Valuing hearing-related changes in health-related quality of life

PhD student

Ms Natalie Williams

Supervisory team

Dr Pádraig Kitterick
Michael Akeroyd
Dr Robert Pierzycki


NIHR Nottingham Hearing Biomedical Research Unit

Study period


In publicly-funded healthcare systems such as the UK National Health Service, different areas of healthcare inevitably compete for a limited pool of resources. In order to allocate resources efficiently across healthcare programmes, decision makers increasingly use information on both the costs of providing a particular service and the health benefits it generates. While the costs of different healthcare services can be readily compared, the unit in which health benefit is measured can vary across services. This variation may prohibit comparisons of different services in terms of the benefit to health that they provide.

A solution to this problem is to measure health benefit in general terms which are equally-applicable to all areas of healthcare. The most common approach is to use the Quality-Adjusted Life Year (QALY) through which both the duration and the quality of life are used to describe both the negative impact of disease on a patient’s health and also the benefits to health provided by a healthcare service. To measure disease- and service-related changes in quality of life, the health of individuals with the disease must be described both with and without access to the healthcare service of interest. Common methods of describing health include defining the degree of problems experienced on each of several general health dimensions (e.g. mobility and pain) or generating text-based narratives based on patient reports, clinical opinions, and published scientific evidence.

With hearing loss, as with many other medical conditions, it is difficult to describe the impact on quality of life either using a set of general health dimensions or with words alone. However, what is relatively unique about hearing loss compared to many medical conditions is that it is possible to simulate many of its effects in healthy individuals through the use of acoustic simulations. In addition, some of the benefits of interventions such hearing aids and cochlear implants may be simulated acoustically.

The primary objective of this PhD project is to evaluate the use of acoustic simulations in generating descriptions of the health-related quality of life of patients with hearing loss. Secondary objectives are (i) to compare the valuations of health states described with the aid of acoustic simulations to those described using conventional methods; (ii) to identify which listening contexts are informative to simulate when describing health states arising from hearing loss; and (iii) to assess the practicality, reliability, and validity of health state descriptions which incorporate acoustic simulations