From Evidence to Action: Guidelines and the Future of Practice with Dr. Riley DeBacker

In this episode, hosts Emily Venskytis, AuD, and Maggie Kettler, AuD, sit down with Riley DeBacker, AuD, PhD, to explore his work with the American Academy of Audiology’s Guidelines and Strategic Documents Committee. They discuss how clinical practice guidelines are developed, why they matter for clinicians, and how emerging concepts like evidence-informed decision-making are shaping the future of audiology. The conversation highlights the real-world impact of guidelines on patient care, policy, and reimbursement, while offering insight into how audiologists can get involved in shaping the profession.

Transcript

SPEAKER_00 0:03

Welcome to Sound Practice, sponsored by the AAA Foundation, where hearing meets understanding. We're your hosts, Emily Vin Skydes and Maggie Kettler, and in this podcast, we'll explore evidence-based clinical care and audiology, focusing on new research in the assessment and management of hearing imbalance disorders. From the latest advances in audiology and hearing technology to real conversations about hearing loss, balance, and cognition, sound practice aims to translate research into real-world application, supporting informed clinical decision making and improved patient outcomes. Whether you're an audiology professional, a student, or simply curious about the world of sound, you're in the right place. Turn up the volume, tune in, and let's listen closer. This is Sound Practice. On today's episode, we'll be talking with Riley DeBacher, AUD PhD, on his work with the American Academy of Audiology's Guidelines and Strategic Documents Committee. Dr. DeBacher is a research scientist at the VA National Center for Rehabilitative Auditory Research and assistant professor of odolaryngology at Oregon Health and Science University. His lab focuses on understanding and preventing autotoxic hearing loss and the uses of AI and audiology through predicting autotoxic hearing loss and creation of hearing aid troubleshooting assistants. He is the vice chair of the Academy Guidelines and Strategic Documents Committee, co-PI for the Academy Research Conference, and a member of the ABA General Audiology Board Certification Task Force. Welcome, Radley.

SPEAKER_01 1:33

Thanks so much, Emily.

SPEAKER_00 1:36

Yes. Well, let's just dive right in and we'd love to hear more about you and specifically tell us about your previous involvement with the Academy and how you became involved with guidelines and strategic documents.

SPEAKER_01 1:51

Yeah, so um when I was a student, I was very involved in SAA. I think I joined the SAA board like right after you rolled off, Emily. And so that meant that when I graduated, I was like, I need to go out and do something else, because heaven forbid I'm associated with students forever. Uh, as if I don't work with students all the time right now, and that would be perfectly fine with me. But at the time it felt very important. And so, since I have a very research-focused job right now, uh, guidelines and strategic documents made a lot of sense. So I joined at just the right time because the academy was really kind of refocusing in on really beefing up our guidelines. Um, and so over the last couple of years, I've been very lucky to be really involved both with Ian Winmill, who was the chair when I joined, and now with Angela Schuop, two past presidents of the academy, who are both incredibly smart, uh, talented people that I've gotten to learn a lot from. And over the last couple of years, we've really been trying to like not just make sure that we're updating the documents that we really need to update, but also taking a look at like the very nerdy process of like, how do we actually make these documents in the first place? And how do we do so in a way that's both like meeting the rigor that we expect from uh scientific documents or clinical practice documents like this today, but also making sure that we're responsive to the fact that like that's also changing in like this age of AI, where we're kind of trying to figure out how we how we fit these new technologies into things, uh, not only in our clinics, but also in like how we create and distribute knowledge products. And so I've kind of gotten involved through a lot of that um as as like a little bit of a tech guru uh for a while and now uh kind of switching over to thinking some more about how we develop some new products and some things that way. So I'm excited to talk about that a little bit more later.

SPEAKER_02 3:56

That's great. Really, Riley, you are so involved in so many projects, uh both in your job and through AAA. So we really appreciate all the work that you've done. You recently have received the Early Career Audiologist Award uh for students or new professionals in audiology. Uh so what how would you reach out to that those other students and new professionals and why should they care about strategic documents so early in their career? What advice would you give to that population?

