OL206 - Teleaudiology for Bone-Anchored Hearing Aids: Development of a Remote Care Protocol

Abstract: Bone-anchored hearing aids (BAHS) effectively treat conductive and mixed hearing loss, but follow-up typically requires in-person visits at specialized centers, limiting access. This student-led study develops and validates a synchronous teleaudiology protocol using Cochlear Remote Assist and Oticon RemoteCare. Phase 1 tests feasibility and audiological outcomes of remote programming under controlled conditions with a local facilitator. Phase 2 applies the Delphi method with expert audiologists to refine and validate content. Remote sessions are expected to achieve outcomes equivalent to in-person care, expanding access to rehabilitation and training future clinicians in innovative service models.

Summary:

Objectives:
This project aims to develop and validate a structured teleaudiology protocol for bone-anchored hearing aid (BAHS) users, ensuring clinical safety, effectiveness, and professional consensus. The study seeks to (1) evaluate the feasibility and audiological outcomes of synchronous remote programming compared to in-person sessions, and (2) establish expert-validated guidelines through the Delphi method.

Rationale:
BAHS are a well-established intervention for individuals with conductive or mixed hearing loss, especially when conventional hearing aids are unsuitable due to anatomical or audiological limitations. However, programming and follow-up typically require in-person visits to specialized centers, posing access barriers and reducing long-term adherence.
Teleaudiology offers a promising solution, with platforms such as Cochlear Remote Assist and Oticon RemoteCare enabling synchronous remote programming without additional hardware. Preliminary evidence shows that remote fittings can achieve outcomes equivalent to face-to-face care, but no standardized, validated clinical protocol exists for BAHS teleaudiology. This student-led study addresses that gap by integrating clinical validation and expert consensus to promote accessible, high-quality hearing rehabilitation.

Design/Methods:
The project is divided into two sequential phases:

Phase 1 – Feasibility and Clinical Validation:
A prospective study will assess synchronous remote programming under controlled conditions, involving a remote audiologist and an on-site facilitator to ensure connectivity and patient safety. Participants will undergo programming, counseling, and verification, including free-field thresholds, functional gain, Digit-in-Noise Test (DIN), and Hearing in Noise Test–Brazil (HINT-BR). Remote and in-person outcomes will be statistically compared using paired t-tests and effect size analyses.

Phase 2 – Delphi Consensus Validation:
Expert audiologists will participate in iterative Delphi rounds to identify, review, and validate essential components of the teleaudiology protocol.
Round 1 will gather input on clinical steps and decision-making; Round 2 will present anonymized feedback for re-evaluation; Round 3 will finalize consensus. Agreement ≥80% will define inclusion in the final validated protocol.

Results (expected):
It is anticipated that remote sessions will demonstrate audiological outcomes equivalent to in-person programming, confirming the safety and feasibility of teleaudiology for BAHS users. Delphi results are expected to yield a consensus-based protocol that ensures standardization and clinical reliability across remote platforms.

Conclusions:
By combining clinical feasibility testing with expert consensus, this project will establish the first validated teleaudiology protocol for BAHS. The findings will enhance access to specialized rehabilitation, support training of future audiologists, and serve as a scalable model for remote auditory care in underserved populations.

Instructional Level (Intermediate):
This session is designed for clinicians and educators with working knowledge of implantable hearing devices and rehabilitation principles. The focus is on the application of new procedures—synchronous remote programming and expert-based protocol validation—rather than basic concepts. Attendees will gain practical insights for implementing and standardizing remote BAHS follow-up in clinical practice.