to the survey was distributed via email to audiology providers in the MENA countries, as well as via social media to professional audiology groups. RESULTS: The ethical sensitivity of MENA audiologists based on the ethical sensitivity criteria used in the present study was: 1) emerging for Q1, Q3, Q4, and low for Q2 in the "Business Incentives from Hearing Aid Manufacturers" category, 2) emerging for Q8 and low for Q5, Q6, Q7, Q9, Q10 in the "Entertainment, Small Gifts, and Visits from Manufacturer Representatives" category, 3) low for all questions Q11, Q12, Q13, Q14 in the "Continuing Education Unit Events Sponsored by Hearing Aid Manufacturers" category, and 4) emerging for Q15 and low for Q16, Q17 in the "Business Practices" category. Also, Q18 in the business practices section revealed emerging ethical sensitivity among MENA audiologists toward paying referral fees to physicians. Significant differences in ethical perception were found between the MENA audiologists and their U.S. counterparts across multiple situations in all four domains, with MENA audiologists generally showing lower ethical sensitivity, particularly in relation to professional development opportunities and manufacturer relationships. CONCLUSIONS: Despite the temporal discrepancy between the contemporary MENA data and historical U.S. data, this study establishes a baseline for understanding the ethical landscape of audiology in the MENA region. Our comparison with historical U.S. data revealed significant regional differences in ethical sensitivity, particularly regarding interactions with hearing aid manufacturers and business practices. These findings underscore an urgent need for the development of culturally sensitive ethics education and stronger professional oversight within the MENA region.
Journal of medical Internet researchLinkai Li, Changgeng Mo, Haoshuai Zhou, Hanlin Yu, Congxi Lu, Shangqiguo Wang, Varsha M Athreya, Matthew B Fitzgerald, Shan X Wang
BACKGROUND: Large language models (LLMs) are increasingly being explored for clinical decision support, but their performance in audiology has not been systematically benchmarked using clinically grounded case materials and rubric-based safety evaluations. OBJECTIVE: This study aimed to develop and evaluate AUDIOLOGYBENCH, a 3-tier benchmark for characterizing frontier LLM capability in clinical audiology along (1) curated domain knowledge, (2) literature-derived evidence, and (3) clinical reasoning under multimodal case input, with an explicit human audit of the automated adjudicator on the primary end point. METHODS: The benchmark comprises 3139 objective items from educational resources, 3175 research article-derived items from peer-reviewed articles published between 2015 and 2025, and 67 multimodal clinical case studies graded against a standardized A-F rubric with 6 prespecified critical-error types that cap scores at D or F. Eight models were evaluated on the educational objective items: 4 frontier multimodal models (Gemini 2.5 Pro, Grok 4, OpenAI O3, and Claude Sonnet 4 Thinking) were evaluated on the research article-derived items, and on 804 case study evaluations. Adjudication used Gemini 2.5 Pro (objective and research-derived items) and Claude Opus 4.5 (case studies). The case study adjudicator was independently audited against PhD-level audiologist consensus on blinded subsamples, supplemented by a post-stratified human-calibrated sensitivity analysis. RESULTS: A striking task-type dissociation emerged on case studies: clinical recommendations (Q3) achieved a mean score of 89.74 (SD 13.92, 95% CI 88.07-91.41), a 98.1% (263/268) pass rate, and no dangerous recommendations; audiometric numerical interpretation (Q1) achieved a mean score of 67.89 (SD 18.47, 95% CI 65.68-70.10), with a 35.4% (95/268) critical-error rate; and differential diagnosis (Q2) achieved a mean score of 67.79 (SD 15.33, 95% CI 65.95-69.63). Question type, not model selection, dominated performance (eta-squared_H=0.333 vs 0.001; rank biserial r≥0.679). Interreviewer reliability between audiologists was high (quadratic-weighted κ of 0.78 and 0.85 across the 80-item and 50-item audits, respectively). When 2 audiologists regraded all 80 model Q1 responses with the diagnostic images available, the adjudicator's per-item Q1 labels diverged from human judgment (κ=0.05; overflagging; sensitivity: 19/26, 73%; positive predictive value: 19/53, 36%), yet its reweighted Q1 critical-error rate (36.2%) was broadly consistent with the image-grounded human estimates (28%-34%), suggesting no systematic inflation of the headline rate. The principal Q3>{Q1, Q2} ranking was preserved under post-stratified human calibration. Web-style multiple-choice items showed ceiling effects (>95% accuracy); short-answer prompts remained challenging (best 30%). CONCLUSIONS: Current frontier LLMs show strong recommendation generation but substantial limitations in audiometric numerical interpretation that are shared across models and that an automated adjudicator partially miscalibrated at the per-item level. AUDIOLOGYBENCH characterizes capability boundaries rather than certifying clinical readiness. Deployment of LLM-assisted audiology workflows requires structured human verification of all numerical findings and awareness of fabrication and severity misclassification failure modes documented here.
