Interventional Audiology: An Example of How to Identify, Interpret and Incorporate Medical Research into Your Marketing Strategy
Bob Tysoe
The law turns on the facts, as does the professions of medicine and audiology. Authoritative, peer-reviewed, trusted published sources of medical research may be found in several places, including the New England Journal of Medicine, the Annals of Internal Medicine, the Journal of American Medical Association, and The Lancet. Mayo Clinic and Johns Hopkins Medical Center are among the most esteemed medical institutions in the world and are also reliable sources for new diagnostic procedures and treatments for hearing loss, tinnitus, and balance disorders. Many of the target populations for this research, published in the aforementioned sources, might also benefit from audiological intervention. For this reason, audiologists must stay abreast of the medical literature, which can be a daunting task.
Because these respected medical journals and institutions are continually generating relevant and germane research, it is critical for audiologists to be monitoring them by using resources such as PubMed to identify research that might affect prospective patients who might benefit from audiologic intervention. By taking the time to monitor the latest peer reviewed research, not only will you find new prospects who benefit from audiologic care, you will — because you are clearly communicating the relationship between untreated hearing and balance problems, with other conditions to medical professionals in your community — enhance your reputation as a leader in your field.
In this article a step-by-step process for uncovering new patients in the medical literature is discussed. Specifically, an example of acquiring new female patients who might benefit from audiologic intervention is reviewed. The process discussed below can be applied to any condition or patient population that might have a comorbidity linked to hearing or balance disorders. The approach, outlined below, serves as an example of how scientific research can be used as part of a comprehensive marketing strategy that generates office traffic.
Step 1. Identify relevant articles in the medical literature.
Use vetted search engines like PubMed and conduct key word searches. In your key word search, enter the current year (2023) and “hearing loss” and “adult population” in the key word search box.
Step 2. Time is precious, so focus your initial review on the article abstracts.
Look carefully at where the article was published, the authors who published it, if the findings attained statistical or clinical significance, and the validity of the authors’ conclusions.
Step 3. Develop a fact-based “call to action” that uses key findings from the relevant studies.
Usually, these key points can be culled from the abstract. Next, when you download the entire article, pay close attention to the first, second, and final paragraph where the authors place their “call to action” for the specialists with whom you seek to share the content. This “call to action” can be used to identify patient populations that might benefit from audiologic intervention.
Using these three steps, let’s work through an example by using a recently published article that addresses gestational diabetes, a population with an unmet need for audiologic intervention.1
Key Demographic Facts
The U.S. Census Bureau states that the population America is 340,205,185 as of August 12th, 2023, and the number of women aged 15 to 44 is 64,543,832. This means that 19% of Americans are of gestational age. Another important demographic fact is that the U.S. annual birthrate in 2021 was 3,664,292 or 11 births per 1000 people.
Why are these facts important? They demonstrate that a large segment of the population – in this example, 1 in 5 individuals are potentially impacted by the findings in this study.
Key Facts About the Condition as Stated in the Article
Gestational Diabetes Mellitus occurred in nearly 1 in 8 pregnancies in the U.S., with even higher rates among individuals who identified as non-Hispanic, Asian/Pacific Islander, those with obesity, and those who are aged 35 years or older at time of delivery. This equates to approximately 7,809,703 pregnant women who give birth each year who might be affected by the condition.1
Gestational Diabetes Mellitus or GDM (i.e., hyperglycemia first diagnosed during pregnancy) is associated with cardiometabolic disease including Type 2 diabetes (T2D) and cardiovascular disease (CVD) in the affected pregnant individual and the exposed fetus. In 2020, GDM occurred in nearly 1 in 8 pregnancies in the U.S., with even higher rates among individuals who identified as American Indian or non-Hispanic Asian/Pacific Islander, those with obesity, and those aged 35 years or older at delivery. The age-standardized rate of GDM at the first live birth has increased from 47.6 to 63.5 years of age per 1000 live births from 2011 to 2019 in the U.S., with further increases documented during the COVID-19 Pandemic.1
Up to half of pregnant individuals with GDM will develop prediabetes or TD2 postpartum. GDM is associated with an approximate 10-fold higher lifetime risk of TD2.
GDM identifies individuals who are at increased risk of subclinical CVD (eg, coronary artery calcium) and clinical CVD (eg ischemic heart disease, cerebrovascular events, and heart failure). A meta-analysis (involving 5 million female individuals and greater than 100,000 events) demonstrated that individuals with GDM have a 2-fold higher risk of CVD events within the first decade postpartum.
Why are these key facts important? They highlight that Gestational Diabetes Mellitus (GDM) has several serious health consequences if not identified and treated.
Why is corroborating evidence important? It shows that the current study fits into a larger body of work with similar findings – a cornerstone of the scientific method.
Corroborating Evidence
This finding is of significant concern because research conducted by the National Institutes of Health (NIH) on diabetes and hearing loss in the United States and published by Bainbridge, et al. (2008) surmises that diabetes affects the vasculature and neural system of the inner ear, leading to hearing loss.2
Bainbridge et al. (2008) go on to assert that hearing loss was more prevalent among adults with diabetes. Prevalence of low- or mid-frequency hearing loss of mild or greater severity in the worse ear was 21.3% vs 9.4% among adults without TD2 diabetes.2
Key Findings to Communicate with Medical Gatekeepers
Hearing loss is common in adults with diabetes, and diabetes seems to be an independent risk factor for the condition. Adult patients with pre-diabetes, whose blood glucose was higher than normal, but not high enough for a TD2 diagnosis, had a 30% higher rate of hearing loss compared to those with normal blood sugar tested after an overnight fast.
