by Neil Bauman, Ph.D.
© November, 2018
Perhaps you’ve noticed that you don’t hear as well as you used to. Perhaps you are getting tired of saying “pardon?” or “what?” or “say that again” because you often can’t understand the person talking to you, or have to turn your TV way up in order to hear it.
Deep down you know it’s time for you to investigate getting hearing aids to help you hear better. You are now ready to do something about your hearing loss, but you have some decisions to make.
Does the high cost of traditional hearing aids scare you off? Therefore, you want to try the much less expensive over-the-counter hearing aids that are just coming out.
Before you go out and purchase your first over-the-counter hearing aids, there is something you should do. You need to evaluate the characteristics of your hearing loss. This is because oftentimes hearing loss is, well, just hearing loss. However, other times hearing loss can indicate that you have a serious underlying medical problem that you need to treat.
So the question you face is whether you should see a medical doctor (ideally an ENT doctor) before you get hearing aids or not?
In the past, you were not allowed to purchase hearing aids for the first time unless you had seen a medical doctor, or signed a waiver that you understood that you should see a medical doctor but had chosen not to do so. Now (since December, 2016), the U.S. Food and Drug Administration (FDA) announced it would no longer enforce this medical evaluation/waiver provision for acquiring a hearing aid.
This wasn’t necessarily such a big deal because when you went to an audiologist for a complete audiological evaluation to determine which hearing aids would best help you, your audiologist typically would catch any “red flags” that indicated that you might have an underlying medical problem and recommend you see an ear specialist before proceeding.
That all changed in August, 2017 when President Trump signed into law the “Over-the-Counter Hearing Aid Act of 2017” which required the FDA to create an over-the-counter hearing aid category, “without the supervision, prescription or other order, involvement, or intervention of a licensed person”.
What this means is that you can now purchase over-the-counter hearing aids just like you can purchase a new cell phone or any other gadget that you fancy. You do not have to see either a medical doctor or an audiologist. The result? This leaves you at risk for undetected medical problems that normally a doctor or audiologist would have otherwise caught.
The thought of this left concerned hearing health care professionals in a quandary. If you don’t see a doctor or audiologist, who was going to catch those, as yet undetected, medical issues?
The result was that a multidisciplinary research team of doctors and audiologists developed the free Consumer Ear Disease Risk Assessment (CEDRA) questionnaire. The whole purpose of this questionnaire is to help identify your risk of having any diseases with ear or hearing symptoms.
This simple questionnaire actually screens for 104 different ear conditions with a relatively-high degree of accuracy. It isn’t perfect, of course, but it will catch a good number of conditions you might not otherwise be aware you have.
In its current form, CEDRA will miss 24% of the people with ear conditions taking this questionnaire, and would over-refer to ear specialists 20% of the people taking it. The good news is that if you fill out the CEDRA questionnaire, it will catch 76% of ear conditions without your having to go in for a medical exam.
The CEDRA questionnaire consists of just 15 checkbox or yes/no questions. If you are like most people, you can fill out and score this questionnaire in less than 10 minutes. The last page is your score sheet. It tells you how to score each question.
You either can fill out this questionnaire online, and it will automatically score it for you, or you can download it in PDF format, print it out, and fill it out and score it yourself.
If your score is 4 or higher, it recommends you see a doctor to make sure you don’t have any underlying health problems that are associated with hearing loss and other ear conditions .
Therefore, before you purchase your first set of hearing aids, point your browser to http://cedra.northwestern.edu or http://sites.northwestern.edu/cedra/whats-my-risk/ and fill out the questionnaire. If you score 4 or higher, make an appointment with an ear specialist (ENT doctor). However, if your score is lower than 4, then it is unlikely that you have some serious ear condition, so feel free to head to your favorite store that sells hearing aids and get your new hearing aids there.
A word of caution. You want to get hearing aids that fit your kind and degree of hearing loss. The only way to know this is to have your hearing tested/evaluated and diagrammed on an audiogram.
This is important because over-the-counter hearing aids are specifically designed for people who have the typical mild to moderate high-frequency (ski-slope) hearing loss. If you have moderately-severe or worse hearing loss, or if you have one of the other kinds of hearing losses such as a low frequency hearing loss (reverse ski slope loss), or you have a hearing loss only in the mid-frequencies (cookie bite loss), or you have a hearing loss in both the low and high frequencies, but hear mid-frequencies well (reverse cookie bite loss), you’d do well to head to your local audiologist and get traditional hearing aids that can be professionally fit to your specific kind and degree of hearing loss.
After all, you want to hear the best you can at a price you can afford.