The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir KommunikasieafwykingsLucie B L Graca, Renate Strehlau, Jacqueline K Bezuidenhout
BACKGROUND: Speech and language skills are essential for effective communication. Speech and language delays may have far-reaching consequences on a child's development; their early identification and intervention are paramount to a child reaching their full potential. OBJECTIVES: To describe the referral process, clinical characteristics, risk factors and outcomes of paediatric referrals to a Speech Therapy and Audiology (STA) department at a district-level hospital in Gauteng, South Africa. METHOD: A retrospective record review was conducted on paediatric outpatient referrals to the STA department between the 01 January 2021 and 30 June 2022. Descriptive statistical analysis was performed on the categorical data. Associations between receptive and expressive language delays and the presence of maternal comorbidities or a bilingual household were analysed using the Chi-squared test and Fisher's exact test. RESULTS: A total of 150 referrals were reviewed, with speech delay being the most common reason for referral (38%). Children under 2 years old accounted for 42% of the referrals. Of the children seen by the speech therapists and audiologists, 58 (49.2%) defaulted on follow-up appointments, and three (2.5%) were identified as having hearing loss. Twenty-eight children (23.7%) were referred for neurodevelopmental assessments, of whom 52% received a diagnosis of autism spectrum disorder (ASD). The mean age of ASD diagnosis was 49.54 months (standard deviation 11.47). CONCLUSION: Understanding the clinical profile and outcomes of children referred to a STA department at a district-level hospital provides valuable insight into the vital role of the speech therapists and audiologists in early identification and intervention of children with speech and language delay.Contribution: The STA departments at South African district hospitals are well-positioned for early identification and intervention, particularly for neurodevelopmental conditions, including ASD.
International journal of medical informaticsIsa Tuncay Batuk, Irem Karakuluk-Celebi
OBJECTIVE: Hearing aid users frequently require accessible and immediate assistance for daily device management. This study aims to evaluate and compare the performance of two prominent Large Language Models (LLMs)-ChatGPT and Gemini, selected for their widespread public accessibility and market dominance-in providing accurate, comprehensible, and repeatable answers to frequently asked questions regarding hearing aids. METHODS: A comprehensive set of 44 user queries was divided into seven core categories. Responses generated by ChatGPT and Gemini were evaluated for comprehensibility and medical accuracy by three expert audiologists, utilizing official manufacturer manuals as a definitive gold standard. Inter-rater reliability was measured using the Intraclass Correlation Coefficient (ICC). Following the establishment of high consensus, repeatability was mathematically measured to objectively assess output similarity and eliminate human bias using a Natural Language Processing (NLP) algorithm (Cosine Similarity). Data were reported as medians and interquartile ranges (IQR), and pairwise statistical comparisons were conducted using the non-parametric Wilcoxon matched-pairs signed-rank test. RESULTS: Inter-rater reliability was strong for both subjective domains (Accuracy ICC = 0.74; Clarity ICC = 0.74, p < 0.001). Both models demonstrated excellent performance in clarity (Median: 5.00, IQR: 0.00), with no statistically significant differences observed across any categories (p > 0.05). Regarding medical and technical accuracy, rank-based analyses revealed that Gemini showed significantly superior overall performance (p < 0.001), specifically excelling in the "Pairing" (p = 0.03) and "Before Using a Hearing Aid" (p = 0.03) categories. In the objective assessment of repeatability via NLP algorithms, both models exhibited high semantic consistency (ChatGPT Median: 0.91; Gemini Median: 0.93), with no statistically significant differences observed between them in any category (overall p = 0.30). CONCLUSION: Both ChatGPT and Gemini generate highly comprehensible information for hearing aid users (Clarity Median: 5.00). However, their performance fluctuates depending on task complexity; while Gemini offers superior technical accuracy (p < 0.001), both maintain high but imperfect repeatability (Cosine Similarity > 0.90). Because neither model demonstrates complete diagnostic stability or perfect reproducibility across all clinical domains, they cannot currently be recommended as independent digital assistants. While LLMs show great promise as supplementary tools for patient education, professional audiological supervision remains essential to verify clinical accuracy and ensure patient safety.