SPEAKER_01 4:30

Oh, so one of the things I think about, especially for folks like about to begin or beginning their careers, is um there's uh hopefully for all of us, kind of a long uh road in front of us for our time as audiologists. And um, I was just teaching a class uh the last couple of weeks, I've kind of transitioned out of it over at University of South Dakota, and I've been talking with their students a lot about genetics and embryology. And even in the time from when I took the comparable class that I took 10 years ago to today, not only do we know more things, but also when I think about how, when I was thinking about how to teach that class, and I swear this is directly relevant to the question you asked, when I think about how I was teaching that class, what was relevant to an audiologist that's going to be graduating in the next couple of years versus what seemed like it was going to be relevant to me 10 years ago is different because now we're starting to see states where ordering genetic testing is part of the scope of practice or may soon be part of the scope of practice. And so for me, it was really important from like a basic science perspective to be a well-rounded professional that could talk as part of a team about things and who might need to be familiar with syndromes or or think about um kind of how all of this fits together to understand the person who was in front of me. And I think that's still what the core of the information was for those students. But I also had a very big like clinical takeaway that was important to them in terms of like, hey, you don't just need to know that someone is going to do genetic testing somewhere. You might actually need to be picking which genetic genetic tests are happening. So let's talk about what kinds of genetic tests there are and why you might want to pick some of these. And so that required me to do some homework on my own as like a professor, the way to go through and be informed and uh help educate informed students. And that was something that I don't really think was on my professor's horizon 10 years ago, because we didn't know where the field was gonna be. And the reason all of this is relevant to guidelines and strategic documents is because those are the kind of conversations we're happening that are happening at the academy level around a couple different places. So a lot of our advocacy partners are having these conversations. And when those advocacy partners have those conversations to say, hey, we have a group of audiologists that want to update their scope of practice, we need evidence to support that. The place they turn to for that evidence is the guidelines and strategic documents committee because we want documents from AAA that put forward, hey, how can we get a quick policy brief together? How can we understand the state of the science right now to ensure that this is a safe practice, that it's a well evidence-informed practice? Um and to do all of that, we need to know what the policymakers are going to want to do in three or four or five years so that when they go to do that, we have a document that's ready because uh there's a lot of work that goes into developing these documents. We're currently working on updating our management of adult hearing loss and our assessment of adult hearing loss, clinical practice guidelines. Um, and that means reviewing like 20 years of scientific literature. And it will shock you to hear uh audiologists have written one or two articles in the last 20 years about how we test adults' hearing and how we manage hearing loss in adults. And so doing all of these things makes a really big difference because when we get this really smart group of people together to understand the science, to understand where clinic is at today, it helps inform where clinic is going to be in five or 10 years. And so when I think about like how all of that fits together for early career professionals, I feel really lucky that I'm getting to see like right now at the beginning of my career, how all of these things fit together and how things might change. And like by being part of this committee, um, I'm getting some insight into like what legislative priorities are coming up and how we can help prepare for those things. And very selfishly as a scientist, um, that's really cool for me too, because it means that as I'm thinking about like my research program and when I'm talking to my colleagues at a at a very busy research center, I can kind of say, like, oh hey, I happen to know that like these are things that are coming up and that are gonna be big and important and that we need more evidence for. And so kind of all of those things fitting together makes it a really interesting way to get a good perspective for where audiology is going. And I think gives me a lot of uh hope and excitement when I look towards the future of audiology in a way that I think sometimes uh as an early career professional, it's a really nice to have that kind of like little boost up uh once a month when I get together with the rest of the GSDC and go, like, oh, we're we're going towards something, we're doing cool things. And there's so many cool possibilities in front of us as audiologists. And so that's that's what I think about a lot.

