1
|
Davis RJ, Lin M, Ayo-Ajibola O, Ahn DD, Brown PA, Parsons J, Ho TF, Choi JS. Over-the-Counter Hearing Aids: A Nationwide Survey Study to Understand Perspectives in Primary Care. Laryngoscope 2024. [PMID: 39192385 DOI: 10.1002/lary.31689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/07/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVES The expansion of over-the-counter (OTC) hearing aids has raised inquiries regarding primary care physicians' (PCP) knowledge, perspective, and perceived roles. We aimed to understand PCP perspectives on OTC hearing aids via nationwide online surveys. METHODS RedCap survey was distributed to PCPs via online forums and public mailing lists. Outcomes included PCPs' attitudes toward, perceived role surrounding, confidence managing, and knowledge of OTC hearing aids. Regression analyses were performed to identify associated factors including demographics and practice characteristics. RESULTS Cohort included 111 PCPs primarily working in non-rural (83.8%) outpatient academic medical centers (47.5%), with a mean (SD) of 16.9 (11.6) years practicing. Most reported unfamiliarity (61.3%) with OTC hearing aids but viewed them positively (91.9%). They often perceived themselves as poor sources of OTC hearing aid information (63.1%) but desired involvement (90.1%) and believed associated knowledge is important (98.2%). Rural practice environment was associated with less familiarity toward OTC hearing aids (β = -0.72, [95% CI -1.40 to -0.04]). Respondents answered 5.0 (2.4) of 10 OTC hearing aid knowledge questions correctly. Using 5-point Likert scale, participants reported most confidence recognizing signs/symptoms of hearing loss 3.71 (0.84), but less confidence educating 1.68 (0.96) about and determining candidacy 1.72 (1.05) for OTC hearing aids. Participants reported continuing medical education courses and published guidelines would effectively improve their OTC hearing aid knowledge. CONCLUSION PCPs displayed positive attitudes toward OTC hearing aids and valued involvement. Addressing unfamiliarity/knowledge gaps surrounding OTC hearing aids through courses and published guidelines may help clarify misconceptions and promote hearing health care. LEVEL OF EVIDENCE NA Laryngoscope, 2024.
Collapse
Affiliation(s)
- Ryan J Davis
- Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - Matthew Lin
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, U.S.A
| | | | - Diana D Ahn
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - Payton A Brown
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - John Parsons
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - Tiffany F Ho
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
| | - Janet S Choi
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| |
Collapse
|
2
|
Haleem A, Rosenthal Z, Lee DJ. Access to Sudden Hearing Loss Care at Urgent Care Centers. Laryngoscope 2024. [PMID: 38953603 DOI: 10.1002/lary.31596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/11/2024] [Accepted: 06/05/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES To compare patient access to urgent care centers (UCCs) with a diagnosis of sudden hearing loss based on insurance. METHODS One hundred twenty-five random UCCs in states with Medicaid expansion and 125 random UCCs in states without Medicaid expansion were contacted by a research assistant posing as a family member seeking care on behalf of a patient with a one-week history of sudden, unilateral hearing loss. Each clinic was called once as a Medicaid patient and once as a private insurance (PI) patient for 500 total calls. Each phone encounter was evaluated for insurance acceptance and self-pay price. Secondary outcomes included other measures of timely/accessible care. Chi-square/McNemar's tests and independent/paired sample t-tests were performed to determine whether there were statistically significant differences between expansion status and insurance type. Calls ended before answering questions were not included in the analysis. RESULTS Medicaid acceptance rate was significantly lower than PI (68.1% vs. 98.4%, p < 0.001). UCCs in Medicaid expansion states were significantly more likely to accept Medicaid (76.8% vs. 59.2%, p = 0.003). The mean wage-adjusted self-pay price was significantly greater in states with Medicaid expansion at $169.84 than in states without at $145.34 when called as a Medicaid patient (mean difference: $24.50, 95% Confidence Interval: $0.45-$48.54, p = 0.046). The rates of referral to an emergency department and self-pay price nondisclosure rates were greater for Medicaid calls than for private insurance calls (8.2% vs. 0.4% and 17.4% vs. 5.8%; p < 0.001 for both). CONCLUSION Medicaid patients with otologic emergencies face reduced access to care at UCCs. LEVEL OF EVIDENCE NA Laryngoscope, 2024.
