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Abstract
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PURPOSE This letter serves to respond to Powell et al.'s (2021) letter to the editor regarding our recent publication, "Preliminary Evidence on the Impact of Hearing Aid Use on Falls Risk in Individuals With Self-Reported Hearing Loss." In our letter, we respond to key concerns and commentary raised by the authors.
We appreciate the opportunity to respond to the letter to the editor by Powell et al. (2021) regarding our recently published article, “Preliminary Evidence on the Impact of Hearing Aid Use on Falls Risk in Individuals With Self-Reported Hearing Loss.” We agree that there is much work to be done in understanding the association between hearing loss and falls. Additionally, there is a dearth of evidence on whether hearing health care intervention, such as hearing aid use, may be an important strategy for reducing falls risk. We believe the data presented in our article, while preliminary, helps further engage our scientific community to think of novel approaches to improve the understanding of the topic at hand. We believe our work, along with their letter to the editor, may serve as a sounding board to continue this important area of study for which audiologists are so uniquely poised to address.
We agree with the authors that there are many ways to approach a research question. It is important to point out that while Powell et al. (2021) proffered an alternative analysis, it yielded the same overall interpretation as our original analyses—that is, when using the same National Health and Nutrition Examination Survey (NHANES) dataset, there is no statistical evidence to suggest a significant difference in odds of falls between hearing aid users and non-users. Specifically, the effect was not statistically significant, and the effect size (odds ratio) were consistent with equivocal risk of falls in both analyses. Therefore, our analyses and those offered by Powell and colleagues would suggest that no statistical differences in interpretation exist, and there is a lack of likely clinical significance as well. We are encouraged that the approach that Powell and colleagues used provides converging evidence of a null finding when using NHANES data.
In the analysis provided by Powell et al. (2021), the research question that they answer is similar but is not the same question raised in our study. Specifically, our research question investigated whether the use of hearing aids modifies the observed association between self-reported hearing loss and falls, as defined as a statistically significant interaction between hearing aid status and self-reported hearing. As such, we have identified reference groups that allow us to provide point estimates that reflect the association between all levels of self-reported hearing and falls separately among hearing aid users and non-users. Although related, the authors pose the different question of whether hearing aid use itself is associated with falls, only among individuals with self-reported hearing loss. Note that the authors' proposed question can still be answered using our analytic approach that includes interactions—that is, in this parametrization, we determine a point estimate for the odds ratio of falls comparing those who report hearing loss and hearing aid use to those who report hearing loss and no hearing aid use (as a reference group) without changing our overall model. Overall, we see this result as complementary information to suggest further that we do not have evidence to date that hearing aid use relates to falls ...
Language: en |