Upload
others
View
9
Download
0
Embed Size (px)
Citation preview
AN EVIDENCE BASED APPROACH TO ADD
VASILIKI (VIVIAN) MARIA ILIADOU ASSOCIATE PROFESSOR MEDICAL SCHOOL
An Evidence-Based Approach to APD
APD- AUDITORY PROCESSING DISORDER
WHAT IS EVIDENCE-BASED?
EVIDENCE-BASED
CLINICAL EXPERTISE
BEST RESEARCH AVAILABLE
PATIENT VALUES & PREFERENCES
Sackett D et al. Evidence-Based Medicine: How to Practice and Teach EBM, 2nd edition. Churchill Livingstone, Edinburgh, 2000
APD- AN EVIDENCE-BASED APPROACH
CLINICAL EXPERTISE
1.APD is a well-established complex disorder of the auditory system (beyond the cochlea).
2.APD test battery gold standard and norms with documented sensitivity and specificity for CANS lesions
ICD-10 & 11 BETA VERSION ASHA 2005
INTERNATIONAL BUREAU FOR AUDIOPHONOLIGIE 2007 AAA 2010
CANADIAN AUDIOLOGY 2012 DANISH MEDICAL AUDIOLOGICAL SOCIETY 2014
NEW ZEALAND REPORT 2014 GERMAN SOCIETY OF PAEDIATRIC AUDIOLOGY 2015, 2019
FRONT NEUROL NOVEMBER 2017
EUROPEAN CONSENSUS 2017 HTTPS://DOI.ORG/10.3389/FNEUR.2017.00622
APD IS A WELL ESTABLISHED DISORDER
TEST BATTERY GOLD STANDARD
THESSALONIKI
DIAGNOSTIC CRITERIA FOR APD
Symptoms & risk factorsSymptoms & risk factorsCriterion Explained
Pure Tone Audiometry ≦15dB HL for each frequency between 250Hz-8000Hz in both ears
Abnormal auditory processing results
performance at or below 2 SD below the mean in at least 2 validated auditory processing tests
Symptoms & risk factorsReported by the affected individual/their family/
educational environment AND/OR presence of risk factors
Non-Verbal intelligence coefficient (IQ) >80
Ability to follow instructions in ideal conditions
Patient can understand and reliably follow instructions for the AP tests and reliably
perform the pre-testing training
EUROPEAN CONSENSUS 2017
APD- AN EVIDENCE-BASED APPROACH
BEST RESEARCH AVAILABLE
Unfiltered info
You have to appraise!
Not for rookies!!
Filtered info
Pre-appraised!
Still needs vetting!!
Berner ES. Clinical decision support systems: State of the Art.
AHRQ Publication No. 09-0069-EF. Rockville, Maryland:
Agency for Healthcare Research and Quality. June 2009.
EUROPEAN APD STUDY GROUP
HEARING & PROCESSINGcABR
BMLD
RGDT
DD
GIN
OAE suppression
SPEECH IN NOISE/
BABBLE
TYMPSABR
OAE
Speech audiometry in quiet
STAPE-DIAL
REFLEXES
PPS
Audio-
gram
DPS
&
EFAS APD
Working Group
EAG= European APD Group
Hearing is more than we are currently testing
Interaction with HS & AP
PTA not enough
Higher order cognition Thought Process
Language
Cognition
Auditory Processing (AP)
Hearing Sensitivity (HS)
Tests of attention &
memory are often implemented
through the auditory modality
HEARING PROCESSING
LISN
Emergence of an auditory deficit is
essential
SUPPRESSION IS INFLUENCED BY THE TIME WINDOW ANALYSED, EAR TESTED
52 APD children
Abnormal SinB:Cutoff 1.33dB
HIDDEN HL (COCHLEAR SYNAPTOPATHY) MORE VALID THAN APD? NO
ADDITIONAL REFERENCES FOR APD
• Chermak, G. D., Bamiou, D. -., (Vivian) Iliadou, V., & Musiek, F. E. (2017). Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: A brief tutorial. International Journal of Audiology, 56(7), 499-506. doi:10.1080/14992027.2017.1284351
• Iliadou, V., & Kiese-Himmel, C. (2018). Common misconceptions regarding pediatric auditory processing disorder. Frontiers in Neurology, 8(JAN) doi:10.3389/fneur.2017.00732
