Hearing aids are the most commonly used management option for individuals with hearing loss. Most of our current knowledge about hearing aids are originated from laboratory studies in which features, functionalities and performance of hearing aids are studied under controlled environments as well as in clinical studies in which various factors influencing hearing aid experiences are examined. However, hearing aid users have become active online where they provide feedback about their experiences on various online platforms (e.g., Hearing Tracker.com) freely at their own will. There is also growing interest from various stakeholders including hearing instrument manufactures and healthcare providers in consumer perspectives in shaping the hearing aid features/functionalities as well as healthcare service delivery models. This project aims to examine the consumer perspectives of hearing aids as it relates to their decision making as well as outcomes. The studies are conducted in partnership with independent hearing aid forums (e.g., Hearing Tracker) and also hearing aid distribution companies (e.g., Lexie Hearing). We aim to develop quick and reliable knowledge in this area so that stakeholders can take advantage of the latest knowledge in making decisions about hearing healthcare.

This project touches on the research themes 1 (online hearing health information) and 4 (new service delivery models). Following are the specific studies within this larger project.

Outcomes of hearing aids (i.e., hearing aid benefit and satisfaction) are generally assessed using standardized patient-reported outcome measures (PROMs). For example, hearing aid outcome is examined using questionnaires such as International Outcome Inventory for Hearing Aids (IOI-HA) or Satisfaction with Amplification in Daily Living (SADL). These questionnaires include specific pre-determined items which are often rated on a Likert scale (e.g., 1 = helped not at all, 5 = helped very much). However, not all the items in such standardized questionnaire may be applicable for all hearing aid users. Open-ended questions may facilitate capturing patients’ views, although the traditional qualitative methods to analyze data from such questions alone are not sufficient for this purpose. Advancements in computer algorithms have resulted in development of various Natural Language Processing (NLP) techniques. In this project we aim to apply a type of NLP called the Linguistic Inquiry Word Count (LIWC) to examine psychologically meaningful dimensions in response to open-ended questions from hearing aid users about their experiences.

The first phase of this project aims to better understand how hearing aid users describe their experiences by doing a systematic review of qualitative studies as well as doing some cross-sectional studies. The second stage of the project aims to develop a custom LIWC dictionary for analyzing the text descriptions of hearing aid users. The final stage of the project involves performing longitudinal studies to examine how open-text data provided by hearing aid users may relate to their outcomes. Overall, this project aims to develop a structured framework for understanding natural language of hearing aid users in a meaningful way as it related to their outcomes. By analyzing the patient’s natural language, the clinician can obtain clinically relevant, yet patient-centered information to predict the hearing aid uptake, usage, benefit, and satisfaction and thus adjust the treatment plan to be more patient-specific.

Study Lead: Ilze Oosthuizen

Much of the knowledge developed about hearing aid use experience as well as benefit and satisfaction are generated via small scale studies from the academics and hearing aid industry partners. Although a few large-scale studies that exists (i.e., MarkeTrak, EuroTrak), they are cross-sectional in nature. Often there is 1-2 years lag behind the research data that is generated, i.e., research has not kept in pace with the technology turnaround time for hearing aids. Moreover, there is seems to be inadequate research into the range of factors that could potentially contribute to hearing aid experience and outcome. In order to address these issues, we propose to develop a large-scale longitudinal hearing aid panel (n>1,000) in collaboration with Hearing Tracker. The panel will include a wide range of participants in the following groups:

Group 1 – Noticing hearing problems with no hearing test;

Group 2 – Hearing loss confirmed by a hearing healthcare professional, but no hearing device(s);

Group 3 – Hearing loss confirmed and using some type of hearing device(s); and

Group 4 – Past hearing aid user but no longer using hearing device(s).

This panel aims to conduct both cross-sectional as well as longitudinal studies about various aspects of hearing aids as it relates to user experience and hearing aid outcomes. Overall, this study examines the audiological and non-audiological factors influencing the hearing help-seeking, hearing aid uptake, hearing aid use, and hearing aid outcome (benefit and satisfaction).

Study Lead: Vinaya Manchaiah

Online reviews from consumers often serve as sources of independent knowledge for others who are looking into making purchases, including hearing aids. The textual response of hearing aid consumer reviews can provide insights into the lived experiences of adult hearing aid owners regarding their acquisition and use of hearing aids, as well as users’ decision-making process and the elements that contribute to the benefits and challenges of hearing aids. We used a variety of NLP approaches to analyze consumer hearing aid reviews from the Hearing Tracker website, and report the consumer experience of hearing aid acquisition and ownership as described in our recent publications (Bennett et al., 2021 IJA; Manchaiah et al., AJA).

Study Lead: Vinaya Manchaiah

Modern hearing aids have various features and functionalities, such as digital wireless streaming, bilateral connectivity, rechargeability, and specialized programs, which allow for a multitude of hearing aid attributes (e.g., comfort, reliability, clarity). Consumers likely vary greatly in their preferences for these hearing aid attributes. Their preferences might be related to various demographic and hearing loss characteristics. The purposes of this study is to examine which hearing aid attributes consumers find desirable when choosing their hearing aids and to explore factors that might predict preferences (Manchaiah et al., 2021 JAAA).

Study Lead: Vinaya Manchaiah

Hearing aid benefit and satisfaction are two separate but related constructs. Hearing aid benefit is defined as improvements in hearing function and communication ability as a result of hearing aid use, whereas hearing aid satisfaction, is defined as a pleasurable emotional experience as an outcome of an evaluation of performance. Although some determinants of hearing aid benefit and satisfaction have been identified, there continues to be significant unexplained variability in these outcomes among existing hearing aid users. To better understand the factors contributing to this variability, it might be helpful to examine the perspectives of a large sample of hearing aid users. The current study examines the relation between hearing aid preferences, benefit and satisfaction from consumer surveys and use advanced statistical techniques to model the relationships between hearing aid benefit, satisfaction, audiologic factors, and demographic factors.

 Study Lead: Vinaya Manchaiah