Collapse
Affiliation(s)
- Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
- Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Zachary Rosenthal
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, U.S.A
| |
Collapse
|
3
|
Tsimpida D, Rajasingam S, Panagioti M, Henshaw H. The leaky pipeline of hearing care: primary to secondary care evidence from the English Longitudinal Study of Ageing (ELSA). Int J Audiol 2024; 63:349-357. [PMID: 36951175 DOI: 10.1080/14992027.2023.2186814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/28/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The proportions of older adults' transitions through acknowledging their hearing loss to getting access to treatment are unknown. This was examined using data from a nationally representative cohort in England. DESIGN Patient and healthcare factors associated with referrals were examined cross-sectionally, through primary to secondary care. Non-report predictors identified using multiple logistic regression models. STUDY SAMPLE 8529 adults with hearing data in the English Longitudinal Study of Ageing Wave 7. RESULTS Nearly 40% of those with acknowledged hearing loss did not tell a doctor or nurse (n = 857/2249). Women (OR 2.68, 95% CI 2.14-2.98), retirees (OR 1.30, 95% CI 1.17-1.44), those with foreign education (OR 2.74, 95% CI 2.47-3.04), lower education (OR 2.86, 95% CI 2.58-3.18), smokers (OR 4.39, 95% CI 3.95-4.87), and heavy drinkers (OR 1.67, 95% CI 1.58-1.85) were more likely to not report hearing loss. Of those who acknowledged and reported hearing difficulties, willingness to try hearing aid(s) was high (78.9%). CONCLUSIONS Unacknowledged, or acknowledged but not reported hearing loss by individuals, and non-referrals by primary healthcare professionals, are barriers to accessing hearing healthcare. Future research should report hearing aid use as the proportion of individuals who acknowledge their hearing loss, to avoid an overestimation of the non-use of hearing aids within study samples.
Collapse
Affiliation(s)
- Dialechti Tsimpida
- Department of Public Health, Policy & Systems, Institute of Population Health, The University of Liverpool, Liverpool, UK
| | - Saima Rajasingam
- School of Psychology & Sport Sciences (Vision & Hearing) Cambridge Campus, Anglia Ruskin University, Cambridge, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC), School of Health Sciences, The University of Manchester, Manchester, UK
| | - Helen Henshaw
- NIHR Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
4
|
Arnautu SF, Arnautu DA, Jianu DC, Tomescu MC, Blajovan MD, Banciu CD, Malita DC. Elderly Individuals Residing in Nursing Homes in Western Romania Who Have Been Diagnosed with Hearing Loss are at a Higher Risk of Experiencing Cognitive Impairment. J Multidiscip Healthc 2024; 17:881-888. [PMID: 38445066 PMCID: PMC10911977 DOI: 10.2147/jmdh.s439282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
Purpose The objective of this research was to determine if there is any correlation between the severity of neurocognitive disorder and hearing impairment in the elderly. Patients and Methods This is a population-based observational study that included subjects aged ≥ 65 years. They were evaluated for the existence of cardiovascular risk factors, diabetes, stroke, alcohol abuse, and smoking. Hearing impairment was diagnosed by an audiologist, using behavioral audiometric examination. These evaluations might have been performed in response to concerns about hearing loss, or they could have been a routine component of yearly comprehensive health screenings that included a Mini-Mental State Examination 2nd Edition (MMSE-2) test. According to the results of the MMSE-2 scale, we divided the individuals into two groups, Group I for those who had cognitive impairment and severe neurocognitive disorder, and Group II for those who did not have cognitive impairment. Results The study enrolled 203 patients with a mean age of 77 ± 7.5 years (range 65-98), 99 (48%) were males. When comparing the two groups, group I patients presented more often cardiovascular risk factors, stroke, diabetes, and impaired hearing. The univariable logistic regression found that cognitive impairment was significantly more frequent in the elderly with cardiovascular disease, diabetes, and stroke (p<0.0001). The multivariate regression analysis found that stroke (p<0.0001) diabetes (p=0.0008), cardiovascular disease (p=0.0004), and impaired hearing (p=0.0011) were significantly linked to cognitive impairment. The occurrence of hearing impairment in the elderly was related to having an MMSE-2 score of 14 or below. Conclusion According to the findings of this research, the elderly who have trouble hearing in addition to other conditions might have an increased risk for severe neurocognitive disorder.
