New Research From the BHI (Part 1)New Research From the BHI (Part 1)Best Practices = Good Outcomes Best Practices = Good Outcomes

Sergei Kochkin, PhD.Sergei Kochkin, PhD.

AgendaAgenda

• Detailed look at the impact of the audiologist Detailed look at the impact of the audiologist on hearing aid user success (4/2010 HR).on hearing aid user success (4/2010 HR).– Updated with new data on benefit and Updated with new data on benefit and

quality of life changes associated with quality of life changes associated with hearing aid usage (6/2011 HJ)hearing aid usage (6/2011 HJ)

• First summarize MarkeTrak VIII trends:First summarize MarkeTrak VIII trends:– 25 year trends in the hearing health market 25 year trends in the hearing health market

(10/2009 HR)(10/2009 HR) – Customer satisfaction with hearing aids Customer satisfaction with hearing aids

(1/2010 HJ)(1/2010 HJ)

2

25 Year Trends in The Hearing Aid 25 Year Trends in The Hearing Aid MarketMarket

October 2009 October 2009

Hearing ReviewHearing Review

Are we really on the fast track?Are we really on the fast track?

• Original cover for Original cover for the first MarkeTrak the first MarkeTrak VIII publicationVIII publication

• Changed to Changed to “Headed for the “Headed for the Fast Track?”Fast Track?”

4

Led to funny editorialLed to funny editorial“…or Slow Train Coming?” “…or Slow Train Coming?”

and some alternate titlesand some alternate titles• Are we on the right track? Are we on the right track? • Are we on the track at all? Are we on the track at all? • Are we headed for derailment? Are we headed for derailment? • Throw Mama on the train! Throw Mama on the train! • Why isn't there anyone under 70 on this train? Why isn't there anyone under 70 on this train? • The train has left the station leaving behind three-quarters The train has left the station leaving behind three-quarters

of its passengers of its passengers • People are in denial about their need to get on the train; it People are in denial about their need to get on the train; it

takes them 3 to 8 years just to get aboard takes them 3 to 8 years just to get aboard • Why are train rides so expensive? Why can't we deduct Why are train rides so expensive? Why can't we deduct

them from our taxes? them from our taxes? • Some still believe the train is too big and noisy—and the Some still believe the train is too big and noisy—and the

whistle drives them crazy! whistle drives them crazy! • My family doctor told me trains don't work My family doctor told me trains don't work • One of my friends told me that the train ride stinks One of my friends told me that the train ride stinks 5

MarkeTrak MethodologyMarkeTrak Methodology

MethodMethod• National family opinion panelNational family opinion panel

– 80,000 households 80,000 households – Balanced to 9 key census variablesBalanced to 9 key census variables– Used since 1984 starting with HIA survey.Used since 1984 starting with HIA survey.– Does not include institutional settings.Does not include institutional settings.

• Screening questions–Phase I(11-12 /2008)Screening questions–Phase I(11-12 /2008)– Hearing lossHearing loss– Hearing aidsHearing aids– TinnitusTinnitus– Physician screening for hearing lossPhysician screening for hearing loss– Detailed employment status beyond NFO panel dataDetailed employment status beyond NFO panel data– Traffic accident dataTraffic accident data

7

MethodMethod

• Screening survey:Screening survey:– Returns – 46,843 householdsReturns – 46,843 households– Identified 14,623 people with hearing loss and or Identified 14,623 people with hearing loss and or

tinnitustinnitus– Response rate: 59%Response rate: 59%

• Detailed survey - Phase II (1/2009)Detailed survey - Phase II (1/2009)– 7 page legal size survey7 page legal size survey– 3,779 hearing aid owners (total population)3,779 hearing aid owners (total population)– 5,500 adult non-owners (random sample)5,500 adult non-owners (random sample)– Response rate 84% & 79% respectivelyResponse rate 84% & 79% respectively– $1 incentive $1 incentive

8

The Hearing Loss PopulationThe Hearing Loss Population

Incidence of hearing loss per thousand householdsIncidence of hearing loss per thousand householdsThere is no hearing loss epidemic only the aging of There is no hearing loss epidemic only the aging of

AmericaAmerica

10

For more than a generation the incidence For more than a generation the incidence of HL has been about one in 10 peopleof HL has been about one in 10 people

