October 5, 2020.
National Center for Health Research’s Comments on the United States Preventive Services Task Force’s Draft Recommendation Regarding Hearing Loss Screening in Older Adults
We are writing to express our views on the United States Preventive Services Task Force’s (USPSTF) draft recommendation statement regarding hearing loss screening for older adults.
The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
We agree with the updated “I” grade recommendation, since the available evidence is insufficient to assess the benefits and harms of hearing loss screening for asymptomatic adults aged 50 years or older. Currently, there are no randomized trials or controlled observational studies that examine the potential harms of screening or treatment. Unfortunately, the benefits of early detection and treatment were largely examined among white male veterans, a group where the prevalence of hearing loss may be higher. This limits the generalizability of findings. As a result, we agree that additional research is needed with screening trials of sufficient sample size that enroll asymptomatic older adults from the general adult population and diverse subpopulations. Since a major limitation in this review was the use of different thresholds and criteria for hearing loss across studies, future studies should also use consistent definitions of hearing loss and examine hearing technology that reflect current treatment standards.
We also agree that future studies should expand their assessment of the benefits and harms of health screening to include quality of life and function, as noted in the USPSTF draft recommendation. However, we also urge that future studies examine factors such as insurance coverage and the cost of screening and hearing technology when evaluating the benefits and harms of screening on health outcomes. Screening tests and technology vary widely in terms of their convenience, complexity, and cost, and these differences can have a significant impact on patient choice and health outcomes.
The National Center for Health Research can be reached at firstname.lastname@example.org or at (202) 223-4000.