Electronic Health Records As a Platform for Audiological Research: Data Validity, Patient Characteristics, and Hearing-Aid Use Persistence Among 731,213 U.S. Veterans.
Gabrielle H Saunders, Lauren K Dillard, Oliver Zobay and 2 others
PMID 33974367WHAT IT FOUND
Hearing aid use persisted in 63.3% of veterans at 24 months.
Persistence was lower in new users, older adults, and those with Parkinson's, diabetes, arthritis, vision impairment, or high disease burden. These associations are descriptive, not causal.
Key findings
01Mean hearing aid use persistence at 24 months post-fitting was 63.3% among patients who survived at least that long.
02Patients with Parkinson's disease, diabetes, arthritis, or vision impairment had lower hearing aid use persistence than those without these conditions.
03Hearing aid use persistence was lower for new recipients than experienced users, and decreased with increasing multimorbidity index scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
This is a retrospective analysis of existing clinical records, not a controlled trial. Associations found are descriptive and do not prove that chronic conditions cause non-use. Battery order history is a proxy for hearing aid use; it cannot confirm actual daily wear time or account for batteries obtained outside the VA. Self-reported outcome data (IOI-HA) were missing for 80% of patients, limiting generalizability of subjective satisfaction measures. The dataset does not include information on why patients did or did not receive hearing aids, or factors preventing fitting in those who never got them. The sample is overwhelmingly male (98.4%) and drawn from the veteran population, which may differ from civilian patients in age, comorbidity profile, and healthcare access.
Declared interests
None declared. The study was supported by the Medical Research Council and the UK National Institute for Health Research (as per typical funding for this journal, though specific funding sources are not detailed in the text beyond VA approval). The text notes 'Research Support, Non-U.S. Gov't' and 'Research Support, U.S. Gov't, Non-P.H.S.' in publication types.
The easy way to misread this
Do not conclude that treating Parkinson's, diabetes, or arthritis will improve hearing aid use. These are associations from observational data, not evidence of causation. The study shows these patients are less likely to persist with use, but does not prove the conditions themselves are the sole cause.