Last week, the UK National Screening Committee (UK NSC) published the notes of its meeting on 19 November, 2015.
You’re probably thinking ‘so what’, but amongst the recommendations it made on screening for cervical cancer, bowel cancer and diabetes, they also made a recommendation in relation to screening for hearing loss in adults.
Screening for hearing loss isn’t a new thing and newborn and infant hearing screening programmes have been in existence for many years in both the USA and in the UK. They are invaluable in being able to identify those babies and children who have a hearing problem and ensure they receive appropriate treatment and support. However, there is no equivalent programme for adults, although many have argued that there is a need to introduce a screening programme in order to identify signs of age and noise related hearing loss in older adults. Hence the discussion a couple of months ago at the UK NSC.
The UK NSC have, however, concluded that:
“although hearing loss in older adults is a serious public health problem it upholds its recommendation not to offer population screening for hearing loss in adults as;
- the evidence is too limited to establish the type of screening test to be used, the severity of hearing loss to target, the age of the population to be screened and the frequency of screening.
- Uncertainty on the effectiveness of the long term use of hearing aids and on the effectiveness of additional interventions aimed at improving the duration of hearing aid use is uncertain
- The absence of RCTs-in the general population. Screening has not shown to provide any hearing related improvement in the quality of life in comparison to hearing loss identified in other ways
Whilst this is probably not a great surprise, what is disappointing is the lack of evidence they say there is around the subject of hearing loss, and gives further support to the need for more research in the field. Cochrane UK has been doing just that by supporting the development of a top ten priorities for research on mild-moderate hearing loss that I attended last Autumn, and it’s also helped by the commitment to research by Action on Hearing Loss; but no doubt the emergence of an evidence base will be slow and take some years to mature.
Another part of the Committee’s debate also caught my eye, and that was over whether or not hearing aids are an effective treatment due to the low uptake and usage amongst people, even when their hearing loss has been established.
“…many individuals once diagnosed with hearing loss had an expectation not to want to wear them and to avoid the stigma. This notion was supported by both the Cochrane and the American systematic review which both indicated that once hearing loss had been diagnosed the use of hearing aids was used infrequently and did not increase the uptake of the treatment.”
We all know that there is a stigma associated with hearing loss and it feels like we have a long way to go to reduce that. However, I’m heartened by the emergence of new technology such as the development of ‘hearables’ and the potential interest of tech companies (such as Apple) in the development of hearing aids, that may go some way to making hearing aid use as fashionable as spectacle use. This field seems to be moving fast and there also been interesting developments announced between Starkey (the global hearing technology creator) and Bragi (the new creator of innovative technology) as recently as last night.
In the meantime, we need more researchers out there taking up the challenge of adding to the evidence base on hearing screening tests, and designing campaigns that begin to destigmatize hearing loss.
Header image from “Traditional hearing aids” by Ike Valdez, CC-BY-2.0.