By Doris-Eva Bamiou, Giorgos Dritsakis and Louisa Murdin
Hearing aids are currently the cornerstone of hearing loss management, with rapid technological advances in this field in the last few decades. But although hearing aids are effective at improving hearing, communication and health-related quality of life, people who wear hearing aids still face several challenges. Listening in noisy environments and poor sound quality are some of the main challenges. This means that around a quarter of prescribed hearing aids end up not being used, particularly in older people. When untreated, hearing loss can lead to unemployment, depression and social isolation, and an increased risk of dementia. This has a high cost to both the person and to society. It is crucial to understand which factors may predict why people do and don’t wear their hearing aids and how effective hearing aids are. This information could help to optimise hearing aid fitting and improve the support provided to people with hearing loss.
We know from previous research that the level of hearing disability reported by the person, their age and the severity of their hearing loss are key factors that predict when and how often a person wears their hearing aids. Data that is logged and stored in hearing aids have also been used to give information about hearing-aid use and what the environment is like when people are listening through their hearing aids. However, research studies to date have been limited in terms of the amount of data that was available. New advances in technology now offer the opportunity to access and examine large and varied sets of data, known as ‘Big Data’. No study has yet collected data as it is happening (‘real-time data’) on how often and when people use their hearing aids, the environment they are using them in, and about the characteristics of the person on this Big Data scale. Studies also haven’t yet examined whether these factors are linked to the persons’ ability to hear, attention and memory, daily activities and listening effort, hearing-aid use as reported by the persons themselves, or how much they believe they benefit from their hearing aids.
Towards a holistic management of hearing loss
EVOTION is a Horizon 2020 EU-funded project which aims to collect ‘Big Data’ from hearing aid users in order to inform public health policies related to the prevention, early diagnosis, long-term treatment and rehabilitation of hearing loss. It also aims to inform policies relating to the detection and prevention of cognitive decline and to improve the inclusion of people with hearing loss within the society (including employment). To this end, the EVOTION project will develop public health decision making models as well as a technology platform that allows data to be fed into a data repository where it can be stored. This process will be supported by data collected from the EVOTION clinical study.
The EVOTION clinical study
A clinical study will start in early 2018 as part of the EVOTION project. The study will collect a big set of varied data including pre-existing hearing aid related data, and new clinical data. It will also collect real-time Big Data by using smart hearing aids, a mobile app and biosensors (wristband sensors that collect health information).
The aims of the study are to:
- Identify factors that predict hearing aid use and benefit
- Identify factors that predict temporary or permanent changes in hearing levels following noise exposure in hearing aid users
- Identify factors that predict cognitive decline
- Investigate the benefits of the person managing their hearing aid settings themselves
- Investigate the benefits of auditory training for hearing aid use and outcome
Ultimately, the data will enable the development of the EVOTION model and platform, which could be used as a tool to help public health policymaking.
What ‘Big Data’ will be collected?
- Pre-existing data collection
Existing hearing aid-logged data, including demographics, hearing loss levels, cause or duration of hearing loss, medical history and hearing aid usage data, from 35,000 hearing aid users will be extracted from existing clinical repositories in the UK (University College London Hospital and Guy’s and St Thomas’ NHS Foundation Trust) and Denmark (Oticon Ltd).
- New data collection
1260 adults who are candidates for receiving a hearing aid will be recruited from NHS clinics. They will be fitted with the EVOTION smart hearing aids. They will undergo a set of audiological and other assessments (including measures of patient-reported hearing aid benefit, mood, cognition and quality of life). Participants will also be given wearable bio-sensors (wristbands) and a smartphone with applications. These features will enable the collection of real life data about their hearing aid use in different, real-life environments and situations. It will also allow physiological data to be collected that is known to be linked with the amount of effort involved in listening (listening effort).
The hearing aid that will be used in the study is an improved research prototype based on the commercially available Oticon OPN. This device has advanced algorithms to optimise and personalize noise reduction and also enable: a) logging of hearing aid use, volume changes, intentional and automatic program shifts and sound environment measures and b) adjustment of the volume and programs via a paired Bluetooth connection and the mobile application.
The data collected will be analysed using Big Data Analytic methods to detect patterns of hearing aid use and effectiveness for different types of hearing loss, and to identify links between different factors affecting hearing aid use and benefit.
Equipment that will be given to EVOTION patients: smart hearing aids, wristband sensors and smartphone with pre-installed applications to allow the collection of Big Data.
Where and when is the study taking place?
The study will start in January 2018 and will run over 24 months across four sites:
- Royal National Throat Nose & Ear Hospital: Prof. Doris-Eva Bamiou & Dr Giorgos Dritsakis
- Guy’s and St Thomas’ NHS Foundation Trust (London): Dr Louisa Murdin & Ms Nina Koloutsou
- University of Athens: Prof. Thanos Bibas and Dr Dimitris Kikidis
- Athens Medical Centre (Athens, Greece): Prof. George Gavalas and Ms Katherine Ploumidou
Who can take part?
Adults that will be referred for a hearing aid at one of the participating clinics between February and December 2018 and will meet the study eligibility criteria can take part.
If you are a patient at one of the participating clinics and you want to take part you must:
- Be 18 years old or above
- Have a basic understanding of English/Greek
- Have mild to severe hearing loss
- Not have dementia
- Be willing to use hearing aids for at least 2 hours daily on average
- Be able to use a smartphone
If you would like more information about the EVOTION project or the clinical study, please contact the EVOTION UK clinical team:
You can also visit the EVOTION website: www.h2020evotion.eu or follow us on Twitter: @h2020evotion