Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary

Betty S. Tsai Do; Matthew L. Bush; Heather M. Weinreich; Seth R. Schwartz; Samantha Anne; Oliver F. Adunka; Kaye Bender; Kristen M. Bold; Michael J. Brenner; Ardeshir Z. Hashmi; Ana H. Kim; Teresa A. Keenan; Denée J. Moore; Carrie L. Nieman; Catherine V. Palmer; Erin J. Ross; Kristen K. Steenerson; Kevin Y. Zhan; Joe Reyes; Nui Dhepyasuwan

doi:10.1002/ohn.749

Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary

Betty S. Tsai Do^*, Matthew L. Bush, Heather M. Weinreich, Seth R. Schwartz, Samantha Anne, Oliver F. Adunka, Kaye Bender, Kristen M. Bold, Michael J. Brenner, Ardeshir Z. Hashmi, Ana H. Kim, Teresa A. Keenan, Denée J. Moore, Carrie L. Nieman, Catherine V. Palmer, Erin J. Ross, Kristen K. Steenerson, Kevin Y. Zhan, Joe Reyes, Nui Dhepyasuwan

^*Corresponding author for this work

Otolaryngology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. Purpose: The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with an explanation of the support in the literature, the evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the Guideline Development Group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. Action Statements: The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life. (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related quality of life at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.

Original language	English (US)
Pages (from-to)	1209-1227
Number of pages	19
Journal	Otolaryngology - Head and Neck Surgery (United States)
Volume	170
Issue number	5
DOIs	https://doi.org/10.1002/ohn.749
State	Published - May 2024

Funding

Betty S. Tsai Do: AAO\u2010HNS/F Practice Management, Education Committee Chair, Education Steering Committee. Matthew L. Bush: AAO\u2010HNS/F Hearing Committee, Telemedicine Committee, Journal Editorial Board/Reviewer/Author, Research Funding (Advanced Bionics), Consultant\u2014Travel Fees Only (Stryker), Advisory Board (Med El). Heather M. Weinreich: AAO\u2010HNS/F Patient Safety and Quality Improvement Committee. Seth R. Schwartz: Key AAO\u2010HNS/F leader. Samantha Anne: AAO\u2010HNS/F Board of Governors\u2014Governance and Society Engagement Committee Vice Chair, Implantable Hearing Devices Committee, Nominating Committee, Journal Editorial Board/Reviewer/Author, Royalty (Plural Publishing royalties). Oliver F. Adunka: AAO\u2010HNS/F Otology and Neurotology Education Committee, Hearing Committee, Journal Editorial Board/Reviewer/Author, CME, Planner/Faculty/Author/Reviewer, Royalty (Advanced Bionics Inc), Consulting Fee (Advanced Bionics, MED\u2010EL Corporation), Intellectual Property Rights (Advanced Cochlear Diagnostics). Michael J. Brenner: AAO\u2010HNS/F Outcomes Research and Evidence\u2010Based Medicine Committee Chair, Nominating Committee, Annual Meeting Planning Committee, Medical Drug and Device Committee, Journal Editorial Board/Reviewer/Author, CME, Planner/Faculty/Author/Reviewer, Centralized Otolaryngology Research Efforts Chair, Research funding (Unrestricted Educational Grant\u2014Medtronic, AAO\u2010HNS/F CORE Grants, University of Michigan Research Innovation Grant). Ardeshir Z. Hashmi: Consulting Fee (Cognivue Inc Advisory Board, AI Based Cognitive Assessment Device). Ana H. Kim: Research funding (Advanced Bionic research funding for Single sided deafness research), Medical Consultant for Advanced Bionic. Carrie L. Nieman: AAO\u2010HNS/F Diversity Committee, Employee of Johns Hopkins School of Medicine, Volunteer member of the Board of Directors for the nonprofit Hearing Loss Association of America, Co\u2010founder and Volunteer Member of the Board of Directors of the nonprofit Access HEARS. Johns Hopkins received grant funding for research from the National Institutes of Health. Catherine V. Palmer: Consulting Fee (Thieme Publisher, NBME). Kristen K. Steenerson, MD: Consulting Fee (Medical\u2010legal independent consulting), Honoraria (Otolith), Stock or Stock Options (Neuro\u2010Sync, Otolith). Joe Reyes: AAO\u2010HNSF staff. Nui Dhepyasuwan: AAO\u2010HNSF staff.