HIA*

* Adjusted by +.7% to account for multiple hearing-impaired per household11

Key HL population dataKey HL population data

• Incidence of HL in U.S. population = 11.3%Incidence of HL in U.S. population = 11.3%– Up from 10.7% (2004)Up from 10.7% (2004)

• Admitted HL population = 34.25 million peopleAdmitted HL population = 34.25 million people– Up from 31.5 million people (2004)Up from 31.5 million people (2004)

• 6 out of 10 are male6 out of 10 are male• 60% are below retirement age60% are below retirement age

12

The Hearing Aid MarketThe Hearing Aid Market

Key hearing aid owner population dataKey hearing aid owner population data

• Current hearing aid owners = 8.41 million Current hearing aid owners = 8.41 million peoplepeople

• Up from 7.8 million (2004)Up from 7.8 million (2004)

• HA adoption now 24.6% primarily due to VA HA adoption now 24.6% primarily due to VA and direct mail growth.and direct mail growth.

14

Hearing aid adoption rates are now in 1 in 4 people Hearing aid adoption rates are now in 1 in 4 people with admitted hearing losswith admitted hearing loss

Growth primarily VA and direct mailGrowth primarily VA and direct mail

15

What’s the REAL market for hearing aids?What’s the REAL market for hearing aids?

• Used subjective measures to segment Used subjective measures to segment marketmarket– Number of ears impairedNumber of ears impaired– Subjective view of HLSubjective view of HL– Gallaudet scaleGallaudet scale– BHI quick hearing check BHI quick hearing check (based on revised AAO-(based on revised AAO-

HNS 5 minute hearing loss screener)HNS 5 minute hearing loss screener)– Difficulty hearing in noiseDifficulty hearing in noise

• Created single HL index (factor analysis)Created single HL index (factor analysis)• Divided total HL population into 10% HL Divided total HL population into 10% HL

segments called decilessegments called deciles– Decile 1 = Lower 10% of HL – mildDecile 1 = Lower 10% of HL – mild– Decile 10 – Top 10% of HL – severe to profoundDecile 10 – Top 10% of HL – severe to profound

16

Hearing aid adoption heavily dependent Hearing aid adoption heavily dependent on degree of hearing losson degree of hearing loss

Decile 5-10=

83% hearing aid owners

43% non-adopters

17

Hearing aid opportunity by age group. Hearing aid opportunity by age group. The viable hearing aid market in the U.S. is about 11 million The viable hearing aid market in the U.S. is about 11 million

more people with untreated hearing lossmore people with untreated hearing loss

Deciles 5-10=6.98 Mil. HA owners11.1 Mil. non-adopters

18

Hearing aid adoption rates redefinedHearing aid adoption rates redefined

• One in four people with admitted One in four people with admitted hearing loss hearing loss ownown hearing aids. hearing aids.

• 40% of people with moderate to severe 40% of people with moderate to severe hearing losshearing loss

• 9% of people with milder hearing losses9% of people with milder hearing losses

19

We are at the right place at the right timeWe are at the right place at the right time

• The hearing loss population is growing at the The hearing loss population is growing at the rate of 1.6 times the general population rate of 1.6 times the general population growth– primarily aging population.growth– primarily aging population.

• Digital technology and the supporting Digital technology and the supporting software is superb – and it will get better.software is superb – and it will get better.

• We have the capability of meeting the needs We have the capability of meeting the needs of the vast majority of people with hearing of the vast majority of people with hearing loss.loss.

20

So why are we on a such So why are we on a such a slow moving train?a slow moving train?

