Knowledge Translation from Research Labs to the Audiology Clinics: A Flow or Just a Trickle?
From the Labs to the Clinics
Renowned auditory researcher Dr. Robert Harrison brings us up to date on information and research from the Labs. Appropriately titled “From the Labs to the Clinics”, Bob is involved in laboratory and applied/clinical research, including evoked potential and otoacoustic emission studies and behavioural studies of speech and language development in children with cochlear implants. For a little insight into Bob’s interests outside the lab and the clinic, we invite you to climb aboard Bob’s Garden Railway.
The title of my column in Canadian Audiologist is “From the Labs to the Clinics,” but I have to say that the gap between audiological science and clinical audiology has not narrowed as much as I would have liked during my (45 year) career. There is a steady stream of new ideas from academic hearing scientists, few of which have had much impact on day-to-day audiology practice.
For example, last month in Canadian Audiologist we had a celebration of Prof. Brian Moore, a very productive auditory scientist with many “contributions” to clinical audiology. However, very little of the new knowledge and ideas that he generated appear in practical, clinical audiology. His research on cochlear dead-areas, resulting in the TENS test, including methods for mapping them has seen scant attention clinically. Having said that, there have been several attempts at making his TENS test more clinically feasible by using a piano keyboard with the search for cochlear dead regions taking seconds rather than 20 minutes (see for example1). And Brian Moore’s work with his colleague Michael Stone has provided the underpinnings for several aspects of modern hearing aid circuitry. But his work on frequency resolution and bandwidth filter shapes has not led to any tests for these important hearing mechanisms in the clinic. In this respect, I am especially disappointed after spending much energy measuring frequency selectivity, including the development of potential clinical tools.2–7
I was thinking about this audiology knowledge-translation gap, and the hopeful title of my column, when I came across a newly published Canadian study8 with the potential to provide a useful clinical tool. The research was headed up by David Purcell and colleagues at Western (NCA) and studied the value of objective electrophysiological signals, specifically speech envelope following responses (EFRs) in predicting speech audibility.
The research study was published in the journal Ear and Hearing. This is the highest-impact journal in the field of audiology. (I do hope some of my readers will be familiar with this journal and from time to time read its published papers!)
Despite my somewhat critical comments above about a lack of knowledge translation and bridge building from the labs to clinics, I can get excited when there is some potential for developing a useful clinical tool based on some new basic science findings. I will be following any progress in that direction closely and will report to you directly.
1. Chasin M. Testing for cochlear dead regions using a piano. Hear Rev 2019;26(9):12.
2. Harrison RV, Aran J-M, and Negrevergne M. The frequency selectivity of the normal and pathological human cochlea. Arch Oto-Rhino-Laryngol 1981;230:221–28.
3. Harrison RV, Aran J-M, and Erre J-P. AP tuning curves from normal and pathological human and guinea pig cochleas. J Acoust Soc Am 1981;69:1374–85.
4. Harrison RV, Aran J-M. Electrocochleographic measures of frequency selectivity in human deafness. Br J Audiol 1982;16:179–88.
5. Harrison RV, Dauman R, Aran J-M, and Negrevergne M. Etude electro-physiologique de la selectivite en fréquence en audiologie. J Otolaryngol 12, 89–91.
6. Portman M, Harrison RV, Negrevergne M, Dauman R, Aran J-M. Electrocochleographic measures of cochlear frequency selectivity in hearing loss of cochlear origin. Acta-otolaryngol 1983;95:657–63.
7. Harrison RV. The evaluation of cochlear frequency analysis in the clinic. Revue de Laryngol Otol Rhinol (Bordeaux) 1983;103:405–10.
8. Easwar VE, Birstler J, Harrison A, Scollie S, and Purcell D. The accuracy of envelope following responses in predicting speech audibility. Ear Hear 2020; July 15, 2020 -Publish Ahead of Print – Issue. doi: 10.1097/AUD.0000000000000892