Keywords

age-related hearing loss
amplification
cochlear implantation
presbycusis
sensorineural hearing loss

ASJC Scopus subject areas

Surgery
Otorhinolaryngology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1002/ohn.749

Cite this

Tsai Do, B. S., Bush, M. L., Weinreich, H. M., Schwartz, S. R., Anne, S., Adunka, O. F., Bender, K., Bold, K. M., Brenner, M. J., Hashmi, A. Z., Kim, A. H., Keenan, T. A., Moore, D. J., Nieman, C. L., Palmer, C. V., Ross, E. J., Steenerson, K. K., Zhan, K. Y., Reyes, J., & Dhepyasuwan, N. (2024). Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary. Otolaryngology - Head and Neck Surgery (United States), 170(5), 1209-1227. https://doi.org/10.1002/ohn.749

@article{68e5e39e1711499983a443ccee9de310,

title = "Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary",

abstract = "Objective: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. Purpose: The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with an explanation of the support in the literature, the evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the Guideline Development Group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. Action Statements: The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life. (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related quality of life at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.",

keywords = "age-related hearing loss, amplification, cochlear implantation, presbycusis, sensorineural hearing loss",

author = "{Tsai Do}, {Betty S.} and Bush, {Matthew L.} and Weinreich, {Heather M.} and Schwartz, {Seth R.} and Samantha Anne and Adunka, {Oliver F.} and Kaye Bender and Bold, {Kristen M.} and Brenner, {Michael J.} and Hashmi, {Ardeshir Z.} and Kim, {Ana H.} and Keenan, {Teresa A.} and Moore, {Den{\'e}e J.} and Nieman, {Carrie L.} and Palmer, {Catherine V.} and Ross, {Erin J.} and Steenerson, {Kristen K.} and Zhan, {Kevin Y.} and Joe Reyes and Nui Dhepyasuwan",

note = "Publisher Copyright: {\textcopyright} 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.",

year = "2024",

month = may,

doi = "10.1002/ohn.749",

language = "English (US)",

volume = "170",

pages = "1209--1227",

journal = "Otolaryngology - Head and Neck Surgery (United States)",

issn = "0194-5998",

publisher = "Mosby Inc.",

number = "5",

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Tsai Do, BS, Bush, ML, Weinreich, HM, Schwartz, SR, Anne, S, Adunka, OF, Bender, K, Bold, KM, Brenner, MJ, Hashmi, AZ, Kim, AH, Keenan, TA, Moore, DJ, Nieman, CL, Palmer, CV, Ross, EJ, Steenerson, KK, Zhan, KY, Reyes, J & Dhepyasuwan, N 2024, 'Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary', Otolaryngology - Head and Neck Surgery (United States), vol. 170, no. 5, pp. 1209-1227. https://doi.org/10.1002/ohn.749

TY - JOUR

T1 - Clinical Practice Guideline

T2 - Age-Related Hearing Loss Executive Summary

AU - Tsai Do, Betty S.

AU - Bush, Matthew L.

AU - Weinreich, Heather M.

AU - Schwartz, Seth R.

AU - Anne, Samantha

AU - Adunka, Oliver F.

AU - Bender, Kaye

AU - Bold, Kristen M.

AU - Brenner, Michael J.

AU - Hashmi, Ardeshir Z.

AU - Kim, Ana H.

AU - Keenan, Teresa A.

AU - Moore, Denée J.

AU - Nieman, Carrie L.

AU - Palmer, Catherine V.

AU - Ross, Erin J.

AU - Steenerson, Kristen K.

AU - Zhan, Kevin Y.

AU - Reyes, Joe

AU - Dhepyasuwan, Nui

PY - 2024/5

Y1 - 2024/5

N2 - Objective: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. Purpose: The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with an explanation of the support in the literature, the evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the Guideline Development Group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. Action Statements: The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life. (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related quality of life at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.

AB - Objective: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. Purpose: The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with an explanation of the support in the literature, the evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the Guideline Development Group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. Action Statements: The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life. (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related quality of life at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.

KW - age-related hearing loss

KW - amplification

KW - cochlear implantation

KW - presbycusis

KW - sensorineural hearing loss

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Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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