• Explore customer satisfaction with Explore customer satisfaction with hearing aidshearing aids

• Explore audiologist’s role in user Explore audiologist’s role in user successsuccess

21

Customer Satisfaction with Customer Satisfaction with Hearing Aids 2008Hearing Aids 2008

January 2010 January 2010

Hearing JournalHearing Journal

Key HA satisfaction measuresKey HA satisfaction measures

23

Satisfied & very satisfied customers have not Satisfied & very satisfied customers have not grown during the digital revolutiongrown during the digital revolution

24

Dissatisfaction has dropped to 14% but….Dissatisfaction has dropped to 14% but…. 8% of new hearing aids are in the drawer 8% of new hearing aids are in the drawer

25

Hearing aids in the drawerHearing aids in the drawer• Varied between 11.7% and 17.9% Varied between 11.7% and 17.9%

historically.historically.• More than half are <= 5 years of ageMore than half are <= 5 years of age• Current rate: 12.4%Current rate: 12.4%

– New hearing aids (</=4 years) : 7.5%New hearing aids (</=4 years) : 7.5%– Brand new HA: 5.2%Brand new HA: 5.2%

• 1,040,000 customers never use their 1,040,000 customers never use their hearing aids.hearing aids.

• Why do so many people spend $2000-Why do so many people spend $2000-$6000 for a product that does not meet $6000 for a product that does not meet their needs?their needs?

26

30% of new user fittings are 30% of new user fittings are probable failuresprobable failures

27

Causes for hearing aids in drawerCauses for hearing aids in drawer

• Poor benefitPoor benefit

• Poor fit and comfort Poor fit and comfort

• Poor performance in noisePoor performance in noise

28

Majority of patients will not repurchase Majority of patients will not repurchase current brand of hearing aidcurrent brand of hearing aid

29

Customer satisfaction with hearing aid Customer satisfaction with hearing aid signal processing and sound qualitysignal processing and sound quality

hearing aids are <= 4 years old.hearing aids are <= 4 years old.

30

Customer satisfaction with hearing aids in Customer satisfaction with hearing aids in various listening situations various listening situations

hearing aids are <= 4 years old.hearing aids are <= 4 years old.

31

Customer satisfaction with hearing aids in Customer satisfaction with hearing aids in various listening situations (continued) various listening situations (continued)

hearing aids are <= 4 years old.hearing aids are <= 4 years old.

32

Hearing aid multiple environment listening Hearing aid multiple environment listening utility (MELU) is not impressive.utility (MELU) is not impressive.

33

Multiple environment listening utility (MELU) is highly Multiple environment listening utility (MELU) is highly related to brand repurchase and positive word of mouth related to brand repurchase and positive word of mouth

advertising.advertising.

34

Satisfaction with benefit is highly dependent on the Satisfaction with benefit is highly dependent on the number of listening situations hearing aids worknumber of listening situations hearing aids work

…and Somewhat satisfied is hardly an endorsement…and Somewhat satisfied is hardly an endorsement

35

Changes since MarkeTrak VII (2004)Changes since MarkeTrak VII (2004)

• Practical Practical (at least 5% point increase)(at least 5% point increase) and and statistically significant improvements (p<.001 statistically significant improvements (p<.001 or better):or better):– Whistling and feedback (12% points)Whistling and feedback (12% points)– Sound of chewing and swallowing (9% Sound of chewing and swallowing (9%

points)points)– Wind noise (7% points)Wind noise (7% points)– Use in noisy situations (7% points)Use in noisy situations (7% points)– Comfort with loud sounds (5% points)Comfort with loud sounds (5% points)

36

The Impact of the Audiologist on The Impact of the Audiologist on Hearing Aid User SuccessHearing Aid User Success

Co-authorsSergei Kochkin, PhD (BHI)Douglas L. Beck, AuD (Oticon)Laurel A. Christensen, PhD (GN ReSound)Cynthia Compton-Conley (Gallaudet U)Brian J. Fligor, ScD (Harvard)Pat B. Kricos, PhD (U of Florida)Jay McSpaden, PhD (Retired audiologist - Oregon)H. Gustav Mueller, PhD (Vanderbilt)Michael Nilsson, PhD (Sonic Innovations)Jerry Northern, PhD (Starkey)Thomas A. Powers, PhD (Siemens)Robert W. Sweetow, PhD (U of C)Brian Taylor, AuD (Unitron)Robert G. Turner, PhD (LSU)ReviewersHarvey B. Abrams, PhD (VA)Ruth Bentler, PhD (U of Iowa)Vic S. Gladstone, PhD (ASHA)Larry Humes, PhD (Indiana U)Michael Valente, PhD (Washington U)

37

THESIS THESIS Audiologist has Direct Control Over Hearing Audiologist has Direct Control Over Hearing

