Tag: Levi Lundquist

Objective data provides the clinical foundation, but patient feedback tells the real story. Audiology experts share how they balance technology and clinical judgment for truly personalized care. By Melanie Hamilton-Basich To deliver truly personalized hearing care, clinicians must look beyond the audiogram and integrate a wide range of data points that tell the whole story of a patient’s experience. The audiogram is a critical diagnostic tool, but it is only one piece of a much larger puzzle. Two patients with nearly identical hearing thresholds can have vastly different communication needs, lifestyles, and goals for their treatment. “Personalized hearing care is the integration of good clinical evidence with a genuine understanding of the individual patient,” says Melissa Wikoff, AuD, CH-TM, DFAAA, founder and director of audiology at Peachtree Hearing in Marietta, Ga. “A technically excellent fitting is not truly successful unless it improves the parts of life that matter to that particular patient.” This means understanding whether a patient’s primary concern is hearing in a boardroom, understanding grandchildren, or simply feeling less exhausted at the end of the day. Achieving this level of personalization requires a thoughtful approach to collecting and interpreting data, from objective measurements to patient-reported outcomes, without becoming overwhelmed by the sheer volume of information now available. Defining the Scope of Personalization Effective personalization starts before the patient even enters the exam room and extends long after the initial fitting. It encompasses the entire patient journey. According to Allan Ilve, vice president of product management at Auditdata, the goal is to gather as much information as possible early on so the in-person appointment can be more effective. And practice management software can help hearing care professionals (HCPs) do that. “The main thing is, of course, to gather as much data as you can on the patient before they enter the room so that the professional can actually focus their time not on gathering missing data, but instead on talking to the patient,” Ilve says. This holistic view is echoed by clinicians who see personalization as a commitment to understanding the complete individual. “Personalized hearing care means understanding how hearing loss affects a person’s daily communication demands, relationships, cognition, and emotions and then building a treatment plan around those factors,” says Levi Lundquist, AuD, CCC-A, ABAC, CH-TM, an audiologist at Timpanogos Hearing and Tinnitus in American Fork, Utah. He emphasizes that while technology makes this process more achievable, personalization itself is not a technology. “It’s understanding the person in front of you,” he adds. “The hearing aid is one tool among several.” This approach requires looking at the patient from multiple angles. Jennifer Gehlen, AuD, owner of Grandfather Hearing in North Carolina, defines it as “looking at the whole person from not only their presented symptoms but their emotional state, social factors and lifestyle, cognitive ability, and finding out their goals.” She also finds it helpful to involve a family member or caregiver to gain insights for communication strategy coaching. Ultimately, personalization is about using best practices to create a tailored treatment plan that addresses a patient’s specific goals. Taming the Data Deluge With sources of data ranging from evaluation results and 3D scanners to real-ear measurement and hearing aid analytics, clinicians face the challenge of avoiding “data overload.” The key is not to collect more data, but to collect the right data and use it to answer specific clinical questions. “The biggest mistake is collecting data without a clinical question attached to it,” Lundquist says. “The goal isn’t more information, it’s the right information.” He thinks of data in three layers: diagnostic data that explains what is happening physiologically, validation data that shows whether fitting goals were met, and patient-reported outcomes that reveal if the person’s life has actually improved. “If a data point doesn’t answer one of those questions, it’s unlikely to change treatment,” he notes. Wikoff recommends a similar strategy, suggesting that clinicians create a hierarchy for the data they collect. “Before ordering another test or reviewing another dashboard, I try to ask, Will this information change my recommendation, change how I program or verify the technology, change how I counsel the patient, or help us measure whether treatment worked?” she explains. “If the answer is no, the information may be interesting, but it may not be clinically useful in that moment.” A patient’s individual goals can serve as the primary filter for organizing and interpreting this information. “By establishing the patient goals during the individualized eval process, you have more pieces of the equation to reach a decision for what to suggest for the treatment plan,” Gehlen says. When clinicians start with what matters most to the patient, the data becomes less of an abstract collection of measurements and more of a body of evidence to solve a specific problem. The Pillars of Objective Data While patient goals provide direction, objective data provides the clinical foundation for a successful fitting. Among the most useful tools are real-ear measurement (REM), speech-in-noise testing, and hearing aid datalogging. Lundquist describes REM as the undisputed standard of care. “No two ear canals are identical, so relying on manufacturer first-fit settings as accurate is an assumption, not a verification,” he says. “Without REM, we’re making an educated guess about what the patient is actually receiving. With it, we’re confirming the intended amplification is reaching the eardrum.” This verification is essential for ensuring that a fitting is optimized for an individual’s unique ear acoustics. Speech-in-noise testing has also become an indispensable tool for many practices because it provides a more realistic picture of a patient’s daily struggles. “Speech-in-noise performance can be particularly revealing because many patients function relatively well in a quiet test booth but struggle substantially in