Collapse
Affiliation(s)
- Sergiu-Florin Arnautu
- Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), Department of Neurosciences, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Diana-Aurora Arnautu
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Dragos-Catalin Jianu
- Center for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), Department of Neurosciences, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Department of Neurology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Mirela-Cleopatra Tomescu
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Marc-Dan Blajovan
- Department XV-Orthopedics-Traumatology, Urology, Radiology and Medical Imagistics, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Christian-Dragos Banciu
- Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Daniel-Claudiu Malita
- Department XV-Orthopedics-Traumatology, Urology, Radiology and Medical Imagistics, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| |
Collapse
|
5
|
Nie L, Xiong YY, Liu Y, Cheng Q, Zhao ZY. Effect of preoperative cluster care nursing on patient compliance during preoperative isolation of pediatric patients before cochlear implant surgery. Int J Pediatr Otorhinolaryngol 2023; 175:111752. [PMID: 37852048 DOI: 10.1016/j.ijporl.2023.111752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/06/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE This study investigates the effect of pre-operative cluster care nursing on patient compliance during preoperative isolation of pediatric patients from their family members before cochlear implant surgery. STUDY METHODS A total of 350 pediatric patients who underwent cochlear implant surgery at Sichuan Rehabilitation Hospital from January 2021 to December 2022 were enrolled. The children were divided into two groups:Experimental group (group E) consisted of 182 children who received pre-operative cluster care nursing, and control group (group C) consisted of 168 children who received pre-operative routine nursing. The compliance scores of the two groups of patients when separated from their families before entering the operating room and the number of patients requiring intravenous injection of midazolam were recorded. RESULTS The compliance scores of group E were significantly lower than those of group C (t = 4.141, P < 0.001). The percentage of patients requiring intravenous injection of midazolam was recorded: it was 21.98% (40/182) in group E and 42.26% (71/168) in group C. Notably, the injection rate of midazolam in group E was significantly lower than that in group C (χ2 = 16.597, P < 0.001). CONCLUSION Pre-operative cluster care nursing can improve patient compliance and reduce the use of sedative drugs during preoperative isolation of pediatric patients from their family members for cochlear implant surgery.
Collapse
Affiliation(s)
- Lin Nie
- Department of Anesthesia Operation, Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Sichuan Chengdu, 611135, China
| | - Yi-Ying Xiong
- Department of Anesthesia Operation, Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Sichuan Chengdu, 611135, China
| | - Ying Liu
- Department of Anesthesia Operation, Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Sichuan Chengdu, 611135, China
| | - Qing Cheng
- Department of Anesthesia Operation, Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Sichuan Chengdu, 611135, China
| | - Ze-Yu Zhao
- Department of Anesthesia Operation, Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Sichuan Chengdu, 611135, China.