Aid User SuccessAid User Success• Hearing aid quality control prior to fitHearing aid quality control prior to fit• Fit and comfort of hearing aidFit and comfort of hearing aid• VerificationVerification• ValidationValidation• Optimal amplification within the residual auditory Optimal amplification within the residual auditory

area of the consumer given current technology & area of the consumer given current technology & softwaresoftware

• Vast array of counseling toolsVast array of counseling tools• Measureable BENEFIT GUARANTEEMeasureable BENEFIT GUARANTEE

Best Practices Benefit Life Changes

38

MethodMethod

• Measured 17 items of the hearing aid fitting Measured 17 items of the hearing aid fitting protocol. protocol.

• Measured 7 real-world success measuresMeasured 7 real-world success measures• Related use of protocol items to real-world Related use of protocol items to real-world

success.success.• Related total weighted protocol to successRelated total weighted protocol to success• Related unweighted protocol to success (e.g. Related unweighted protocol to success (e.g.

simple counting of steps performed)simple counting of steps performed)

39

Protocol items measuredProtocol items measured• Hearing tested in sound boothHearing tested in sound booth• Real ear measurement verificationReal ear measurement verification• Subjective benefit measurementSubjective benefit measurement• Objective benefit measurementObjective benefit measurement• Patient satisfaction measurementPatient satisfaction measurement• Loudness discomfort measurementLoudness discomfort measurement• Auditory retraining software therapyAuditory retraining software therapy• Aural rehabilitation groupAural rehabilitation group• Received self-help bookReceived self-help book• Received self-help videoReceived self-help video• Referred to self-help groupReferred to self-help group

40

Protocol items measuredProtocol items measured• Fit and comfortFit and comfort of the hearing aid of the hearing aid (single Likert (single Likert

scale item)scale item)• Achieved sound quality : Achieved sound quality :

– clearness of tone/soundclearness of tone/sound– whistling and feedbackwhistling and feedback– use in noisy situationsuse in noisy situations– natural soundingnatural sounding– sound of voicesound of voice– ability to hear soft soundsability to hear soft sounds– comfort with loud sounds comfort with loud sounds – single index from Factor analysis. Proxy for:single index from Factor analysis. Proxy for:

• Optimal amplification of residual auditory area of Optimal amplification of residual auditory area of patientpatient

• Functionality of hearing aid (quality control pre-fit)Functionality of hearing aid (quality control pre-fit)41

Protocol items measuredProtocol items measured• Attributes of the audiologistAttributes of the audiologist: :

– knowledge knowledge – professionalismprofessionalism– empathyempathy– creation of realistic expectationscreation of realistic expectations– explained care and maintenance of hearing aidsexplained care and maintenance of hearing aids– quality of service during the fitting processquality of service during the fitting process– quality of service after the hearing aid fittingquality of service after the hearing aid fitting– all measured on a 7 point Likert scaleall measured on a 7 point Likert scale– single index from Factor analysissingle index from Factor analysis

42

Protocol items measuredProtocol items measured• Attributes of the hearing healthcare Attributes of the hearing healthcare

officeoffice: : – front office stafffront office staff– hours of operationhours of operation– attractiveness and comfort of the officeattractiveness and comfort of the office– ease of access to the officeease of access to the office– convenient location convenient location – all measured on a 7 point Likert scaleall measured on a 7 point Likert scale– single index from Factor analysis.single index from Factor analysis.

43

Protocol items measuredProtocol items measured• Counseling:Counseling:

– the amount of time spent in hours the amount of time spent in hours explaining care and maintenance of the explaining care and maintenance of the hearing aids and hearing aids and

– the hours spent in aural rehabilitationthe hours spent in aural rehabilitation– total counseling hours spent in the first 2 total counseling hours spent in the first 2

months of the new hearing aid fitting.months of the new hearing aid fitting.

• The The number of visitsnumber of visits to get the to get the hearing aid working just right for the hearing aid working just right for the patient.patient.

44

Success measuresSuccess measures• Hearing aids in the drawer and hearing aid Hearing aids in the drawer and hearing aid

usage in hours.usage in hours.• Benefit. Benefit.