Numerous studies have verified that there is cause and effect between pre-diabetes, diabetes, obesity, hyperlipidemia, hypercholesterolemia, high blood pressure, micro-vascular disease, cardiovascular disease, and hearing impairment and communication disorders.
It is worth noting that currently there are few, if any, recommendations for postpartum hearing healthcare testing. Effective lifestyle interventions to prevent TD2 delivered over a period of 1-to-3 years postpartum include dietary counseling and monitored exercise. These interventions likely reduce insulin resistance through weight loss and physical activity, which lowers the secretory demands of B-Cells.
Further, the rate of postpartum oral glucose screening has remained suboptimal (less than 50%). Reasons for suboptimal screening include clinician non-adherence (test was not ordered), lack of patient follow-up for postpartum care, patient burden associated with a fasting 2-hour laboratory procedure, and patient difficulty with accessing care while caring for an infant.
There are barriers to diabetes prevention, which include adverse social determinants of health and practical obstacles to patient engagement in intensive lifestyle modification (e.g., limited childcare and social support, emotional stress, and financial barriers), inadequate knowledge about the lifetime risk of Type 2 Diabetes, and access to postpartum care, including a timely transition to primary care.
Individuals who experience a pregnancy complicated by gestational diabetes mellitus, and their offspring in utero, are at higher risk for poor cardiometabolic health. Recognizing the lifetime and intergenerational risks associated with GDM requires greater awareness by clinicians, patients, and researchers. It is critical to highlight that GDM is a window into future cardiometabolic health, not merely an isolated complication of pregnancy that ends with delivery.
Pregnant individuals are at risk for developing hyperglycemia, which progresses to gestational diabetes, pre-diabetes, Type 2 diabetes, and quite possibly to impaired cardiometabolic health. Each of these conditions carries an increased risk of hearing loss and associated disabilities, which can be effectively managed by audiologists.
Why is communicating key findings with medical gatekeepers important? It is an opportunity to use evidence from peer-reviewed research to raise their awareness about an under-treated condition and also that audiology plays an instrumental role in the early identification and effective long-term management of this condition in a population that may have flown under the radar.
Who is a target audience for the message?
A target market is a group of people that have been identified as the most likely potential customers for a product/service/ specialist because of their shared characteristics, (i.e., patient types) such as age, income, lifestyle, and comorbidities.
Identifying the target market is a key part of the decision making process when audiologists advertise their audiology practices.
Marketing professionals divide consumers into four major segments:
Demographic: Main characteristics can be age, gender, income, occupation etc.
Geographic: Identify the country, state, city, and market area in which potential customers are located.
Psychographic: Consider lifestyle, attitudes, interests, and values.
Behavioral: Understand the research decisions of current customers, and the proven appeal of past products and services.
Carefully consider each of these marketing characteristics so that you are efficient with your new customer/patient “reach and frequency” planning objectives.
The Obstetrics and Gynecology specialists have many patient-types in common with Audiology. Audiologists should identify the OB/GYN specialists who practice within a reasonable radius, (i.e., the zip codes that are within 15 miles of their practice). Then, create a digital list of names, phone numbers, addresses, fax numbers, and location maps. Mail out a letter of introduction with the goal of providing interventional audiology strategies and examples of scientific research, and clinical services that mesh with each physician’s preventive care responsibilities and patient and outcome objectives.
Why is target audience a valuable consideration? Rather than broadly communicating the message, it is more effective to only target medical professionals who work with this population.
This collaboration may lead to the audiologists sharing the now recognized proven risk that pregnant patients face in developing hyperglycemia which progresses to gestational diabetes, pre-diabetes, Type 2 diabetes, and eventually to impaired cardiometabolic health, and quite possibly hearing loss.
The Benefit of Collaboration Between Specialties
Through shared exposure of respected scientific research OB/GYN specialists, primary care physicians, nurse practitioners, physician assistants, endocrinologists, and other gatekeepers will understand the reasons why pregnant women may end up suffering from hearing loss that potentially compounds postpartum disabilities, and associated co-morbidities.
Upon receipt of a new patient referral, audiologists should take an extensive personal and family medical history of female patients that reveals/uncovers hyperglycemia, hyperlipidemia, abnormal cholesterol labs, hypertension, atherosclerosis, ischemic heart disease, stroke, and obesity among other prominent maladies, that are proven precursors of hearing impairment. This may lead to an increase in physicians and staff referring more at-risk OB/GYN patients to an audiologist who will provide a baseline hearing evaluation and a routine annual follow up, plus a digital or hard copy patient report to the referring medical specialist, which subsequently may enable patients to achieve improved outcomes.
Implementation bias on the part of physicians and audiologists is a reality that delays and impedes the provision of sorely needed health care, and worsens the quality of public health in the United States and around the world. The decision to act with urgency because of new scientific research can make a difference in millions of lives when we combine the results of new medical and audiological science with a well-defined target audience.
Final Thoughts
Identifying, interpreting, and incorporating medical research into your marketing strategy requires intimate knowledge of evidence-based practice, strong communication skills, and an abundance of time. Turnkey methods of the approach outlined here can be tailored to your practice by contacting the author. n
References
- Venkatesh KK, Khan SS, Powe CE. Gestational Diabetes and Long-Term Cardiometabolic Health [published online ahead of print, 2023 Aug 10]. JAMA. 2023;10.1001/jama.2023.
- Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149(1):1-10.
Bob Tysoe is the founder and owner of Hearing Healthcare Marketing. He can be reached at