| |
Collapse
|
6
|
Carlson ML, Lohse CM, Marinelli JP, Sydlowski SA, Collaborative HH. Perceptions Surrounding Cochlear Implants Among At-Risk and Qualifying Older Adults in the United States. Otol Neurotol 2023; 44:1021-1026. [PMID: 37889933 PMCID: PMC10662571 DOI: 10.1097/mao.0000000000004041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
OBJECTIVE Limited evidence to date has examined public perceptions of cochlear implants among adult hearing aid users with moderate to profound hearing loss. The current work was conceived with the chief objective of characterizing the perceptions surrounding cochlear implants among the prospective candidate pool. STUDY DESIGN National cross-sectional survey study. SETTING United States. PATIENTS Adults between 50 and 80 years of age with self-reported moderate to moderately severe (n = 200) or moderately severe to profound (n = 200) hearing loss currently using hearing aids. RESULTS The overall survey response rate was 12%. Median age at time of survey for the 400 respondents was 66 years (interquartile range, 60-71 yr) and included 215 (54%) men. In total, 26% did not think of hearing loss as a medical condition, and another 23% were unsure. Overall, 63% of respondents had heard of cochlear implants, but only 2% indicated they were very familiar with them. Despite 52% of respondents reporting "very positive" or "somewhat positive" feelings about cochlear implants, only 9% indicated they were "very likely" to get a cochlear implant in the future, including 7% of those with estimated moderately severe to profound hearing loss at time of survey. CONCLUSIONS Even among people with presumed qualifying levels of hearing loss, there exists a widespread lack of familiarity with cochlear implantation as a viable treatment option. This limited awareness seems influenced by a generally poor appreciation for hearing loss as a chronic disease state that warrants treatment. However, among those familiar with cochlear implants, they are generally viewed favorably.
Collapse
Affiliation(s)
| | - Christine M. Lohse
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - John P. Marinelli
- Department of Otolaryngology–Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas
| | | | | |
Collapse
|
7
|
Marinelli JP, Reed NS, Lohse CM, Fussell WL, Petersen RC, Machulda MM, Vassilaki M, Carlson ML. Cognitive Performance, Sociodemographic Factors, Pure-Tone Audiometry, and their Association with Speech Discrimination: A Prospective Population-Based Study of 1,061 Older Adults. Otol Neurotol 2023; 44:860-865. [PMID: 37621101 PMCID: PMC10529826 DOI: 10.1097/mao.0000000000004003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Hearing loss is increasingly recognized as a chronic disease state with important health sequelae. Although considered a central component of routine audiometric testing, the degree to which various patient factors influence speech discrimination is poorly characterized to date. The primary objective of the current work was to describe associations of cognitive performance, sociodemographic factors, and pure-tone audiometry with speech discrimination in older adults. STUDY DESIGN Prospective study. SETTING Olmsted County, Minnesota. PATIENTS There were 1,061 study participants 50 years or older at enrollment in the population-based Mayo Clinic Study of Aging between November 2004 and December 2019 who underwent formal audiometric and cognitive testing included in the current investigation. MAIN OUTCOME MEASURES The primary outcome measure was word recognition scores (WRSs; measured as <100% vs 100% as well as continuous), with pure-tone averages (PTAs; 0.5, 1, 2, and 3 kHz), age, sex, years of education, state area deprivation index (ADI) quintiles, and global cognition z scores as explanatory features. RESULTS The mean (SD) age among the 1,061 participants was 76 (9) years with 528 (50%) males. Participant age [OR (95% CI) for a 10-year increase of 1.8 (1.4-2.3), p < 0.001], male sex [OR = 2.6 (1.9-3.7), p < 0.001], and PTA [OR for a 10-dB hearing loss increase of 2.4 (2.1-2.8), p < 0.001] were all significantly associated with <100% WRSs, with the greatest explanatory ability attributable to the PTA. Years of education ( p = 0.9), state ADI quintile ( p = 0.6), and global cognitive performance ( p = 0.2) were not associated with WRS. The multivariable model demonstrated strong predictive ability for less than perfect WRSs, with a c index of 0.854. Similar results were seen for WRSs analyzed as continuous, with the multivariable model resulting in an R2 value of 0.433. CONCLUSIONS Although PTA exhibited the greatest influence on speech discrimination, advancing age and male sex both independently increased the likelihood of having worse speech discrimination among older adults, even after accounting for years of education, neighborhood-level socioeconomic disadvantage, and cognitive function. These findings help identify patient factors that can be instrumental when designing screening programs for adult-onset hearing loss.
