More than 40 million adults in the United States have reported having hearing problems from minor hearing issues to deafness. Despite this prevalence, there are considerable low specialist referrals. A new study found a disproportion between self-reported cases of hearing loss and those who received medical evaluation and treatment recommendations, such as auditory rehabilitative options and amplification, including hearing aids and cochlear implants (CI).
Researchers performed a cross-sectional analysis of data collected from 239.6 million adult respondents, who provided answers to the hearing module questions in the 2014 National Health Interview Survey. The study participants were 51.8 percent women and 48.2 percent men, with an average age of 47 years.
About 95.5 percent of the participants reported functional hearing or the ability to hear either normal voice or whispering, 3.4 percent can only hear shouting, and 1.1 percent could not hear shouting. Also, 16.8 percent of the respondents noted that their hearing was less than "excellent/good," ranging from "a little trouble hearing" to "being deaf." Of these, 12.9 million had never seen a clinician for hearing problems and 11.1 million had never had their hearing tested.
The study also reports that out of the 48.8 million who visited a physician for hearing-related problems in the five years prior to the study, about 60 percent were referred to specialists: 15.9 million were referred to otolaryngologists and 13.3 million to audiologists. About 2.8 million adult respondents reported they could not hear shouting (not appreciating shouting). Of these, about 148,000 were recommended getting a CI but only 22.1 percent received it.
"It is difficult to determine the exact contributing factors with the data presented in this study," said lead author Hossein Mahboubi, MD, MPH, of the University of California in Irvine, CA, when asked about the possible contributing factors for this gap. "However, it is likely a multi-factorial process with lack of access, lack of awareness, and financial aspects playing the major roles."
"The low CI utilization rate is also likely multi-factorial," he told The Hearing Journal. "The need for surgical implantation and possible comorbid conditions or patient preference/compliance may influence candidacy and financial constraints may also play a role. Future studies are required to further characterize these associations and investigate the contributing factors," said Mahboubi on the main issues deterring patients from getting a cochlear implant.
The study noted that improved awareness of the importance of referrals to otolaryngologists and audiologists as well as auditory rehabilitative options among clinicians may improve hearing loss care.
"I believe there needs to be an effort, most appropriately led by otolaryngologists and audiologists, to increase awareness of physicians and the community about hearing loss, its common prevalence, and consequences if left untreated," Mahboubi added.