– Satisfaction with benefit (7 point Likert scale)Satisfaction with benefit (7 point Likert scale)– Perception of % hearing handicap reduction in Perception of % hearing handicap reduction in

10 listening situations. 10 listening situations. – Multiple Environmental Listening Utility (MELU). Multiple Environmental Listening Utility (MELU).

The percent of 19 listening situations in which The percent of 19 listening situations in which the patient was satisfied or very satisfied.the patient was satisfied or very satisfied.

• Quantified Client Oriented Scale of Improvement Quantified Client Oriented Scale of Improvement (COSI) measure.(COSI) measure.

• Only situations for which patient had need to hear.Only situations for which patient had need to hear.45

Success measuresSuccess measures• Patient recommendations Patient recommendations

– Would recommend the audiologistWould recommend the audiologist– Would recommend hearing aids to friendsWould recommend hearing aids to friends– Would repurchase current hearing aid brandWould repurchase current hearing aid brand

• Overall success. Overall success. – A composite measure of success derived from A composite measure of success derived from

factor analyzing the above variablesfactor analyzing the above variables– Converting to factor scores and standardizing to Converting to factor scores and standardizing to

a mean of 5 and standard deviation of 2 (stanine a mean of 5 and standard deviation of 2 (stanine scores).scores).

46

Consumer perceptions of hearing aid fitting Consumer perceptions of hearing aid fitting protocol received comparing new and protocol received comparing new and

experienced users.experienced users.

47

Summary of statistically significant relationships between Summary of statistically significant relationships between outcome measures and protocol items for new and outcome measures and protocol items for new and

experienced usersexperienced users

48

High-low analysisHigh-low analysis

• Compare patients experiencing below Compare patients experiencing below average (-1 std) and above average (+1 average (-1 std) and above average (+1 std) real-world std) real-world successsuccess..

• Let’s look at the patients’ experience Let’s look at the patients’ experience during the hearing aid fitting during the hearing aid fitting process!process!

49

A comparison of above average (+1 std) and below average (-1 std) A comparison of above average (+1 std) and below average (-1 std) hearing aid successhearing aid success as measured by subjective real-world outcomes as measured by subjective real-world outcomes

showing protocol received based on consumer perceptions.showing protocol received based on consumer perceptions.

50

A comparison of above average (+1 std) and below average (-1 std) A comparison of above average (+1 std) and below average (-1 std) hearing aid success as measured by subjective real-world outcomes hearing aid success as measured by subjective real-world outcomes

showing protocol received based on patient perceptions.showing protocol received based on patient perceptions.

51

A comparison of above average (+1 std) and below average (-1 std) A comparison of above average (+1 std) and below average (-1 std) hearing aid success as measured by subjective real-world outcomes hearing aid success as measured by subjective real-world outcomes

showing protocol received based on patient perceptions.showing protocol received based on patient perceptions.

52

A comparison of above average (+1 std) and below average (-1 std) A comparison of above average (+1 std) and below average (-1 std) hearing aid successhearing aid success as measured by subjective real-world outcomes as measured by subjective real-world outcomes

showing protocol received based on consumer perceptions.showing protocol received based on consumer perceptions.

<--------Dispenser Attributes ------- > <-------- Office Attributes ------- >

53

A comparison of above average (+1 std) and below average (-1 std) A comparison of above average (+1 std) and below average (-1 std) hearing aid successhearing aid success as measured by subjective real-world outcomes as measured by subjective real-world outcomes

showing protocol received based on consumer perceptions.showing protocol received based on consumer perceptions.

54

High-low analysis #2High-low analysis #2

• Use high/low difference scores from Use high/low difference scores from past analysis to weight protocol past analysis to weight protocol received.received.

• Sum weighted scoresSum weighted scores• Compare top and bottom 15% weighted Compare top and bottom 15% weighted

protocol scores.protocol scores.• Now let’s look at the patients’ real Now let’s look at the patients’ real

world outcome!world outcome!

