In Reply

Letters to the Editor The Prevalence of Hearing Loss and Provision With Hearing Aids in the Gutenberg Health Study by Dr. med. Julia Döge, Dr. med. Berit Hackenberg, Dr. med. Karoline O Brien, Andrea Bohnert, Prof. Dr.-Ing. Tobias Rader, Prof. Dr. med. Dipl.-Psych. Manfred E. Beutel, Prof. Dr. med. Thomas Münzel, Prof. Dr. med. Norbert Pfeiffer, Markus Nagler, Dr. rer. physiol. Irene Schmidtmann, Prof. Dr. med. Philipp S. Wild, Prof. Dr. med. Christoph Matthias, and Dr. med. Katharina Bahr in issue 7/2023

The Gutenberg Health Study is a large cohort study in which many participants undergo diverse study center examinations on a daily basis. In case of staff shortages, whole centers remain closed on a day to day basis. The multitude and the close timing of the examinations rule out the decision in favor of well-meaning assistants running an examination, even though our correspondent has perhaps experienced such a situation.

Our study pointed out deficiencies in detecting hearing disorders (1). We wanted to sensitize not only ear, nose, and throat specialists but also general practitioners. Studies have shown that hearing disorders can be accompanied by impaired quality of life and social isolation, loneliness, and depression. In this setting, provision of hearing aids has been attested to have a positive effect (2). Furthermore, high-level evidence exists for the positive effects of hearing aids, even in mild hearing loss.

The economic costs of non-provisioned hearing loss in Germany amount to some €39bn per year according to “Hearing Loss—Number and Costs” (2019). Expenditure for hearing aids incurred by the statutory sickness funds amounted to about €900m in 2014; private expenditure was of a similar order of magnitude. At this point we wish to point out explicitly that hearing aids are prescribed only after a detailed examination by an otorhinolaryngologist or phoniatrist.

As far as the costs of hearing screenings and their utility/benefit are concerned, we point readers in the direction of a high-quality study published in Lancet Global Health (2022), which explicitly showed the health economic benefit of hearing screenings (4).

Regarding the ethical concerns around communicating a hearing disorder, opinions may well diverge. The “right not to know” is generally accepted and also communicated.

DOI: 10.3238/arztebl.m2023.0109

On behalf of the authors

Dr. Katharina Bahr-Hamm

Hals-, Nasen-, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz

Conflict of interest statement

The authors of both contributions declare that no conflict of interest exists.

References

1. Döge J, Hackenberg B, O‘Brien K, et al.: The prevalence of hearing loss and provision with hearing aids in the Gutenberg Health Study. Dtsch Arztebl Int 2023; 120: 99–106

2. Ellis S, Sheik Ali S, Ahmed W: A review of the impact of hearing interventions on social isolation and loneliness in older people with hearing loss. Eur Arch Otorhinolaryngol 2021; 278: 4653–61

3. Löhler J, Akcicek B, Wollenberg B, et al.: Umsetzung der neuen Qualitätssicherungsvereinbarung zur Hörgeräteversorgung im Praxisalltag. HNO 2014; 62: 605–12

4. Tordrup D, Smith R, Kamenov K,et al.: Global return on investment and cost-effectiveness of WHO‘s HEAR interventions for hearing loss: a modelling study. Lancet Glob Health 2022; 10: e52–e62