What does big data tell us about hearing aid use in adults with mild hearing loss?

Evidence suggests HCPs shouldn’t hesitate in fitting hearing aids to motivated patients with mild hearing loss.

There is some evidence that hearing care professionals (HCPs) hesitate in fitting hearing aids to patients with a mild hearing loss. For example, the large-scale Marketrak VIII study conducted with US individuals with hearing loss found that 43% of respondents with a mild hearing loss reported that their audiologists had taken a ‘wait and retest’ approach to providing hearing aids (Kochkin, 2012). For those who had visited a hearing instrument specialist, the percentage was similar, at 35%.

This hesitance could be due to a number of factors. The individuals with mild hearing loss may not have indicated a perceived need for an intervention such as a hearing aid, despite seeing a HCP. Alternatively, the HCPs may show reluctance in providing hearing aids due to a perceived lack of benefit from hearing aids for a mild degree of hearing loss.

Our recent study explored the question that when individuals see a HCP and are fitted with hearing aids, do those with a mild hearing loss use hearing aids less or differently than individuals with a moderate degree of loss. We used an international database of 16,766 fittings from 159 clinics in 4 countries and extracted total of 8489 bilateral fittings which contained data on hearing loss and hearing aid use. The hearing aid use values were extracted from the hearing aids’ data logging feature, and hence were an objective measure of use.

The individuals in the database were then divided into groups based on their average hearing loss at 500, 1000, 2000 and 4000 Hz, using both the British Society of Audiology (BSA) and American Speech-Language-Hearing Association (ASHA) descriptors of degrees of hearing loss. Both define mild hearing loss to be an average loss between 25 and 40 dB HL. The BSA describes a moderate hearing loss to be between 41 and 70 dB HL while ASHA recognises a moderate degree to be between 41 and 55 dB HL and a moderately-severe degree of hearing loss to be between 56 and 70 dB HL.

In general, the results showed that hearing aid use was 8.5 hours per day for those with a mild or moderate degree of hearing loss, and 9.0 hours per day for those with a moderately severe hearing loss. There were some differences in use of the left hearing aid (none for the right) but these were minor and would not be deemed clinically relevant.

The pattern of hearing aid use also did not differ between the groups, with 8 to 12 hours of hearing aid use per day being the most common for all hearing loss groups. Similarly the use of hearing aids in different listening situations (quiet versus in noise) also did not vary amongst the groups.

In essence the study showed when individuals attend a HCP and are provided a hearing aid, those with mild hearing loss can be expected to use those hearing aids as much as individuals with moderate degrees of hearing loss. Therefore there is little evidence from this study that clinicians should hesitate in recommending hearing aids to motivated individuals who visit their clinics.

If you would like further information about this study, it is available in the ‘fast track articles’ section of the Journal of the American Academy of Audiology: Timmer BHB, Hickson L, Launer S. (2016) Hearing aid use and mild hearing impairment: Learnings from big data. J Am Acad Audiol.

Reference: Kochkin S. 2012. MarkeTrak VIII: The key influencing factors in hearing aid purchase intent. Hear. Rev., 19, 12-25.

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