Validation of the Decision model of the Burden of Hearing loss Across the Lifespan (DeciBHAL) in Chile, India, and Nigeria.

Journal Article (Journal Article)

BACKGROUND: There is no published decision model for informing hearing health care resource allocation across the lifespan in low- and middle-income countries. We sought to validate the Decision model of the Burden of Hearing loss Across the Lifespan International (DeciBHAL-I) in Chile, India, and Nigeria. METHODS: DeciBHAL-I simulates bilateral sensorineural hearing loss (SNHL) and conductive hearing loss (CHL) acquisition, SNHL progression, and hearing loss treatment. To inform model inputs, we identified setting-specific estimates including SNHL prevalence from the Global Burden of Disease (GBD) studies, acute otitis media (AOM) incidence and prevalence of otitis-media related CHL from a systematic review, and setting-specific pediatric and adult hearing aid use prevalence. We considered a coefficient of variance root mean square error (CV-RMSE) of ≤15% to indicate good model fit. FINDINGS: The model-estimated prevalence of bilateral SNHL closely matched GBD estimates, (CV-RMSEs: 3.2-7.4%). Age-specific AOM incidences from DeciBHAL-I also achieved good fit (CV-RMSEs=5.0-7.5%). Model-projected chronic suppurative otitis media prevalence (1.5% in Chile, 4.9% in India, and 3.4% in Nigeria) was consistent with setting-specific estimates, and the incidence of otitis media-related CHL was calibrated to attain adequate model fit. DeciBHAL-projected adult hearing aid use in Chile (3.2-19.7% ages 65-85 years) was within the 95% confidence intervals of published estimates. Adult hearing aid prevalence from the model in India was 1.4-2.3%, and 1.1-1.3% in Nigeria, consistent with literature-based and expert estimates. INTERPRETATION: DeciBHAL-I reasonably simulates hearing loss natural history, detection, and treatment in Chile, India, and Nigeria. Future cost-effectiveness analyses might use DeciBHAL-I to inform global hearing health policy. FUNDING: National Institutes of Health (3UL1-TR002553-03S3 and F30 DC019846).

Full Text

Duke Authors

Cited Authors

  • Borre, ED; Ayer, A; Der, C; Ibekwe, T; Emmett, SD; Dixit, S; Shahid, M; Olusanya, B; Garg, S; Johri, M; Saunders, JE; Tucci, DL; Wilson, BS; Ogbuoji, O; Sanders Schmidler, GD

Published Date

  • August 2022

Published In

Volume / Issue

  • 50 /

Start / End Page

  • 101502 -

PubMed ID

  • 35770254

Pubmed Central ID

  • PMC9234074

Electronic International Standard Serial Number (EISSN)

  • 2589-5370

Digital Object Identifier (DOI)

  • 10.1016/j.eclinm.2022.101502


  • eng

Conference Location

  • England