SPEAKER_02 9:49

Yeah, it's great. And you know, as a not early professional, um, it's really important for us to have resources too, as things change, to have a place where we can go back and seek this as new things are on the horizon, as our scope changes in the profession. Those of us who were in school many years ago uh will be seeking out more knowledge and more information. Obviously, with conferences and lectures is very important as well. But a quick um stop at the guidelines can really help provide um, you know, some quick tips and and get you the knowledge that you need to stay current and practice and really be able to move your profession forward. Thanks.

SPEAKER_00 10:37

And you know, it sounds like you have a lot of forward thinkers in this group of people that are working on the guidelines and strategic documents, right? And um I'm also hearing you say there's a lot of collaboration going on between people that are leading this group, other members of the academy, other leaders in the audiology field. So tell us more specifically about who the key stakeholders are for these strategic documents.

SPEAKER_01 11:04

This is, I think, one of the things that I have learned the most about since joining this group because I think coming in, like I said, I joined this group as a researcher because I was like, ah yes, reading a bunch of articles, what a good fit for things that I already have to do all of the time in my job. And I think so many people that I talk to think that's what like the clinical practice guideline groups are. It's a bunch of us like stodgy professors sitting in a room together and like arguing about like whether it's better to press a button or raise your hand to respond to a beep. And that's not it at all, actually. When we look at like who cares about the academy's clinical practice guidelines, everybody who like touches audiology in some way has a stake in these documents being developed, right? We want good engagement with patients because sometimes this is what patients are looking for. Our very high information patients are going to these and saying, okay, I want to make sure I have somebody that's that's on top of their business. Or this, I had this recent experience and I want to see if it's like a normal experience or not. Um, and so uh patients will engage with these documents because they're available to them. Policymakers engage with these things because it's a way to look towards what is the expectation of the field when they're defining kind of what's normal or what should be included in scope of practice laws, in how they value our codes and our reimbursements, um, and what specific procedures should be part of uh different kinds of reimbursement. Um, as a brief carve out from this, one of the things I never really would have thought about when we were going and we were talking about the assessment guideline that's chaired by uh Dr. Deb Carlson, who is absolutely brilliant. Um, but one of the things I so value in working with her is she's an audiologist that's very in the weeds on these things and has done a lot of work with the PPAC and RUC, two of our big advocacy groups, and has been really involved in advocating for reimbursement for audiologists. And one of her concerns when we were putting together our outline for how we were going to write that document on like what is the clinical practice of assessing adults' hearing, was to be mindful about which things we included in that document and how we described them. Because if we included a bunch of new procedures, it might get added to the standard 92557 code. And then suddenly we would need to do a lot more work without seeing a comparable increase in reimbursement for that. And I would never have thought that way about putting something in. As my approach, I want to throw everything that we might do into this document because I want this great one-stop shop for where we can get information about how to check people's hearing out. But learning how other people, especially people who aren't audiologists, use these documents made me recognize that, oh, actually, we need to be really mindful about the way we organize this and we need to be talking to people that have a lot of different experiences. And that's another reason why. So, outside of clinicians who should care about this because obviously we want to be on top of our practice, we also should care about this because it affects our bottom line and how much we're getting paid or our hospitals are getting reimbursed for the procedures that we're providing. Um, and so the the number of people that interact with these documents, both in the US and then internationally, looking towards what the what AAA is doing as kind of like a standard bearer for audiology, has been really, really interesting to sort of engage with and has made some interesting conversations when we're doing our kind of reviews of these documents and thinking about like, okay, how is somebody going to interpret this? Um, and how do we want to make sure that we're saying this in just the right way for what we want to come out of this at the end?

SPEAKER_00 15:01

Well, that that's a really great perspective on how much thought really goes into these documents. I can say that I've interacted with the Guidelines and Strategic Documents Committee in my role with the Academy, and that that is so much more than I expected, truly. So I I wouldn't even have considered the implications that this has on our billing if you include those those extra features andor extra testing in part of your description. So that's really interesting to hear about and just makes me even more excited about learning about these documents and how they can can benefit us and the changes that that they make for our field.