Collapse
Affiliation(s)
| | | | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Wanda L Fussell
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | | |
Collapse
|
8
|
Marinelli JP, Lohse CM, Fussell WL, Petersen RC, Reed NS, Machulda MM, Vassilaki M, Carlson ML. Association between hearing loss and development of dementia using formal behavioural audiometric testing within the Mayo Clinic Study of Aging (MCSA): a prospective population-based study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e817-e824. [PMID: 36410368 PMCID: PMC9831680 DOI: 10.1016/s2666-7568(22)00241-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/02/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hearing loss has been identified as a potential major modifiable risk factor for developing dementia. This study examined associations between formal behavioural pure-tone and speech audiometry assessed by an audiologist with development of dementia in the Mayo Clinic Study of Aging (MCSA). METHODS The MCSA is a prospective population-based study examining the incidence, prevalence, and risk factors of mild cognitive impairment and dementia in Olmsted County, Minnesota, USA. Participants undergo clinical examinations with neuropsychological testing at enrolment and every 15 months. Participants were 50 years or older at enrolment between Nov 29, 2004, and Dec 23, 2019, who underwent formal behavioural audiometric evaluation by an audiologist due to concerns about hearing loss or as a part of annual comprehensive health assessments. Associations of pure-tone average (PTA) and word recognition scores (WRS) with the development of dementia were evaluated using Cox proportional hazards regression with age as the timescale, and associations with changes in cognitive testing scores over time were evaluated using linear mixed-effects models. FINDINGS Among 1200 eligible participants, the mean age at enrolment was 79 years (SD 9), 593 (49%) were men, and 207 developed dementia during a mean of 7·0 years (SD 3·7) of follow-up. After adjusting for sex, years of education, smoking status, diabetes, hypertension, apolipoprotein E ε4 carriership, and hearing rehabilitation (defined as hearing aid or cochlear implant use), neither PTA (hazard ratio [HR] per 10-decibels hearing level increase of 0·99 (95% CI 0·89-1·12; p=0·91) nor WRS (HR per 10% decrease of 0·98, 95% CI 0·89-1 ·07; p=0·65) was significantly associated with the development of dementia. However, both PTA and WRS were significantly associated with poorer performance in cognitive testing over time: participants with a PTA higher than 25 decibels hearing level or a WRS lower than 100% had significantly worse declines in cognitive testing scores. Informant-based hearing difficulties assessed by the participant's study partner were significantly associated with the development of dementia (HR 1·95, 95% CI 1·45-2·62; p<0·0001). INTERPRETATION In this prospective population-based study, subjective informant-based hearing difficulties were associated with development of dementia, whereas objective measures on formal behavioural audiometry were predictive of poorer performance on cognitive testing over time but not the development of dementia. Other factors related to central processing might potentiate the effects of peripheral hearing loss detected on behavioural audiometric testing. FUNDING National Institute of Health, the Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic, the GHR Foundation, the Mayo Foundation for Medical Education and Research, the Liston Award, the Schuler Foundation, the Rochester Epidemiology Project medical records linkage system, and the National Institute on Aging.
Collapse
Affiliation(s)
- John P Marinelli
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN USA,Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, JBSA, TX, USA
| | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA
| | - Wanda L Fussell
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN USA
| | - Ronald C Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA,Department of Neurology, Mayo Clinic, Rochester, MN USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN USA
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN USA,Department of Neurologic Surgery, Mayo Clinic, Rochester, MN USA
| |
Collapse
|