55

Impact of Best Practices on Consumer Success Impact of Best Practices on Consumer Success Comparison = bottom and top 15% of Best PracticesComparison = bottom and top 15% of Best Practices

56

Total hearing aid user success achieved as a function of a Total hearing aid user success achieved as a function of a weighted fitting protocol (in stanines, n=1,613)weighted fitting protocol (in stanines, n=1,613)

Correlation = .70Correlation = .70

57

Other findingsOther findings• Factors explaining less than 1% of variance in the Factors explaining less than 1% of variance in the

hearing aid fitting protocol:hearing aid fitting protocol:– Age of the patientAge of the patient– GenderGender– User User (new versus experienced)(new versus experienced)– Size of city Size of city (rural to metropolitan)(rural to metropolitan)– Price of hearing aidPrice of hearing aid– Style of hearing aidStyle of hearing aid– Degree of hearing lossDegree of hearing loss

• Occupation of person Occupation of person (Audiologist/HIS)(Audiologist/HIS) fitting hearing fitting hearing aid explained < ½ of 1% of the protocol used OR aid explained < ½ of 1% of the protocol used OR real-world hearing aid user success. real-world hearing aid user success. – Confirmed by the Hearing Industry Association Consumer Confirmed by the Hearing Industry Association Consumer

Journey Study.Journey Study.– Audiologists and HISs are equivalent in both protocol and Audiologists and HISs are equivalent in both protocol and

ability to generate successful hearing aid users.ability to generate successful hearing aid users.58

ConclusionsConclusions• What occurred in HHP offices has a very What occurred in HHP offices has a very

strong relationship to real-world success.strong relationship to real-world success.• Evidence that a weighted protocol is better Evidence that a weighted protocol is better

predictor of success then simple count of predictor of success then simple count of steps performed.steps performed.

• Variability of protocols performed and the Variability of protocols performed and the distribution of patient success is massive in distribution of patient success is massive in America.America.

• Consumer ReportsConsumer Reports estimates in a small scale estimates in a small scale study that 2 out of 3 hearing aids are misfit.study that 2 out of 3 hearing aids are misfit.

• Anecdotal reports from expert fitters indicate Anecdotal reports from expert fitters indicate that many NEW hearing aids brought in to that many NEW hearing aids brought in to their practice were programmed incorrectly.their practice were programmed incorrectly.

59

Quality control at the point of sale is Quality control at the point of sale is critical to user success & industry growthcritical to user success & industry growth

• Not all consumers are tested in a sound booth.Not all consumers are tested in a sound booth.• Many hearing aids are not tested for functionality prior to Many hearing aids are not tested for functionality prior to

the fitting.the fitting.• The majority of audiologists fail to verify the hearing aid The majority of audiologists fail to verify the hearing aid

fitting with REM.fitting with REM.– Considered by the industry intelligentsia to be Considered by the industry intelligentsia to be

unethical and unprofessionalunethical and unprofessional• Many audiologists do not validate the fitting pre/post with Many audiologists do not validate the fitting pre/post with

objective or subjective benefit measures.objective or subjective benefit measures.– ““We just don’t want to know” We just don’t want to know” (Ignorance is bliss!)(Ignorance is bliss!)– ““What should we do if we can’t find benefit – refund What should we do if we can’t find benefit – refund

the customers money”? the customers money”? (greed and unethical)(greed and unethical)• Ultimately we take the short term sale and sacrifice the Ultimately we take the short term sale and sacrifice the

long term growth and our reputation in our community.long term growth and our reputation in our community.• Aural rehabilitation is virtually non-existent.Aural rehabilitation is virtually non-existent. 60

OpportunitiesOpportunities

• Establishment and enforcement of a standardized and Establishment and enforcement of a standardized and comprehensive hearing aid fitting protocol comprehensive hearing aid fitting protocol (similar to (similar to Optometry)Optometry) with a with a measureable benefit guaranteemeasureable benefit guarantee will will result in:result in:– Massive market share shiftsMassive market share shifts– More positive word-of-mouth advertisingMore positive word-of-mouth advertising– Tapping new marketsTapping new markets– Greater brand Greater brand (hearing aid and distribution)(hearing aid and distribution) loyalty. loyalty.– Transforming the lives of many more hard of hearing Transforming the lives of many more hard of hearing

people, after all isn’t this our REAL business?people, after all isn’t this our REAL business?– And believe it or not stigma will evaporate for most And believe it or not stigma will evaporate for most

people when they achieve SUBSTANTIAL BENEFIT.people when they achieve SUBSTANTIAL BENEFIT.

