Anyone for home hearing testing? And how about an NHS-provided fit-at-home hearing aid?

To make it perfectly clear, the testing in question is self-administered at home from the internet, and the fittings are do-it-yourself at home, without the usual face-to-face contact with a professional.

So, anyone? Well, yes, a majority it seems! Researchers at the University of Manchester say they have compelling evidence from a survey that UK adults are interested in giving both a go. But the survey of a nationally representative sample of more than 2000 adults randomly selected from members of the YouGov Plc UK panel is, the positive responses notwithstanding, an indicator of willing. Whether the pudding would taste as good as it looks is a matter for further study.

Nevertheless, if those who indicated a preference for an at-home testing and fitting route managed well with it in practice, opening up that route could go a long way to easing the difficulties that are a concern not only to the UK Government. Easier access to services, less waiting times, and freed-up NHS capacity to attend to cases needing more personalised attention would also reduce pressure on professionals currently suffering because of low public satisfaction and pressure from the poor NHS outcomes revealed in the uncomfortable conclusions of the Government-commissioned Darzi investigation (2024): the NHS is in a “critical condition”.

 

What percentage of those surveyed are up for carrying out their own internet-guided hearing testing?

 

 

 

 

 

The data from the survey is being prepared for a peer-reviewed journal, but the main findings are as follows:

 

• Around 65% of UK adults would be willing to conduct an NHS approved hearing test at home. Some 63% would trust the results (although 50% by only a little) if they themselves took a hearing test at home.
• The most common benefit was reported as convenience (e.g., no waiting time for an appointment and no need to travel). Perceived problems were concerns over accuracy and reliability.
• At least 65% of UK adults who feel willing/neutral about getting a hearing aid if needed would be willing to try each of the three proposed NHS pathways, with less than 10% being unwilling to try any of them.
• But, if provided with a choice, 52% of those willing to have a hearing aid if needed would choose to see an audiologist for a hearing aid fitting and 38% a fit-at-home hearing aid (27% would choose to have the NHS send them pre-set hearing aids and 12% would choose to have the NHS send them self-fit devices).

 

The researchers behind the survey – Profs. Kevin Munro and Gabrielle Saunders, both of Manchester Centre for Audiology and deafness and NIHR Manchester Biomedical Research Centre – put the results forward as compelling evidence that adults in the UK are willing to self-test their hearing at home and to try NHS-provided fit-at-home hearing aids. But they also stress that the results are “evidence that NHS Adult Hearing Services should evaluate such care pathways because: (i) this has the potential to shift care closer to home, and (ii) provide innovative pathways that are popular with the public”.

 

A government looking to be “proactive” on prevention

 

If these positive results translate into practice, the UK Government will be happy to see its urgings on innovative health solutions, such as AI-driven technology in over-the-counter hearing aids, being investigated and supported by research.

Professor Munro told Audiology Worldnews: “This sort of innovation is exactly what the DHSC is interested in so the timing could not be better. The findings indicate that the public or, at least, a good proportion of them are willing to try this move from “hospital to home” and “analogue to digital.”

“Successive governments, including the current one” continued Munro, are interested in moving from treatment to prevention (or early detection) i.e., move away from being reactive to being proactive. I imagine a future where young people take an interest in their hearing and regularly test their hearing remotely across their lifespan. That would be a positive development.”

But the Manchester-based academic also warned that there is a gap between being a willing to do and comfortably seeing something through: “It is probably naive to assume answers in a survey will accurately translate into practice,” said Munro.

“The success, or otherwise, of the pathway of home test, followed by remote hearing aid fitting, remains to be tested in those who prefer and are willing to try this route. If it is shown that many members of the public can cope with the remote testing and home-fit hearing aids (and if the outcomes are not inferior to the traditional face-to-face service), this could make access to services easier and with less waiting times, and potentially free up limited NHS capacity for those requiring the more resource-intensive face-to-face service with a hearing professional,”

The academic points out that a negative outcome in practice does not diminish the value of the survey.

“If the survey results don’t transfer into practice (e.g., few people are really willing to do the remote testing or they end up needing lots of support), this may not be the way to go. Either way, we need to know the answer. Remote testing and home-based fitting will not suit everyone but it would be helpful to know how successful it is for the people who prefer this approach,” Munro continued.

 

Reasons behind trusting home hearing testing…or perceived snags?

 

Professor Munro underlined that the survey did include a free-text question about possible benefits. “convenience, easing pressure on NHS, quick, can be repeated were the main replies,” the researcher clarified.

“There was a single question asking about perceived barriers. As might have been predicted, the main barriers/concerns were about trusting the home results e.g., are they accurate (same as hospital ones) and are they reliable (do you get the same answer if you repeat the test?).  There is a need to evaluate the tests to confirm they are accurate and reliable (some are likely better than others) and there is also an issue of the public trusting the results (or even having the opportunity to discuss them with a professional, possibly remotely),” explained Munro.

 

Caveats? And sharing the results and future research with the hearing profession and industry

 

One aspect of the survey and its results that deserves caution revolves around the concept of public trust in the provider of home tests and fittings.

Professor Munro points out: “A point that may be important to bear in mind is the public who responded to the survey were told that the remote home testing and the remote home-fit hearing aids were part of the NHS. Their responses may have been different if, for example, the public trust other providers less (or more) than the NHS.”

The research awaits publication and dissemination within the scientific community and, of course, for scrutiny by policymakers.

“In the meantime, we have already shared the main message with colleagues in BSA (British Society of Audiology), BAA (British Academy of Audiology), NHS England, and RNID (Royal National Institute for Deaf People).  Some of the leading hearing aid companies are interested in the findings and may, for example, be willing to support an NHS evaluation of the different pathways.  This could be just the sort of innovation that will be welcomed by overstretched NHS hearing professionals, but time will tell,” concluded Prof Munro.

Source: University of Manchester