Conclusions

The proposed set of procedures considered in this user evaluation can be said for the most part to be well-accepted by professionals. There was less difference than expected between the views of professionals in UK and those in Germany and the Netherlands despite the differences in the systems of provision and required standards (German and Dutch practice are already fairly well-aligned with each other).

There are two broad areas, in the use of speech tests and of questionnaires, where the views of professionals underline the need for a clearer scientifically-led consensus. The professionals we have surveyed are often conservative in their views. Both for speech tests and questionnaires, there are many possible options. With speech tests in particular it is very evident that professionals prefer methods that are familiar. In this and other novel areas, there is much to be done to educate professionals into the advantages of taking up new approaches. It is also crucially important, if standardisation is to be improved, to reduce the range of alternatives that are potentially able to be used.

Some progress in the introduction of improved and more standard procedures may be possible by making a case that results are more accurate. However the impact of time constraints on current practice is powerful. Professionals are interested in change, but primarily in the “ideal” world. This signals that procedures that give better information are only likely to be accepted if they involve no additional time and effort from the professional. This is in contrast to the views of hearing-impaired people, who are very willing to invest time in improved results from hearing aid fitting. It may well be that major changes in professionals’ practice require not only education but also external pressure, for example, from quality standards required by health insurance bodies or, where provision is state-funded, from national standards bodies. In addition, the best approach to this must include the widespread provision of very easily used implementations of procedures that are selected for sound scientific reasons.

In the consideration of remote hearing aid fitting and evaluation, professionals had widely varying opinions. Only half of the respondents were positive about patients assessing benefit remotely. Fewer professionals were positive about patients adjusting their hearing aids remotely. It is clear that one of the disadvantages of a survey is that a full explanation or discussion of topics is not possible. However it is a good indicator of the first impressions of professionals.

As with other novel approaches, professionals will need further education as to the benefits of remote fitting and benefit evaluation procedures in order for them to be happy to use them with their patients. In addition to the benefits, professionals will most likely need full explanations concerning how the technique is carried out and how much control the professional may have over what the patients does remotely. There may be particular safety measures that would make professionals happier about such a technique and it is clear that those developing these tools should take note of the reservations noted in the survey. This is also important for any other areas of HearCom that are developing Internet-based procedures for professionals. The same information may be needed to enable professionals to be happy about using any such procedures.