SPEAKER_02 15:38

So let's shift a little bit and start talking about um some external um groups that influence the work. So recently, the World Health Organization has highlighted the difference between evidence-informed and evidence-based practice. I'd love to hear your perspective on how those difference on those differences and how they impact um the work you're doing within the academy.

SPEAKER_01 16:04

Yeah, so I promise that despite how nerdy this difference sounds, uh, it it's been something that uh we've dedicated a lot of of thought to. So basically, um a couple of years ago, WHO came out with this document that introduced the idea of evidence-informed decision making, which they super unhelpfully abbreviated EIDM. Um so basically, what they were seeking to do was look at the fact that we're in this really cool space right now where new products and needs are being identified faster than the sort of traditional scientific pipeline maybe can keep up with. Um I think about this in the specific context of audiology uh with respect to things like uh new clinical devices that are coming out. Or I think actually maybe the clearest example of this is something like new hearing aid technologies, right? When we think about how rapidly hearing aid technology is advancing today, if I stick to this really traditional idea of evidence-based practice where I need a good, well uh empirically evaluated clinical trial of a technology before I recommend it to my patients, I'm almost never going to be able to recommend a new hearing aid technology because the lag time between it hitting the clinic and the scientific evidence hitting publication is so big that technologies have been updated again uh by the time we get to that. And this, I think, is only becoming more pronounced in this era of like rapid technology innovation. So, for example, like if we were wanting to run a clinical trial on the use of Chat GPT for something, the version of Chat GPT that was tested in a study is going to be radically different from the version that's commercially available at the time when that study comes out. And so, in response to this and a number of other factors, um, WHO introduced this idea basically of okay, how do we be evidence-informed, if not evidence-based? So, how do we take this importance of rigorous process that we established and have used in healthcare for years to create evidence-based practice and bring it up to today where we recognize that there are multiple needs of people, right? Policymakers and clinicians are going to have slightly different needs and slightly different environments depending on where they're practicing. And that's really important for us to not insist that they use outdated technologies or wait to implement practices that are really demonstrated to be effective until we have this critical mass of scientific evidence for it. And so this framework of evidence-informed decision making tries to apply that same level of rigor. This isn't kind of moving away and saying, okay, we don't, we don't need scientists anymore, which made me take a nice sigh of relief personally. I like uh eating and being able to pay my rent. So um, but instead saying, instead of kind of making this the ultimate standard that we have to match up to, how can we look at these other data sources that we can collect and rely on in the way that we've previously sort of leaned really heavily on clinical expertise and um scientific published evidence? And instead can kind of bring in these other perspectives. Like, what is the context that people are practicing on? What are the like economic and other practical limitations that people are confronting? And what are the specific contexts? Um WHO obviously is very interested in global versus local implementation, right? Like, what are our global gold standards versus what are reasonable local gold standards that can be implemented? But I think that also applies, especially in a country as big and diverse as the US. Um, when I think about uh the even the resources that are available uh in different places I've lived in the US, right? When I was growing up in rural Ohio, the resources that were locally available to me and that would be good clinical practice in hospitals and clinics near where I grew up, and the things that would be considered like gold standard typical practices in Columbus, Ohio, where I went to school and there were three major healthcare systems, um, were very different. And it's not that those people in rural Ohio are doing bad practice or not kind of doing evidence-informed care. They're just doing it in a slightly different way based on the context. And so, how can we sort of speak to that? How can we, in preparing documents, think about the fact that maybe it's not one standard that applies across the board as a best practice, but thinking about what are our core best practices, what are kind of things that in ideal situations can happen, and what are the sort of minimum standards that all people must meet? And how can we speak across those different things? And also, how do we bring in new and updating technologies and give people the tools they need to evaluate those things as they're advancing? Because even if we update these standards every five years moving forward, we want to make sure that people have ways of using these standards to interpret things that will come out in that kind of meantime without needing to wait for the academy to issue a statement maybe on a particular technology or on a particular type of therapy that emerges.

