PP812 - Hybrid Validation of Synchronous Teleaudiology for Bone-Anchored Hearing Systems

Abstract: This prospective non-randomized clinical trial validates synchronous teleaudiology platforms—Cochlear Remote Assist and Oticon RemoteCare—as safe and effective alternatives to in-person programming for bone-anchored hearing aid (BAHS) users. The hybrid design combines remote teleprogramming with in-person facilitation under controlled acoustic conditions. Objective measures (free-field thresholds, functional gain, HINT-Brazil, Digit-in-Noise Test) and subjective outcomes (VAS satisfaction, Telehealth Usability Questionnaire) will be compared between remote and in-person sessions. Preliminary observations suggest clinical equivalence and high usability, supporting hybrid teleaudiology as an evidence-based model for accessible implantable hearing care.

Summary: Access to specialized auditory rehabilitation remains limited for users of bone-anchored hearing aids (BAHS), particularly in low-resource or geographically distant regions. Although teleaudiology has been successfully implemented for conventional hearing aid programming, there are no validated, clinically structured protocols for BAHS remote care. The COVID-19 pandemic accelerated the acceptance of telehealth but also highlighted the lack of evidence-based frameworks for implantable hearing solutions. This study was designed to validate synchronous teleaudiology solutions—Cochlear Remote Assist (RA) and Oticon RemoteCare (RC)—as effective and safe alternatives to in-person programming, offering a hybrid model that integrates remote programming with on-site facilitation under controlled conditions. The main hypothesis is that hybrid synchronous teleaudiology can achieve audiological outcomes equivalent to in-person care while improving accessibility and patient satisfaction.

This is a prospective, non-randomized clinical trial involving unilateral or bilateral BAHS users (Baha® Attract, Baha® Connect, and Ponto® systems). Participants undergo teleprogramming conducted by a remote audiologist using RA or RC, supported by a local facilitator. Each session replicates real-world hybrid teleconsultation: remote adjustments, counseling, and verification procedures, followed by immediate in-person audiometric validation. Outcome measures include free-field audiometry, functional gain, the Hearing in Noise Test (HINT-Brazil), and the Digit-in-Noise Test (TDR). Subjective outcomes include user satisfaction (Visual Analog Scale – VAS) and telehealth usability (Telehealth Usability Questionnaire – Brazil). Data will be analyzed using parametric or non-parametric tests according to the Shapiro–Wilk normality results, with α = 0.05.

Preliminary clinical observations suggest that teleprogramming via RA and RC produces results equivalent to traditional in-person sessions regarding audiological performance and user satisfaction. Expected findings include no significant differences between groups in speech-in-noise performance, functional gain, or free-field thresholds. It is anticipated that hybrid teleaudiology will demonstrate clinical equivalence and high usability, validating its adoption as an evidence-based care model for BAHS users. Hybrid synchronous teleaudiology can safely reproduce the precision of face-to-face programming while reducing geographical and logistical barriers.

This is the first validation study integrating synchronous teleaudiology for BAHS programming through a hybrid in-person teleconsultation model. The approach bridges the gap between conventional and remote clinical care, allowing for real-time adjustment, verification, and training. The study aligns with AAA 2026 priorities in innovation, access, and technology-driven rehabilitation. Its findings are expected to influence national teleaudiology regulations and guide implementation in public health systems such as Brazil’s Unified Health System (SUS).

This presentation is targeted at advanced clinicians and researchers with experience in implantable hearing solutions and teleaudiology. It will provide an evidence-based model for integrating synchronous remote programming into everyday clinical workflows.