Editor's Message: Treating Subclinical Hearing Loss is a Business Opportunity

Author: Brian Taylor, Au.D.

Unsurprisingly, the traditional pure tone audiogram, which has been around for about 100 years, has some significant limitations when it comes to identifying individuals with hearing difficulties. Estimates vary, but it is likely that about 12% of the entire US population, a number that equates to more than 25 million people have self-reported hearing difficulties yet their audiogram is completely within the normal range.

Additionally, two recent studies suggest subclinical Hearing Loss is not a benign condition. Both studies come from researchers at Columbia University, both published in 2020. One study showed an independent association between cognitive ability and subclinical hearing loss, while the second study showed a link between subclinical hearing loss and depressive symptoms. The results of both studies underscore the importance of earlier intervention of middle aged and older adults– even when their hearing thresholds are in the normal range.

Brent Edwards at the National Acoustic Laboratories makes a strong case that individuals with no measured hearing loss and self-reported hearing difficulties, quadrant C in Figure 1 below, are more likely to self-direct their care and buy over-the-counter hearing devices rather than seeking the services of an audiologist.
Figure 1. Edwards segmentation quadrants as reported in MarkeTrak 10


He might be right, but the experience of many audiologists would suggest otherwise. It is common to see a handful of patients each month that fit into quadrant C. When we encounter one of these patients, besides telling them in an often off-putting way that their hearing is “normal” and , by the way, here are some strategies you can use to communicate more effectively: face the speaker, stay close, when dining out, ask for an out-of-the-way table or, better yet, a padded booth, and face away from the kitchen or other noisy areas. You all know the schtick.

Now, given the convergence of hearing aid and consumer audio technology, audiologists can provide an effective intervention for those with subclinical hearing loss. These so-called hybrid devices offer their users multi-tasking capability: stream music and podcasts, talk on a cell phone hands-free and situational amplification in challenging listening places. Hybrid devices are really hearing aids disguised as earbuds. Before you scoff at the opportunity to recommend people hybrid devices to patients with subclinical hearing loss, there is another study that might convince you.

As part of his landmark OTC study, Humes collected data on several potential study participants with normal hearing. Using the Hearing Handicap Inventory for the Elderly (HHIE) to measure self-reported hearing difficulty, Humes found that individuals with normal hearing had essentially the same degree of self-reported hearing difficulty as measured on the HHIE, and interestingly, the same measured aided benefit as individuals with mild and moderate hearing loss. Based on Humes’ 2020 report, published in the July issue of Hearing Review, why not offer adults with subclincal hearing loss a hybrid or muti-tasking device that they can wear as a situational amplifier that easily doubles as a device that streams music and podcasts? With the advent of hearing aids disguised as earbuds, entrepreneurial audiologists have a chance to grow their business and address an unmet need.