It’s not about incompetence or malfeasance though. Clinically it’s a poor test and ads little to our process: I’d rather tell you your articulation index objectively derived directly from your audiogram.
Or I could do a WRS at 10 o’clock in the morning when you turn up fresh, fed and fully caffeinated. Then do exactly the same one at half past four in the pm: which will pretty much always be worse - who tells me the correct result to put in your file?
I fully concede that you’re the expert and know a hell of a lot more about this than I do. I would argue that there is test variability in any kind of test. Repeat the audiogram in the same situation you mentioned and I’d be surprised if you got exactly the same results. I’m not saying that everybody should do a word recognition test on everybody. I do think for somebody with a severe or profound loss that one wonders if a cochlear implant might be beneficial that a WRS adds something to the picture.
If I understood correctly you said you have nothing to do with cochlear implants and refer possible candidates back to PMD? Is that just how the system works to get a referral for a cochlear implant? I’m thinking an audiologist is a lot more qualified to determine if somebody might benefit from cochlear implant than a PMD.
That would only be based on the perceived loudness of the sounds, not on the brain’s recognition of the words.
I’ll happily concede it adds ‘something’ but the amount of something is questionable.
Lots of posters on this forum throw around figures/arguments about how their WRS score means X or Y. I don’t think the scores make a good basis for an argument or a course of treatment.
It’s like going for a ride in a modern car blacking out the windows and asking you if it ‘felt’ fast or slow . You’re probably going to be correct, but it’s relying on sensory interpretation. Now I’m going to ask you were you doing 40 or 50? There’s practically no way you could tell.
What if the referral criteria was set at 45?
Agreed: but unless I’m mistaken, hearing aids don’t correct retrocochlear issues anyway. Your ability to resolve sounds at a neurological level is what it is.
You have a cochlear amplifier function, which basically disappears when you insert a CI. The system basically gets destroyed as part of the process of modifying the cochlear. The criteria for CI needs to be solid enough to make sure that it’s worth the cost/benefit of trashing this function.
Using a test % like WRS to determine this is likely to lead to potential issues: especially if there’s a profit motive at play.
Imprecision of test results is not unique to WRS. On a topic I actually now something about, I’m amazed at the variability in lab values. As lab orders have gotten computerized and two different doctors ordering the same test will result in the lab running the test twice, I’ve seen incredible variability. The variability is enough to impact decision making. My response to any kind of inconsistency like this is: “Engage brain.” Judgement calls are common in medicine. One needs the whole picture, not any one value. There are lots of ways to game results if one has ulterior motives.
If you’re getting itching ear canals then this product will help. I have had itch ears due to silicone full shell ear molds so l use the Starkey hard shell full earmolds with no vents.
Hi everyone. Thank you all so much for your input. Just a quick update, today my hearing aid tube was full of water. I wore it 7am and by 12.30pm it was sopping. I had to put them away because it sounded very crackly. I spoke to the audiology department and I have an appt booked for 20th of this month for a mould fitted with a vent. I spoke to an actual audiologist which helped and He said that I was never really a candidate for having domes anyway… exactly what you all told me, really. I am worried because as I explained already I have never got on with moulds because they cause so much issues with my ears, but got no other option if I want to hear properly. I just need to get on with it and work around it.