• Iliadou, V., Moschopoulos, N., Sidiras, C., Eleftheriadou, A., & Nimatoudis, I. (2018). Over-diagnosis of cognitive deficits in psychiatric patients may be the result of not controlling for hearing sensitivity and auditory processing. Psychiatry and Clinical Neurosciences, 72(9), 742. doi:10.1111/pcn.12768
• Jutras, B., Lafontaine, L., East, M. -., & Noël, M. (2018). Listening in noise training in children with auditory processing disorder: Exploring group and individual data. Disability and Rehabilitation, , 1-9. doi:10.1080/09638288.2018.1482377
• Ptok, M., Kiese-Himmel, C., & Nickisch, A. (2019). Guideline: Auditive processing and perception disorders: Definition: Guideline of the german society of phoniatrics and pediatric audiology. [Leitlinie „Auditive Verarbeitungs- und Wahrnehmungsstörungen“: Definition: S1-Leitlinie der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie] HNO, 67(1), 8-14. doi:10.1007/s00106-018-0598-y
• Raben Pedersen, E. (2018). The danish test battery for auditory processing disorder evaluated with patient and control data. International Journal of Audiology, 57(10), 755-763. doi:10.1080/14992027.2018.1481537
• Iliadou, V., Ptok, M., Grech, H., Pedersen, E. R., Brechmann, A., Deggouj, N., . . . Bamiou, D. -. (2017). A european perspective on auditory processing disorder-current knowledge and future research focus. Frontiers in Neurology, 8(NOV) doi:10.3389/fneur.2017.00622
• Musiek, F. E., Chermak, G. D., Bamiou, D. -., & Shinn, J. (2018). CAPD: The most common ‘hidden hearing loss’ central auditory processing disorder-and not cochlear synaptopathy-is the most likely source of difficulty understanding speech in noise (despite normal audiograms). ASHA Leader, 23(3) doi:10.1044/leader.FMP.23032018.6
• Iliadou, V. V., Chermak, G. D., Bamiou, D. -., Rawool, V. W., Ptok, M., Purdy, S., . . . Musiek, F. E. (2018). Letter to the editor: An affront to scientific inquiry re: Moore, D. R. (2018) editorial: Auditory processing disorder, ear hear, 39, 617-620. Ear and Hearing, 39(6), 1236-1242. doi:10.1097/AUD.0000000000000644
• Mattsson, T. S., Follestad, T., Andersson, S., Lind, O., Øygarden, J., & Nordgård, S. (2018). Normative data for diagnosing auditory processing disorder in norwegian children aged 7–12 years. International Journal of Audiology, 57(1), 10-20. doi:10.1080/14992027.2017.1366670
• Stavrinos, G., Iliadou, V. -., Edwards, L., Sirimanna, T., & Bamiou, D. -. (2018). The relationship between types of attention and auditory processing skills: Reconsidering auditory processing disorder diagnosis. Frontiers in Psychology, 9(JAN) doi:10.3389/fpsyg.2018.00034
• Keith, W. J., Keith, R. W., & Purdy, S. C. (2018). Letter to the editor: Comments on the ear and hearing ban on certain auditory processing disorder articles re: Moore, D. R. (2018) editorial: Auditory processing disorder, ear hear, 39, 617-620. Ear and Hearing, 39(6), 1242-1243. doi:10.1097/AUD.0000000000000643
• Ptok, M., Kiese-Himmel, C., & Nickisch, A. (2019). Guideline: Auditive processing and perception disorders: Definition: Guideline of the german society of phoniatrics and pediatric audiology. [Leitlinie „Auditive Verarbeitungs- und Wahrnehmungsstörungen“: Definition: S1-Leitlinie der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie] HNO, 67(1), 8-14. doi:10.1007/s00106-018-0598-y
• Gyldenkærne, P., Dillon, H., Sharma, M., & Purdy, S. C. (2014). Attend to this: The relationship between auditory processing disorders and attention deficits. Journal of the American Academy of Audiology, 25(7), 676-687.