SPEAKER_00 21:44

That's great. So these are a really valuable tool, then, that audiologists can use or researchers. Again, you mentioned it's used in the advocacy space as well. But how can a clinically practicing audiologist access this? Or you can tell us more about how. You disseminating this information so that audiologists can find it and all these other stakeholders as well.

SPEAKER_01 22:06

Absolutely. So, uh, one resource that I definitely want to point everyone to, audiology.org. If you go into practice resources, we are the top, uh, the the top menu item in uh practice resources. So please, if you have questions about what the academy currently has in terms of these guidelines and strategic documents, that is the best place to go to and see everything collected in one place. And all of those documents are available to everyone through the website. Um, in terms of kind of like other ways to find these kind of best practices or these emerging practices, we're trying really hard to make sure that we're moving away from only putting together these really like stodgy sounding uh clinical practice guidelines or consensus statements or strategic documents, and are instead looking also at other ways of disseminating tools that are going to be directly useful in a clinic setting. So, for example, like what are the kinds of infographics that we can translate some of these key recommendations to so that somebody can throw it on their clipboard or or throw it on the bulletin board next to their desk and can reference it when they need to without needing to pull up a full document and read through. Uh, because I don't know any clinicians who are uh who have told me that they just sit at their desks all day, dying to kind of highlight through 35-page documents to figure out how to change their practice. Um, but also ways that we can increase dissemination uh across uh different avenues. And actually, one of the ways we've recently seen that happen is with this podcast. So last month, uh your guests were two of the chairs from a recent writing group, uh, Carol and Anna have been working really hard on that systematic review, which is a really important uh document in fitting again into we need systematic reviews. We need somebody or groups of somebody, because it's a lot of work, to dig through all of that evidence and present it to folks, uh, be they clinicians or or politicians, in a way they're that it's kind of summarized and ready for them. But that scientific document, that that paper that's gonna be coming out in JAA isn't the only way they're talking about that. They've talked about it with you guys on this podcast. They presented at American Auditory Society last month. They did an audiology online webinar. Um, they're also looking at ways that they might be able to prepare some infographics or put out some other kind of video or other content. And so we're really trying to look across what are ways people are interested in receiving this information and how can we kind of like tweak it to the right things. Um, another thing that we do a lot of working with is the advocacy team to make sure that uh we're we're going back and forth about developing policy briefs and leave behinds that when folks are going through a meeting with legislators about important priorities, uh, they can do that.

SPEAKER_02 25:00

Yeah, that's great. And along these lines, we know that the recently the clinical consensus statement on pediatric vestibular assessment uh was recently published. Uh, tell us more about this work specifically.