the environments that make up their actual lives,” Wikoff says. “That information can change how I counsel the patient and the technology I recommend.” Once a device is fitted, datalogging offers invaluable insight into how a patient is using it in the real world. Hearing aid specialist Leanne E. Polhill, BA, LHAS, BC-HIS, finds datalogging essential for gathering numerous data points. “Beginning with something as fundamental and important as the number of hours the hearing aids are worn each day,” she says. “When a patient is not wearing their hearing aids regularly, we have an opportunity to counsel them on the importance of regular and consistent use.” Datalogging also captures the different listening environments a patient encounters and any manual adjustments they make, which helps HCPs make global changes to better align with the patient’s preferences. But patients are using more technology every day, and similarly to hearing aids, auditory training apps such as Lace Pro by Neurotone AI capture detailed data on a patient’s progress, which clinicians can use to refine care. The app tracks how long and how often a person trains, as well as their results. Clinicians can access this information at any time through a portal. “It’s very similar to data logging in a hearing aid,” says Brian Taylor, AuD. “You’re looking at how many hours they’re doing the exercises and their progress over time.” This data can be empowering for both the clinician and the patient. By reviewing progress, a clinician can be more precise in their counseling, focusing on specific areas of difficulty. For example, if a patient is struggling in background noise, the clinician might emphasize the speech-in-noise module. “You can compare the individual to patient norms in each training category,” Taylor explains. This data can also inform adjustments to hearing aid settings, such as the noise reduction algorithm, creating a complementary relationship between amplification and auditory training. It might not be long before other devices tracking patient health and behaviors are being used in audiology to further personalize hearing care. The Power of the Patient’s Voice Objective measurements provide a crucial part of the picture, but they don’t tell the whole story. Patient-reported outcomes are just as important for understanding treatment success and should be treated with the same respect as clinical test results. “I think we sometimes treat the patient’s description of their experience as being less objective or less valuable than a test result. Patient-reported information is data,” Wikoff states. “It may be influenced by emotion, expectations, health, personality, and environment, but those factors are part of the patient’s real-world outcome. A patient can be well fit on paper and still not be well served.” Validated questionnaires are a primary tool for gathering this data systematically. HCPs find various instruments useful depending on the patient’s specific concerns. Gehlen uses the 10-question version of the Revised Hearing Handicap Inventory - Screening (RHHI-S), the 10-question Vanderbilt Fatigue Scale for adults (VFS-A-10), the Tinnitus Handicap Inventory (THI), and the Client Oriented Scale of Improvement (COSI). Wikoff also finds the COSI valuable because it asks patients to identify the specific listening situations they want to improve, providing a meaningful benchmark to revisit after treatment. For tinnitus patients, both Lundquist and Wikoff rely on questionnaires like the THI to quantify severity and track improvement over time. These tools do more than just produce a score; they facilitate deeper conversations. “Questionnaires don’t replace conversation; they sharpen it, and they often surface concerns patients wouldn’t otherwise mention in the appointment,” Lundquist says. Wikoff agrees, noting, “The most useful questionnaire is ultimately one that the clinician will review, discuss with the patient, and use to guide care.” The Clinician’s Role Ultimately, all this data is only as valuable as the clinical expertise used to interpret and apply it. The clinician’s role is to balance objective data, technology, and patient preferences to create a treatment plan that works in the real world. “Objective data tells me what should work; patient feedback tells me what actually is working,” Lundquist says. “The best outcomes happen when the two align.” Wikoff uses a similar analogy: “The data gives us the guardrails, but there may be more than one appropriate path within those guardrails.” The art of audiology lies in navigating that path through counseling, education, and shared decision-making. Data can be particularly powerful when it validates a patient’s subjective experience. Wikoff recalls a patient with a mild-to-moderate audiogram who reported substantial difficulty in social situations. “She had previously been told that her hearing loss was not severe enough to explain the level of difficulty she was reporting,” Wikoff says. Speech-in-noise testing revealed a significant deficit, and real-ear measurements of her existing hearing aids showed she was not receiving adequate amplification. “The data changed the technology plan, but it also did something equally important: it validated the patient’s experience,” she says. “Being able to show her why those environments were genuinely difficult helped replace frustration with a more realistic and constructive plan.” This highlights the core principle that data should support clinical judgment, not replace it. “It reduces uncertainty, improves consistency, and lets us demonstrate outcomes, but data without interpretation doesn’t improve patient care on its own,” Lundquist says. “The clinician is still the most important part of the process." As the field continues to evolve and more advanced tools become available, the ability to thoughtfully integrate data will become even more central to providing excellent care. As Gehlen puts it, “It’s only going to get better as we tie more information together on how hearing is a factor for cognitive health and many chronic diseases and discover more tools to implement for better, personalized care.” Featured image: Dreamstime

Tag: Levi Lundquist

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