Ubiquitous real-world sensing and audiology-based health informatics

Background: Hearing impairment and hearing rehabilitation strategies have historically been studied within the confines of a sound booth under controlled experimental conditions. The real world is quite different from the clinical setting and it is important to study how a person with hearing impairment interacts with the world both with and without a hearing assist intervention. A person's ability to hear enables them to communicate and to effectively interact with the world. If a person suffers from hearing impairment, we might anticipate that they could become more disengaged from the world, more socially isolated, potentially depressed, and have additional comorbidities such as cognitive and physical impairment. Indeed, prior research has shown that hearing impairment is associated with social isolation, decreased functional ability and mobility, fall risk, diabetes, and cognitive impairment. However, nearly all of the work that has been done in this area of assessing the impact of hearing impairment on a person's social, cognitive, and physical health has been done through clinical tests or self-report studies using questionnaires and surveys that attempt to objectively quantify various aspects of health. Unfortunately, clinical tests, questionnaires, and surveys oftentimes inaccurately assess a person's true social, cognitive, and physical health. Only when a person is observed in their natural living environment can amore accurate assessment of health be obtained. The ability to assess hearing health, social engagement, cognitive, and physical health in natural living environments is becoming possible with the advent of ubiquitous sensing capabilities. Purpose: Here we discuss some of the work that has been done by our group and others that may be of use to the field of audiology e-health. The purpose of this article is not to present new experimental data, but rather to describe a new method of using advanced in-home sensing techniques to better understand how hearing diagnostics, interventions, and rehabilitation influence the lives and behaviors of patients.