• ULTIMATELY QUALITY WILL WIN!ULTIMATELY QUALITY WILL WIN!61

Benefit & Quality of Life Changes Benefit & Quality of Life Changes Associated with Hearing Aid UsageAssociated with Hearing Aid Usage

June 2011 June 2011 Hearing JournalHearing Journal

In PressIn Press

MethodMethod• Consumers rated on 0-100% scale hearing Consumers rated on 0-100% scale hearing

handicap improvement in 10 acoustic handicap improvement in 10 acoustic environments due to their hearing aids.environments due to their hearing aids.

• Consumers rated 14 QOL changes in their Consumers rated 14 QOL changes in their life due to hearing aids life due to hearing aids

• N=1,900 for hearing aids <= 4 yrs of ageN=1,900 for hearing aids <= 4 yrs of age

63

Hearing handicap improvement (%) Hearing handicap improvement (%)

Mean = 55%

64

Hearing handicap improvement (%) for the Hearing handicap improvement (%) for the U.S. population in 10 listening situations U.S. population in 10 listening situations

65

Quality of life changes attributed to hearing Quality of life changes attributed to hearing aid usage by hearing aid ownersaid usage by hearing aid owners

66

Quality of life changes attributed to hearing aid usage Quality of life changes attributed to hearing aid usage 75% of hearing aid owners experience improvement in 75% of hearing aid owners experience improvement in

at least 1 of 14 QOL issues.at least 1 of 14 QOL issues.

67

Consumer satisfaction with QOL changes attributed to Consumer satisfaction with QOL changes attributed to hearing aid usagehearing aid usage

8 of 10 people are satisfied with QOL changes in their life due 8 of 10 people are satisfied with QOL changes in their life due to hearing aids.to hearing aids.

68

Hearing handicap improvement (%) segmented by Hearing handicap improvement (%) segmented by composite best practices ranking scored in percentiles composite best practices ranking scored in percentiles

69

QOL changes attributed to hearing aids by hearing aid QOL changes attributed to hearing aids by hearing aid owners segmented by composite best practices owners segmented by composite best practices

ranking scored in percentilesranking scored in percentiles

70

Overall consumer success (mean=5, std=2) by level of Overall consumer success (mean=5, std=2) by level of composite best practices ranking scored in percentiles composite best practices ranking scored in percentiles

Highly vulnerable to disruptive technologies: over-the-counter, direct-mail and personal sound amplifierProducts (PSAP)

71

SummarySummary• The average benefit The average benefit (hearing handicap improvement)(hearing handicap improvement) achieved achieved

by patients with recent hearing aid technology is 55%.by patients with recent hearing aid technology is 55%.• The upper bounds of hearing handicap improvement may be in The upper bounds of hearing handicap improvement may be in

the 65-70% range.the 65-70% range.• Wireless revolution and inductive looping should improve this Wireless revolution and inductive looping should improve this

figure.figure.• 75% patients report at least one area of their life was improved 75% patients report at least one area of their life was improved

through wearing hearing aids.through wearing hearing aids.• 8 out of 10 hearing aid users are satisfied with the changes that 8 out of 10 hearing aid users are satisfied with the changes that

have occurred in their lives due to hearing aidshave occurred in their lives due to hearing aids• 9 out of 10 patients are projected to experience significant 9 out of 10 patients are projected to experience significant

improvements in their QOL once they experience a 70% improvements in their QOL once they experience a 70% reduction in their hearing handicap.reduction in their hearing handicap.

• Strong relationship between quality hearing healthcare, benefit Strong relationship between quality hearing healthcare, benefit and quality of life improvementsand quality of life improvements

72

New BHI Research (Part 2)New BHI Research (Part 2)

• Impact of hearing aids on income and employmentImpact of hearing aids on income and employment• Impact of mini-BTEs on the marketImpact of mini-BTEs on the market• Impact of Direct mail and PSAP on private Impact of Direct mail and PSAP on private

practicespractices• Validation of the BHI Quick Hearing Check Validation of the BHI Quick Hearing Check

– Co-author Dr. Ruth BentlerCo-author Dr. Ruth Bentler– 11,000 subjects11,000 subjects

• Thursday 4:30-5:30 pmThursday 4:30-5:30 pm

73