SPEAKER_01 25:15

Uh, this uh document actually is one that I'm really excited about because A, on its face, it's something where I don't think I need to sell too many audiologists on the fact that we want more information about like how do I do Vestib assessment in kiddos? Uh I say as someone who is pretty far in my clinical practice away from the stib. Uh, but it's something where when we were working on this document, when we talked about this document with folks, people were very excited because this is an area that's been perceived as a pretty big gap. We need good guidelines on what do you do when you're uh assessing balance in kiddos at various ages and stages of development. And so there was a strong need for the document. But also it's really cool because it was an example of a case where a group got together and said, hey, we think this is something we really need, and approached AAA to say, we'd really like to write up a clinical practice guideline. Could we work with you to make that happen? And so it was a good example of the fact that this guideline process is not just like Angela and I sitting in a room uh with staff at the academy and saying, like, what do I think is the most important? Because if so, I promise you we'd be working on an autotoxicity update right now. I think it's the single most important part of clinical practice. Um, no, but in in actuality, it was this group who came together and said, we want to write this document. We have the expertise necessary to write this document. Can we work with AAA to put this document together? And we said, absolutely yes. Um, there is a form on the website. So when you're going through and you're checking out all those great clinical uh resources that we have available, if you have a great idea for a document, whether you've got a group of people or not, you can go through and fill out an interest form to basically say, I want to, I want the academy to put together a resource on this. And here's kind of an outline of the the document that I see. Um we describe the different kinds of documents that we have, and I can get into some of those because there's a pretty big difference between a clinical practice guideline that we think of first, which requires a lot of evidence to produce, and then some of our things like consensus statements or position statements, where we get a group of experts together, they review the literature and they tell us what's going on. But getting back to question at hand, what that means is if you've got a great idea, especially if you've got a group of people who are motivated and interested in writing that up, we want to know about that because having good motivated people is one of the most important things to making these documents actually happen. Um it takes a lot of work to put together a clinical document. It takes a big team of people. And so when we already know there's a core interested group in doing it, it makes it so much easier for the board to say, yeah, we have the resources to support this group of people to do it. And we know it's going to get done quickly because the group's already assembled and ready to go, versus adding a couple months where we have to go through and kind of beg and plead with folks uh to get together a group that's willing to invest the time and who has the availability to invest the time in making one of these documents happen. And so I was really excited last July. This document came out, this kind of clinical consensus document where a bunch of experts uh got together and said, Hey, we are very knowledgeable about this. We have a lot of clinical experience that can inform this, and also happen to be the people that uh tend to be the ones writing these documents. And so we um came together, got an outline, uh, got everything written up. And now there is on the Academy website the the first thing you'll see when you go to that great resource uh is this clinical consensus document where folks came together and now are providing recommendations. So if I wanted to start up, for example, a pediatric vestibular clinic, um, I think the first question my boss would have is is the VA the right place for this? But uh I if if I could get through answering that question, I could then refer to this document and say, here are the different things that we would need to do, the equipment we would need to do that. And sort of based on the number of procedures I would need to perform, this is the time I'd need. So that creates a really good cornerstone for building these programs out and sharing out that expertise without you having to kind of email Violette Lavender personally and say, hey, can you help support me in pulling all of this together?

SPEAKER_00 29:49

That's really cool. Uh it's great to hear that people can go on and express interest in a document or request something to be updated if it hasn't been updated in a long time. And really awesome to hear that if it's something you're really passionate about and you want to organize the group that's going to be contributing or participate. Um, it sounds like that interest form is something great to utilize. Are there any other ways that people can get involved with this group or volunteer to participate?

