Hearing Loss Clinical Trial
Official title:
Assessing the Feasibility of a Clinical Trial of an Online Audiological Rehabilitation Program
The study will assess the feasibility of conducting a full-scale clinical trial of the effectiveness of an online rehabilitation program for adults living with hearing loss. The program aims to help people use their hearing aid(s) and interact in social settings more effectively. The program is made up of 5 modules that cover different topics, such as hearing aids, communication strategies, and relaxation techniques.
STUDY PURPOSE
This feasibility study is a precursor of a randomised controlled trial (RCT) that will
evaluate the effectiveness of an English-speaking version of the online program originally
evaluated by Thorén et al in adult hearing aid users. This study will estimate a number of
parameters necessary for the robust design of an RCT. This systematic approach of completing
a feasibility study prior to a full-scale evaluation is strongly advocated by the Medical
Research Council (MRC) guidelines for developing and evaluating complex interventions,
ensuring that any uncertainties are addressed and that the intervention operates as intended.
OBJECTIVES
This study will be used to estimate the following parameters:
(I) Recruitment
1. Willingness of clinicians to recruit participants
2. Willingness of participants to consent
3. Number of eligible patients.
(II) Feasibility/acceptability of approach (Quantitative outcomes)
1. Characteristics of the outcome measures
2. Standard deviation of outcome measures to estimate sample size
3. Follow-up rates, response rates to questionnaires, adherence/compliance rates
4. Time needed to collect and analyse data.
(III) Users' perspective/opinions of the intervention (Qualitative outcomes)
1. Participant's views regarding delivery of the program through different devices
2. How the program is used and how often (i.e. usability)
3. Participants views concerning what they like and dislike about the program (i.e.
acceptability)
4. How much of the program is completed (adherence).
STUDY CONFIGURATION
A single-centre feasibility study of a clinical study with one arm (intervention-only). A
before and after intervention design will be used. A sub-group of participants will take part
in a qualitative follow-up session.
Primary endpoint. In accordance with objective (II) feasibility/acceptability of approach,
follow-up measures will be recorded upon completion of the last intervention module
Secondary endpoint. In accordance with objective (III) users' perspective/opinions of the
intervention, completion of focus groups.
Participant Duration. Participants will take part in an initial assessment, which is
estimated to last 1.5 hours. After completing the weekly online modules from home,
participants will then take part in a follow-up assessment which will last up to 1.5 hours. A
sub-sample of 16 participants will also be invited to take part focus groups lasting 1.5
hours (end of the study).
Recruitment. Existing hearing aid users will be identified from the National Institute for
Health Research (NIHR) Nottingham Biomedical Research Centre (BRC) Otology and Hearing
Group's participant database. Participants in this database have provided consent to be
approached about future research studies.
First-time hearing aid users will be recruited from publically funded National Health Service
(NHS) Adult Audiology Departments in the East Midlands, UK.
All participants who express an interest in the study will receive a participant information
sheet, alongside a pre-paid, addressed envelope in which to return their response if they
choose to take part.
STATISTICS
Methods. The study data will be analysed by the research team at the NIHR Nottingham BRC. All
data will be analysed on University of Nottingham computers and backed up to the University
of Nottingham servers. Data will be analysed using STATA version 14. Continuous data will be
summarised using means and standard deviations, whereas categorical data will be summarised
using percentages. For each measure, the difference between baseline and follow-up will be
examined using a paired samples t-test or Wilcoxon signed rank test. Medians and quartiles
will be reported for non-parametric data, and means, standard deviations and 95% confidence
intervals for parametric data. Statistical significance will be set at p=.05. As outcome data
will be collected after the intervention period, no interim analyses will be performed.
Sample size and justification. The sample size estimate is based on the difference between
two dependent means; baseline and follow-up. An a priori sample size calculation (G*power
v.3.0.10) based on a medium effect size (Cohen's d=0.5), a one-sided Type I error rate of 5%,
and 80% power, revealed that a sample size of 27 participants will be required for each
sample (first-time and existing hearing aid users).
Assessment of efficacy. This is a feasibility study of a clinical study and, as such, will
not assess the efficacy of the online rehabilitation program.
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