ASHA Disappointed in USPSTF Final Recommendation on Adult Hearing Screening

On March 23, 2021, the U.S. Preventive Services Task Force (USPSTF) updated its 2012 recommendation on screening for hearing loss in adults 50 years or older to Grade I. The USPSTF recommendation concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in older adults who have not noticed any issues with their hearing. USPSTF reviewed this topic because age-related sensorineural hearing loss is a common health problem among adults. Hearing loss can adversely affect an individual’s quality of life and ability to function independently.

ASHA commented [PDF] on the draft recommendation statement cautioning against a Grade I recommendation. Instead, ASHA recommended issuing a Grade B for hearing screening for asymptomatic adults 50 years or older given the impacts of hearing loss on quality of life, independence, and communication. Grade B would encourage providers to screen persons ages 50 and older for hearing impairment, and to further specify that:

• Screening should be conducted in health care settings by staff who are appropriately trained to use the screening test(s) and with procedures in place for appropriate initial referral and follow-up.
• A failed screening should be followed by an audiologic evaluation to diagnose the severity and cause of any potential impairment, and to suggest treatment or referral, as appropriate.

ASHA is disappointed by the updated recommendation. The USPSTF, however, clarified that its Grade I is neither a recommendation for nor against screening. Rather, the recommendation is a conclusion that the evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss.

A University of Michigan National Poll on Healthy Aging [PDF] reports that 62% of adults aged 50 to 80 felt it was somewhat or very important to have their hearing tested at least once every two years. ASHA will continue working with clinicians and other stakeholders to improve the evidence and their knowledge about the benefits of routine hearing screenings for all individuals—including adults 50 years or older—and how early detection of hearing loss leads to improved communication, function, and quality of life. ASHA’s patient education handout, Comorbidities and Hearing Loss [PDF], describes the connection between hearing loss and health conditions that can be risk factors for or consequences of hearing loss.

Questions?

Contact Daneen Sekoni, ASHA’s director of health care policy, health care reform, at dsekoni@asha.org.