SPEAKER_01 30:20

I have yet to work with a group, uh, a volunteer group at all, but particularly within the academy, who has said, no, we just really we're at capacity, please go away when folks are interested in volunteering. And the GSDC definitely falls into that. So I'll say there are two or three major kinds of volunteer opportunities that we would love to have people join for. Um, one, obviously, are writing groups. So these are the groups that are currently kind of working on putting together these documents. Um and so if you have any interest, I've already mentioned we have our both clinical practice guideline for the management of adult hearing loss, our clinical practice guideline for the assessment of adult hearing loss. Both of those groups would be thrilled to have folks join in kind of writing that up. Um, but we also have um some other documents that are kind of ongoing right now. We have some vestibular documents that are in their late stages that we'll be presenting some updates on soon. And then we have um some other folks, uh some documents that are in the pipeline that we'll be sending out some calls for volunteers for soon. And so if folks are interested in participating in writing groups, even if there's not one currently that matches up, uh, you can always kind of indicate in the Academy volunteer interest form that you're interested in serving on a writing group. And we can kind of bank your name so that we can contact you when writing groups are being formed, because finding people to come together for that uh is one of one of the biggest parts of uh Angela and my job early on in this process and for the chairs of those groups. But then we also actually have an entirely separate pool of volunteers who work on the guidelines and strategic documents committee. And so um, if you are a big old nerd and you want to learn a whole bunch about the nuts and bolts of the things I've been talking about. So, like, how do we make these documents in the first place? Um, if you want to be involved in some of the prioritization for which documents are are coming up next, um, but also in just kind of learning how we do these various steps. So, like, how do you actually conduct a systematic review? How do you go through and pull articles, evaluate which ones are correct, and then extract out the relevant information and turn that relevant information into actual clinically implementable recommendations? Um, that's a really big part of what we do as the GSDC. So when I liaise with the different writing groups, my role isn't to like write specific recommendations or to evaluate the evidence directly. I'm there to kind of help answer questions so that when folks are trying to figure out the nuts and bolts and how they can do this correctly and rigorously, we have one kind of unified way that we're approaching this. Um, and the reason that's actually so important to meander just a little bit is that when we go through, because we're preparing these things for other people, something that's really important is not just creating one standard for audiology documents and making sure we meet that, but comparing that audiology standard to other professions so that our documents are viewed favorably by our healthcare colleagues. Like uh guidelines look very heavily at uh other groups like AAO to try and determine what they're doing and how they evaluate their evidence. Um, and we're often asked to um both kind of work with AAO on documents they're developing. So they currently have a couple documents in development that the academy has writing group members sitting in on those documents to make sure audiologists' voices are being represented. Part of the way we make sure we can do that is because they respect the fact that we have a rigorous process and we have well-trained folks that are ready to participate in those processes. But also, when we think about like stakeholders of on the policy level or things that way, it's important that we can really say, like, hey, these are legitimate, well uh informed documents uh that you should respect. And here are all of the reasons why. Um, and that we keep our professional reputation where it needs to be. Also, one of the stakeholders I didn't mention earlier, um, these are often uh these are medical-legal documents. So uh in areas like malpractice or other things that way, uh, it's important to have these documents that we as providers can refer to to say, hey, I did what the American Academy of Audiology recommends that I do. And so I uh was following appropriate clinical practice and it should not um be at fault in what happened as a result of that. Um so it's very important for all three of those cases to have good, rigorous documents. And that's why we need a bunch of nerds to come join our group to learn all of those things, um, so that it's not just me attending like 19 meetings a month uh to do a bunch of trainings on these things. Uh, I feel like I have implied that this is a lot of work. It's very scalable to what you have available. Uh please come volunteer with us. Um but it's it's a very fun way to kind of scale up if you're interested in learning how to do any of those things uh on your own or for other purposes. I will say my like science has gotten much better because of the things I do with the academy. I was in a meeting last week where um we were talking about different AI tools for things like literature reviews. And right now, uh the GSDC is currently evaluating ways we could include AI in the process of kind of evaluating evidence and going through all of this. And so I was so ready for those questions to come up at work because I've spent the sat last several months like reading Cochrane reviews and updates on different ways that other people have tried to do this and was really conversant in that literature. So I could say, hey, here's the current state of evidence and things that are good ideas and things that are probably really not good ideas based on what we know right now. Uh and I didn't have to do any extra work because this was something that was already kind of at my fingertips from volunteering with AAA. So uh if any of that sounds interesting to you, please come join us.

SPEAKER_02 36:42

It's a great plug, Riley. And as as we wrap up for today, tell us what's on the horizon? What are some new exciting things that we can see from the guidelines and strategic documents committee in the future?

