Presentation (CTI)

OBJECTIVES: The choice of a hearing rehabilitation strategy depends on a combination of clinical indications, professional judgment, and patient-centered preferences. While clinicians consider factors such as hearing loss profile, anatomical suitability, and device-related limitations, patients may prioritize comfort, aesthetics, and usability. These aspects are particularly relevant for bone conduction devices (BCDs), which are safe and effective options for conductive or mixed hearing loss. Understanding patient-valued benefits supports individualized rehabilitation, shared decision-making, reimbursement policies, and device development. This scoping review aims to synthesize published evidence on patient preferences related to BCDs and to structure a patient-preference elicitation study to inform decision-making around coverage and reimbursement.
METHODS: This scoping review followed the Joanna Briggs Institute guidance. Search strategy was based on the “PCC” framework, including Population, Concept, and Context and was conducted in MEDLINE via PubMed and ScienceDirect, supplemented by manual searching. Only English-language publications were included. Two independent reviewers screened records, assessed eligibility, and extracted data, with disagreements resolved by a third reviewer. Findings were summarized through a structured narrative synthesis and used to develop a Discrete Choice Experiment (DCE) study proposal.
RESULTS: Of the 84 records identified, 23 underwent full-text screening, and 13 were included in the quantitative analysis of patients’ preferences for hearing solutions. Six studies explored patients’ choice related to hearing aids (HAs), while three focused on cochlear implant (CI) users or their parents. The remaining studies addressed hearing-service or implant-care delivery. No quantitative study on BCDs patients’ preference was retrieved, highlighting the evidence gap for these devices.
CONCLUSIONS: When multiple treatment options are available, decisions should balance clinical recommendations with patient preferences. Although stated-preference evidence is available for HAs and CIs, patient trade-offs for BCDs remain unexplored. Therefore, a European ISPOR-aligned DCE study proposal was developed to quantify patient preferences and support patient-centered evidence in reimbursement decision-making for BCDs.