Economic Evaluation and Research Prioritization of Adult Hearing Screening in the US

美国成人听力筛查的经济评估和研究优先顺序

• 批准号: 10313942
• 负责人: Ethan D borre
• 金额: $ 4.6万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10313942
• 关键词: Academy; Address; Adult; Affect; Age; Aging; Area; Awareness; Caring; Clinical; Clinical Research; Cognitive; Conflict (Psychology); Costs and Benefits; Data; Decision Analysis; Decision Making; Decision Modeling; Detection; Diagnosis; Early Diagnosis; Economic Burden; Economics; Effectiveness; Elderly; Epidemiology; Evaluation; Evaluation Research; Failure; Fellowship; Frequencies; Future; Goals; Guidelines; Health; Health Policy; Health Sciences; Healthcare; Hearing; Hearing Aids; International; Intervention; Investments; Knowledge; Literature; Loneliness; Longevity; Medicine; Methods; Modality; Modeling; National Institute on Deafness and Other Communication Disorders; Natural History; Outcome; Outcomes Research; Patients; Persons; Physicians; Policies; Population; Positioning Attribute; Prevention; Psychosocial Factor; Public Health; Quality of life; Recommendation; Research; Research Personnel; Research Training; Science; Scientist; Sum; Targeted Research; Testing; Uncertainty; United States; Veterans; career; cost; cost effective; design; economic evaluation; economic outcome; economic value; effective therapy; experience; hearing impairment; hearing loss treatment; hearing screening; improved; models and simulation; novel; patient screening; policy implication; population health; randomized trial; research study; screening; screening policy; screening program; skills; systematic review; uptake; years lived with disability

PROJECT SUMMARY/ABSTRACT Hearing loss affects over 70% of US adults at some point in their lifetime and has significant effects on patient quality of life and overall health. Effective treatment for mild to moderate hearing loss includes hearing aid provision, but over 80% of adults with hearing loss do not use a hearing aid. One factor contributing to this treatment gap is lack of awareness of hearing loss and no uniform guidance around hearing screening in adults. Current guidelines on US adult hearing screening are conflicting, and overall rates of screening in the US are low despite the potential for early detection and linkage to beneficial care. This lack of uniform guidelines is in part due to the absence of sufficient quantitative evidence on the long- term clinical and economic effects of adult hearing screening strategies in the US. The proposed research seeks to address this evidence gap and has the long-term goal of helping US clinical and policy decisionmakers identify the most effective and cost-effective adult hearing screening programs for their populations. Aim 1 develops and validates a decision modeling framework of adult hearing screening, diagnosis, and treatment in the US. These modeling efforts are in conjunction with an ongoing Lancet Commission on Hearing Loss that will provide clinical and policy expert guidance and support. Aim 2 will utilize the modeling framework from Aim 1 to project clinical and economic effects of alternative adult hearing screening programs in the US. The analysis will project costs and benefits of screening interventions that vary by age at first screen, screening frequency, and screening test modality. Aim 3 will estimate the economic benefit obtained from reductions in uncertainty of model inputs that can be achieved through future research. This Aim will inform future adult hearing screening research prioritization through value of information analysis. The results of these three Aims will clarify optimal policy and investment in research targeting adult hearing screening in the US. This fellowship application is designed to prepare the PI to achieve his long-term goal of becoming an independent physician scientist using decision science to increase the value and provision of care for aging populations. Towards that long-term goal he will develop skills in advanced methods in decision science and population health sciences, maximize the policy relevance of his research, gain further clinical experiences and integrate clinical knowledge into his research, and build professional skills key to a successful career. The rigorous clinical and research training proposed will enable the PI to be well-positioned for his future career as a clinician investigator.

项目总结/摘要 听力损失影响超过70%的美国成年人在他们一生中的某个时候， 患者的生活质量和整体健康。轻度至中度听力损失的有效治疗包括听力 助听器的使用，但超过80%的成年听力损失患者不使用助听器。造成这种情况的一个因素是 治疗差距是缺乏对听力损失的认识， 成年人了目前美国成人听力筛查的指南是相互矛盾的， 尽管有早期发现的潜力和与有益护理的联系，但美国的发病率很低。 缺乏统一的指导方针，部分原因是缺乏足够的定量证据，说明长期以来， 美国成人听力筛查策略的长期临床和经济效果。拟议研究 旨在解决这一证据缺口，并有帮助美国临床和政策的长期目标 决策者确定最有效和最具成本效益的成人听力筛查计划， 人口。目的1建立并验证成人听力筛查的决策模型框架， 在美国的诊断和治疗。这些建模工作与正在进行的柳叶刀 听力损失委员会将提供临床和政策专家指导和支持。目标2将利用 目标1中的建模框架，以预测替代成人听力的临床和经济效果 美国的筛查项目。该分析将预测不同筛查干预措施的成本和收益， 根据首次筛查时的年龄、筛查频率和筛查测试方式。目标3将估计经济 通过未来的研究，可以从减少模型输入的不确定性中获得好处。 这一目标将通过信息分析的价值为未来的成人听力筛查研究提供信息。 这三个目标的结果将阐明针对成人听力研究的最佳政策和投资 在美国进行筛查。 该奖学金申请旨在为PI实现其成为一名 独立的医生科学家使用决策科学，以增加价值和提供护理老龄化 人口。为了实现这一长期目标，他将发展决策科学先进方法的技能， 人口健康科学，最大限度地提高他的研究的政策相关性，获得进一步的临床经验， 将临床知识融入他的研究中，并建立成功职业生涯的关键专业技能。的 严格的临床和研究培训建议将使PI能够为他未来的职业生涯做好准备， 临床研究者。