PloS oneTwinkle Lijo Kirianthan, Dhanshree R Gunjawate, Rohit Ravi
OBJECTIVE: Evidence-based practice is central to audiology; however, adherence to best-practice guidelines varies, particularly in pediatric settings. This study explored current pediatric audiology practices among audiologists in India. METHODS: A cross-sectional survey was conducted using an adapted version of the American Board of Audiology's Pediatric Audiology Clinical Practice Analysis Survey modified for the Indian context. The survey was distributed electronically via email using contact information available with Rehabilitation Council of India (RCI). Eligible participants held at least a bachelor's degree in Audiology and Speech-Language Pathology and had a minimum of one year of clinical experience. Participation was voluntary, informed consent was obtained, and confidentiality of responses was ensured. Descriptive statistical analyses were performed. Scale content validity index was calculated to assess content validity of the questionnaire. RESULTS: A total of 130 audiologists participated, representing a predominantly early-career workforce (mean experience = 4.92 ± 5.41 years). Core pediatric audiology procedures were widely practiced. Newborn hearing screening was considered very important by 66.2% of participants, while 35.4% performed it several times daily. Tympanometry was rated very important by 61.5%, with 40% performing it several times daily. Counselling-related practices were strongly emphasized, with 68.5% rating explanation of test results as very important and 48.5% performing it several times daily. In contrast, advanced procedures demonstrated lower utilization. Cortical evoked potentials were not performed by 35.4% of participants, vestibular assessments by 43.1%, cochlear implant programming by 45.4%, and bone conduction device management by 57.7%. CONCLUSIONS: Indian audiologists consistently provide essential pediatric audiology services; however, gaps persist in specialized diagnostics and rehabilitation. Enhancing infrastructure, professional training, and adherence to evidence-based guidelines is necessary to strengthen pediatric audiological care in India.
PloS oneDiana Tang, Jessica Turner, Ugochukwu Eze, John Newall, Kompal Sinha, Carolyn Mee, Claudia Odello, Andrew Blaikie, Bamini Gopinath
INTRODUCTION: There is a high prevalence of undiagnosed and untreated hearing loss among older adults. Due to finite resources, task shifting to trained non-specialists is a strategy to improve equity of access to hearing health care. This pilot study aims to implement and evaluate a novel model of hearing care known as the SOUND-BITES program. This will leverage evidence-based mobile health technologies (Arclight otoscopy and Sound Scouts hearing screening app) and partnerships with Meals on Wheels New South Wales and Master of Clinical Audiology students. METHODS: SOUND-BITES provides a hearing health assessment involving otoscopy using Arclight, hearing screening using the Sound Scouts tablet-based app, and hearing health education to consenting Meals on Wheels clients and their household members. Volunteers from Meals on Wheels and audiology students will be trained to deliver the screening, education and referral components of this program. This pilot study utilises a mixed-methods approach to evaluation. The primary outcomes are program acceptability and feasibility; and secondary outcomes are actions taken by clients to address hearing loss, changes in hearing handicap and cost-benefits six months after program completion. Quantitative data will be collected from a pre- and post-program survey, and qualitative data from an optional post-program interview with clients and volunteers. Findings from the project will be disseminated through peer-reviewed journals and conferences as well as to relevant communities including the Meals on Wheels network.
