A study of better hearing rehabilitation in Denmark (the BEAR project)

Background: The overall vision of the project is to improve hearing rehabilitation through an evidence-based renewal of clinical practice. The structured approach comprise studies of the current practice in Denmark, considerations for new methods, experimental application and refinement of this, evaluation and implementation of the most promising renewals.

Method: The reference for existing practice is based on data for almost 2,000 patients, which have been fitted with hearing aids during 2017-2018 in two of the participating clinics. The considerations for new profiling methods are based on the analysis of prior studies incl. more diverse diagnostics than used currently. New fitting strategies are preliminarily tested using hearing-aid simulations in laboratory settings, in parallel to test trials of new aided-performance tests and paradigms for assessing user experiences in the field. These studies are all on going and will be reported in more detail in accompanying presentations. The experimental application of the novel fitting strategies is currently being planned, and will include the experimental application of the prospective strategy in real hearing aids. The refinement of novel strategies includes studies of the clinical efficiency, socio-economic trade-offs, options of out-of-clinic application, and attention to populations with low benefits. The evaluation and implementation includes proposals for future standardization, and the collection of any additional reference data for this effort.

Results: A clinical database for almost 2,000 patients has been established, which includes standard data supplemented with widely used questionnaires for the assessment of outcome. The clinical practice has been examined for tacit knowledge in validation and assessment of user outcomes. A proposal for four differing hearing profiles has been developed, and six different fitting strategies is examined for their potential. A test battery for aided listening performance has been developed.

Acknowledgements: This work was supported by Innovation Fund Denmark Grand Solutions 5164-00011B (Better hEAring Rehabilitation project), Oticon, GN Resound, Widex and other partners (University of Southern Denmark, Aalborg University, the Technical University of Denmark, Force, and Aalborg, Odense and Copenhagen University Hospitals). The funding and collaboration of all partners is sincerely acknowledged.