Jabra Enhance: Committed to audiology

Frequently asked questions

• Doesn't the profession of audiology have concerns about remote hearing testing and fitting hearing aids without any in-person patient contact?

  As a result of considerable tele-audiology research in recent years (Swanepoel et al. 2010; Krumm 2016), remote hearing assessment and hearing aid fitting is now recognized as an evidence-based approach for providing hearing services to more people who need them. For resources supporting this shift in professional opinion, you might want to read two editorials in the Journal of the American Academy of Audiology - one in the June 2016 issue entitled "Perceptions of Internet Delivery of Hearing aids" (Jacobson 2016) and the other, published in February 2017 entitled "Build a better assessment and patients will beat a path to your clinic" (McCaslin 2017). You may also want to read a systematic review entitled "Efficacy of Remote Hearing Aids Programming Using Teleaudiology" (Ba Mashmous 2022).

• Are audiologists involved at all in the Jabra Enhance approach to delivery of hearing aids?

  Yes. Audiologists were involved from the outset in the development of the Jabra Enhance approach for hearing assessment and hearing aid fitting. These leaders in the profession still provide expert advice on the entire process. In addition, our licensed audiologists and hearing aid dispensers are in close contact with our customers for their hearing aid needs, beginning with the initial Orientation and continuing throughout long-term follow up.

• How can Jabra Enhance begin the hearing aid process without an audiologist first inspecting the patient's ear canal without the results of otoscopy? Aren't you concerned about the possibility of excessive ear wax or ear disease?

  We understand the question because in-person audiologists and hearing aid dispensers typically perform an inspection of the patient's external ear canals before beginning hearing assessment. But the FDA has made clear that hearing aids sold under the new "over-the-counter" regulations, like Enhance Select, do not require any examination. Even so, Jabra Enhance takes several steps to address the issue of ear canal status. Customers receiving audiology services are directed to complete the Consumer Ear Disease Risk Assessment, or CEDRA. The National Institutes of Health funded research on this validated 15-item consumer questionnaire to detect disease risk before a person purchases hearing aids. These customers are also specifically asked about past problems with excessive cerumen in their orientation with a licensed Jabra Enhance hearing specialist. Persons with such a history are encouraged to seek medical consultation.

• Is the Jabra Enhance system for hearing aids appropriate for children?

  No. Children or anyone under the age of 18 years should seek hearing health care directly from a licensed audiologist or other qualified provider. Jabra Enhance is for adults 18 and older with self-perceived mild to moderate hearing loss only.

• Shouldn't diagnostic hearing testing be performed with calibrated equipment and with the patient sitting in a sound-treated room meeting ANSI standards. Is it possible to get accurate test results over the telephone or via the internet?

  Research from around the world confirms that pure tone hearing screening and assessment conducted online, or even with a smartphone, can yield results comparable to the conventional hearing assessment conducted by a hearing professional with the patient in a sound-treated room (Whitton et al. 2016; Hazan et al. 2022). You can find more information with a PubMed literature search at www.nlm.nih.gov. In fact, there is considerable research validating remote assessment of speech perception in quiet and noise (de Graaffe et al. 2018; Paplialonga et al. 2018).

  It is important to note that the tests patients receive at an audiologist's office are designed not only to measure how well they hear, but also to identify any conditions that may require medical intervention, something the FDA has determined is not typically a necessary step when purchasing over-the-counter hearing aids such as Enhance Select.

  Our test is designed only to indicate if a prospective customer may be an appropriate candidate for our hearing aids, and to provide us enough information to create their personal hearing profile and initially program their hearing devices. Our test does not diagnose hearing loss or any other disease or condition. However, if results suggest any medical conditions beyond common hearing loss, we may advise customers to seek further care.

• You hear a lot about best practices in audiology these days. How can Jabra Enhance follow best practices if the patient never sees a hearing professional in person?

  As mentioned above, strategies for hearing assessment and rehabilitation of hearing loss are rapidly changing. Telehealth has been shown to be an effective tool to deliver services and care in a more convenient and accessible manner. Many hearing aid-related services a professional can perform in a traditional clinical setting can now be done remotely using the kind of technology and techniques used by Jabra Enhance. Outcome research within the past decade confirms that hearing aid-related services delivered via technologically remote means can produce patient benefits equivalent to what we would expect for traditional face-to-face clinical services that are consistent with best practices (e.g. Tao et al. 2021; Ba Mashmous 2022; Hazan et al. 2022). So we can provide effective professional support via telehealth for our customers who choose to take advantage of it.

• On the same topic, aren't real ear measurements part of best practices? How can Jabra Enhance be sure the hearing aid fitting included with the 3 years of audiology services is appropriate for a patient without probe mic verification?

  While probe-microphone verification represents an in-person audiologic best practice, technological developments such as adaptation algorithms, face-to-face follow-up sessions and the ability to remotely fine-tune the full suite of hearing aid features has yielded excellent client outcomes.

• Does the Jabra Enhance model represent a threat to the audiology profession?

  On the contrary, the Jabra Enhance model expands and extends the availability of high quality hearing aids and professional services to more patients, and reinforces our belief that the involvement of a qualified professional helps achieve the best benefit, value, and performance from hearing aids. People with hearing loss and difficulties with communication now have different options for seeking hearing health care. These people value, and in many cases require, convenience, access, and cost-effectiveness as they attempt to find a solution to their communication problems. The increased public interest in OTC products is evidence for this trend. Jabra Enhance offers an attractive professionally-focused option for adults who have hearing loss and who have decided it's time to do something about it and want professional support but aren't well-served by a process requiring numerous in-person visits.