Journal of the American Academy of AudiologyNoura I Alothman, Ahmad A Alanazi, Rawan A AlQarni, Nisreen N AlAwaji
BACKGROUND: Developing professional competencies such as empathy, counseling, and communication is an essential yet often underemphasized aspect of audiology education. Traditional instruction may provide theoretical knowledge but limited opportunity for experiential practice in emotionally charged clinical situations, such as delivering bad news to patients and families. PURPOSE: We compared the impact of simulation-based training and case scenario discussions on audiology students' confidence in professional competencies. RESEARCH DESIGN: We used a randomized controlled pre- and posttest study design. All participants attended a 1-hour lecture on counseling strategies for delivering bad news and completed a professional competence confidence questionnaire before and after the intervention. STUDY SAMPLE: Sixteen undergraduate audiology students enrolled in a single university program were randomly assigned to either the simulation group (n = 8) or the case-scenario discussion control group (n = 8). INTERVENTION: The experimental group engaged in a live simulation with standardized patients, whereas the control group viewed recorded case scenarios; both groups participated in guided debriefing sessions. DATA COLLECTION AND ANALYSIS: Self-reported confidence levels across domains of empathy, professionalism, and provision of support/resources were measured using a validated questionnaire. Pre- and postintervention scores were analyzed within groups using the Wilcoxon signed-rank test and between groups using the Mann-Whitney U test, with significance set at p < 0.05. RESULTS: Despite the small sample size, students in the simulation group demonstrated statistically significant gains in confidence across empathy, professionalism, and supportive communication skills (p < 0.05), whereas the control group showed modest improvements limited to support and resources. CONCLUSIONS: Simulation-based training was more effective than case-scenario observation, even when observation was paired with structured debriefing, highlighting the added value of hands-on, experiential participation. CLINICAL RELEVANCE STATEMENT: Integrating simulation into audiology curricula offers a practical method to strengthen students' interpersonal and counseling skills in emotionally sensitive situations. These findings highlight the potential of simulation as a scalable and evidence-informed strategy to improve clinical readiness and patient-centered communication in audiological practice.
Journal of the American Academy of AudiologyKatijah Khoza-Shangase, Ayanda Gina, Sphilile Mbhele
BACKGROUND: Vestibular dysfunction (VD) is a common yet often overlooked comorbidity in children with hearing loss, particularly those with sensorineural hearing loss (SNHL), congenital anomalies, or cochlear implants. These challenges are global, but they are especially critical in low- and middle-income countries (LMICs), including South Africa, where diagnostic resources and service integration are limited. Motor development, gaze stability, school performance, and quality of life (QoL) are affected by VD, yet it is seldom included in pediatric hearing health-care frameworks or routine clinical practice. PURPOSE: This review synthesizes global evidence of VD in children with hearing loss and examines how vestibular care is integrated into pediatric audiology with a focus on service delivery gaps and policy implications in LMIC contexts. METHODS: A narrative review of peer-reviewed literature (2015-2025) was conducted using databases including PubMed, Scopus, and Web of Science. Twenty studies met the inclusion criteria and were thematically analyzed for prevalence, assessment and management practices, developmental impacts, and policy considerations. RESULTS: An estimated 20 to 85 percent of children with hearing loss, depending on diagnostic tools, age, and underlying etiology, are affected by VD, which contributes to delayed motor milestones, reduced balance control, learning challenges, and poorer psychosocial adjustment. Despite the prevalence and developmental impact of VD, vestibular care remains inconsistently implemented worldwide. Major gaps persist in pediatric-appropriate diagnostic protocols, rehabilitation strategies, workforce training, and policy integration. These limitations are most pronounced in LMICs, where audiology services are often constrained by limited infrastructure and competing health priorities. CONCLUSIONS: Integrating vestibular assessment and management into pediatric audiology represents a critical step toward comprehensive and equitable child hearing health care. Coordinated policy development, capacity building, and context-adapted clinical pathways are urgently required to close this gap globally. CLINICAL RELEVANCE STATEMENT: This review highlights the importance of incorporating vestibular considerations into pediatric audiology practice. Feasible screening and rehabilitation strategies may improve developmental outcomes, enhance educational participation, and strengthen more holistic and multidisciplinary models of care for children with hearing loss.
Vestnik otorinolaringologiiL E Golovanova, S S Chibisova, M Yu Boboshko, E R Tsygankova, G Sh Tufatulin
UNLABELLED: Work time management is an important aspect in organizing medical care. Current regulations do not establish recommended time limits for audiologists. STUDY OBJECTIVE: To determine the time spent on audiologist's appointments and performing various diagnostic and rehabilitation procedures. MATERIALS AND METHODS: At the City Audiology Center for Adults (St Petersburg), a time estimate was conducted for 10 audiologists who performed various medical diagnostic and rehabilitation audiology services. RESULTS: The advisability of standardizing audiologist's appointment duration to 30 minutes was established (for adult patients, without an instrumental audiological assessment or 60 minutes if an assessment (pure tone audiometry, acoustic impedance, otoacoustic emissions) is included). The results of medical appointments for diagnostic tests (acoustic impedance, speech audiometry, nasopharyngeal endoscopy, otoacoustic emissions, auditory brainstem response (ABR), ASSR, central auditory processing disorders tests, and vestibular tests) and rehabilitation interventions (hearing aid issuance, selection, or fitting of hearing aids) are determined. CONCLUSION: The obtained data can be used for inclusion in specialized regulatory documents governing the activities of audiologists and otolaryngologists.
