OBJECTIVES: Previous work examined whether preferences for hearing-related health states can be described using a sensory experience, in the form of an acoustic simulation of hearing loss, rather than using vignettes. This research examined whether utility values vary depending on how participants interact with the stimuli, and whether simulating healthy hearing as a comparator to simulations of hearing loss would increase the reliability of health valuations.

METHODS: Single-sided deafness (SSD), a complete loss of hearing in one ear, was simulated. Several talkers were positioned within a virtual acoustic environment to create multi-talker conversations. 64 normal-hearing participants were asked to express their preferences for two hearing-related health states based on acoustic simulations using a time trade-off task. Participants either listened actively for a talker within the simulation and were asked to report what the talker said, or listened passively to the simulations without any further instructions. In 50% of participants, the simulations of SSD were presented with a simulation of perfect hearing health as a comparator.

RESULTS: Actively listening to the simulations resulted in significantly lower utility scores compared to passively listening (mean difference -0.14, CI 0.03 to 0.25). On average, there was no effect on utility values from providing a simulation of perfect hearing health as a comparator to the simulations of SSD. However, providing a perfect hearing health comparator made utility values more reliable (ICC 0.81, CI 0.67 to 0.92) compared to when no comparator was provided (ICC 0.74, CI 0.57 to 0.88).

CONCLUSIONS: The use of an active listening task together with a comparator simulation of perfect hearing health produces utility values more in line with those reported by patients. The use of a comparator simulation also increases the reliability of valuations, making the large-scale use of simulations more feasible by avoiding the need to obtain repeated valuations.