SPEAKER_01 36:57

So I think I I've hit on a couple of things, but just to like collect it all in one place. Right now in development, we have um guidelines on the assessment and management of hearing loss in adults. And so if either of those is part of your clinical practice and you want to make sure that you're on the cutting edge of what's going on there, uh keep an eye out for those things. We also have an updated document coming out for vestibular assessment and diagnosis in adults. Um, and we'll have another kind of follow-up document to that coming out later because one of the things we're recognizing is historically we've made these really big documents that now there's a whole lot of evidence for. And so we're starting to split those up into smaller pieces so that we can actually accomplish them in uh under seven to 10 years. Um, and then um we also have recently been working as a team with the board and with some of our policy stakeholders to prioritize things that are coming down the pipeline. Those haven't been finalized by the board yet, so I can't say for sure. But um, we're currently considering some updates, for example, to APD documents, to odotoxicity-related documents. Um, we're working together and we'll probably be putting together some statements related uh to AI and its use in clinical practice in other audiology-related settings. And so uh through collaboration with kind of external partners and also the work internally, we're coming up with what those things are gonna be. I can't give you a firm preview of any of that yet. But if you heard any of those things and you have very strong feelings about which ones of those should be in, the best way to get a vote on that is either to join the AAA board. That's the best vote since they literally vote on it. But also uh by joining either the advocacy teams or uh the GSDC, we kind of help pick out which of those things are upcoming and which of those things we think are going to be the biggest impact moving forward.

SPEAKER_02 38:54

Excellent. Thank you so much. Our show is called sound practice. Outside of the clinic, what is one sound practice, a hobby, a habit, mindset that helps you stay balanced and focused?

SPEAKER_01 39:09

Oh, so this is a very uh probably a moderately embarrassing uh thing. But when I think about sound practices, I'm a really big musical theater nerd. Uh, when I started college, that was actually my declared major. And I mosied my way over to audiology through SLP after I realized I was never gonna be on Broadway. Um, and so I try and take at least one trip to New York City a year to watch a truly disgusting amount of shows. Last time I was there, I was there for four days and I saw six Broadway shows. Um, and I am going next week and I will be there for five days and have eight shows booked. So I just I I the first time my husband was coming with me on one of these trips, uh, I was like breaking everything down. And Michael was like, okay, but like when are we gonna eat? And I was like, Oh, last time I just brought a suitcase full of Pop Tarts and I just ate those for the week. Um, and uh that was admittedly when I was like 20 years old. So I I have matured in my outside of seeing theater hobbies in doing that. But that is my biggest sound practice uh uh right now, I think.

SPEAKER_02 40:21

Well, Riley, I hope that when you're in New York, you have some time to try some of their delicious cuisine. And if not, then enjoy your Pop Tarts uh and all of your shows. That actually sounds like a very fun trip. I would like to go and watch all of those shows as well. Thank you, Riley, for sharing your knowledge and your expertise with us. Uh, I know from listening to you talk, I had many ideas that triggered in my mind. Um, as part of a large healthcare center, we're always trying to make sure that our practice is meeting all of the standards that we want and that kids are getting the best care possible. Um, I rely heavily on the strategic documents already, and I think it's something that we'll continue to do in our practice and really look forward to the odotoxicity and the auditory processing uh to come in the future, because I think those are definitely areas of need within the profession. Emily?

SPEAKER_00 41:19

It sounds like that was Maggie's plug for what she's voting for the next uh documents that should come out should be. Um But I really enjoyed listening to you talk about this too. Thank you so much for sharing all that information about how these are generated. And my biggest takeaway is, you know, as Maggie was alluding to in a big hospital system, how this can be such a valuable tool, but really for audiologists in every setting, as you mentioned, this is a way for us to document the minimum standard. And how can we, we we talk a lot on this so far on this podcast about practicing at the top of your license, but also practicing in a way that's consistent with what the research shows us, what's up to date. Um, I liked what you said about minimum standards, so that there is that avail availability for us or people that are using them to adapt to their unique situation, but still have that evidence that they can fall back on as to how can I make sure that I'm doing this in the right way in the best interest of our patients and the community that we serve. So it was really great to hear about this tool. Thank you so much.

SPEAKER_02 42:24

And thank you for listening to Sound Practice, sponsored by AAA Foundation. We hope today's discussion provided clinically relevant insights you can apply in your practice and professional development. For references, additional resources, and future episodes, be sure to follow the American Academy of Audiology to stay connected. If you found this episode valuable, consider sharing it with audiology colleagues, friends, and students. Until next time, this is Sound Practice translating research into better patient care.