Current aging scienceS Chitra Thara, K Vidhya Lekshmi, N Venkateswaramurthy
Hearing loss is a prevalent condition affecting over 500 million people globally, with projections estimating more than 700 million cases by 2050. Artificial Intelligence (AI) holds transformative potential in audiology, enhancing diagnostic, therapeutic, and rehabilitation outcomes. This review explores the applications of AI in hearing aids, cochlear implants, sign language recognition, and tele-audiology. A comprehensive literature review was conducted using PubMed, Google Scholar, and other academic databases. Relevant studies on AI-driven advancements in audiology were analyzed, focusing on hearing aid technologies, cochlear implants, diagnostics, and tele-audiology platforms. AI technologies significantly enhance hearing aids through real-time personalization and adaptive algorithms. Cochlear implants leverage AI for improved speech recognition and listening comfort. AI-powered sign language systems facilitate communication through real-time gestureto- text conversions, while tele-audiology expands care access using AI-enabled platforms. Diagnostic advancements include AI-enhanced audiometric testing and otoscopy. AI is revolutionizing hearing healthcare by providing personalized, efficient, and accessible solutions. Its integration into audiology represents a paradigm shift, offering significant improvements in patient outcomes and quality of life.
Journal of health care for the poor and underservedPaul M Evitts, Carrie Reichwein, Ellie Blackburn, Britley Brubaker, Grace Coppersmith, Gabby Deitrich
Rural populations face distinctive challenges that may hinder their ability to access health services, including speech-language pathology and audiology. To address this, our speech-language pathology program partnered with local agencies and traveled to neighboring rural communities to provide speech and hearing services in central Pennsylvania for a minimal investment.
International journal of audiologyMustafa Yüksel, Şengül Terlemez, Merve Bayri Ulukan, Ahmet Fevzi Parlak
OBJECTIVE: This mixed-methods study explores audiologists' perspectives on remote programming (RP) for cochlear implants (CIs) and compares patient satisfaction between initial activation and follow-up sessions. DESIGN: A mixed-methods approach combined qualitative interviews with audiologists and a survey of CI users. Thematic analysis was applied to interview data, and survey responses were analysed descriptively and comparatively. STUDY SAMPLE: Six experienced audiologists participated in semi-structured interviews, while 136 CI users (44 initial activation, 92 follow-up) completed satisfaction surveys. RESULTS: Audiologist interviews revealed four key themes: RP advantages, implementation challenges, technical requirements, and professional satisfaction. Survey data showed significantly higher satisfaction among follow-up users across seven of eight items. Both groups rated technical quality and communication highly, but follow-up users reported greater ease, confidence, and willingness to use RP again. CONCLUSION: RP is a viable alternative for CI programming, particularly for follow-ups, while initial activations pose unique challenges best managed through hybrid care models. Incorporating both patient and clinician perspectives, this study underscores the need for robust infrastructure, enhanced communication strategies, and standardised professional training to ensure consistent, high-quality remote audiological care.
International journal of audiologyMohamed Rahme, Muneeb Alam, Hasan K Saleh, Paula Folkeard, Robert Koch, Steve Beaulac, Matthew Holden, Sheila Moodie, Vijay Parsa, Susan Scollie
OBJECTIVE: To evaluate the validity, clinical utility, barriers and facilitators of the manikin-based audiometric simulator, Clinical Assistant for Research and Learning. DESIGN: The validity, clinical utility, barriers, facilitators and simulation accuracy were evaluated via an online questionnaire and in-person pure-tone audiometric assessments. STUDY SAMPLE: A total of 38 participants (age range 21-63) completed the study. All participants had formal training in pure-tone audiometric assessments. Participants were audiology students, registered practicing audiologists, hearing instrument dispensers, and undergraduate students. RESULTS: The programmed and measured audiograms had an absolute agreement within 5 decibel hearing level. Ease of use, clarity of workflow, realism, and feasibility in clinical practice were the reported facilitators, whereas cost and availability of technical support were the identified barriers to implementation. CONCLUSIONS: The manikin-based simulator was shown to be an accurate and valid tool in practicing pure-tone audiometric procedures. Clinical applications and future directions were also discussed.