1. Caryn A. Turner, MPH 1 ; Hasanat Alamgir, PhD 1 ; Jose A. Betancourt, DrPH 1 ; David L. Tucker, BS 2 ; Sharon P. Cooper, PhD 1 ; Nicole J. Wong, MPH 1 ; Tanisha L. Hammill, MPH 4 ; MAJ Andrew J. Senchak 3 ; Col. Mark D. Packer 4 1 UTSPH San Antonio; 2 The Geneva Foundation; 3 Walter Reed National Military Medical Center; 4 DoD Hearing Center of Excellence Challenges to studying the impact of Hearing Impairment and Noise-Induced Hearing Injury (HINIHI) on quality of life (QoL) in the active duty military population Background: The VA reports a steady increase in auditory system disabilities since 1999, with a 12% increase in disability recipients in 2013. Determining QoL is vital to understanding the comprehensive burden of HINIHI due to psychological, cognitive and social effects. Objective: Examine the feasibility of studying the impact of HINIHI on QoL in active duty Service Members (SMs). Defining QoL: No uniform definition for quality of life. Discussion: Literature consistently shows an association between HINIHI and lower QoL, especially in deployed populations. Few studies investigated HINIHI and QoL: Some investigate Veteran status, HINIHI and QoL, usually after an intervention. None have investigated HINIHI and QoL in active duty SMs. No HINIHI specific QoL instruments made for Military populations. Acknowledgements: Funding awarded through BAA 11-01-HPW from DoD Hearing Center of Excellence: “Clinical Investigation of Hearing Injuries, Noise Exposures, and Cost Burden in Active Duty US Military Service Members”. Inquires to Caryn Turner Caryn.A.Turner@uth.tmc.edu Future Direction and Recommendations: Form a uniform definition for QoL. Future studies should: Use a generic QoL instrument (SF- 36). Use a HINIHI specific QoL instrument made for active duty personnel. Why study QoL in military populations? Sociodemographics are different when compared to civilian populations: Primarily younger, males, with higher physical demand, and high degrees of noise exposure. Organizational policies require SMs to be disqualified if unfit for action/ non-deployable. Commonly Used Generic QoL Measurements: SF-36 (SF-36V, VR-36, VR-12, RAND-12, RAND-36) Health Utilities Index Mark 3 (HUI3) Short Portable Mental Status Questionnaire (SPMSQ) Geriatric Depression Scale (GDS) Self-Evaluation of Life Function (SELF) Mini-Mental State Examination (MMSE) Nord-Trondelag Health Study (HUNT) Q1 and Q2 HINIHI Specific QoL Measurements: Hearing Handicap Inventory for the Elderly (HHIE) Quantified Denver Scale of Communication Function (QDS) International Outcome Inventory-Cochlear implant (IOI-CI) Findings from HINIHI related QoL studies in civilians: Associated with higher depression rates in men. Affects effective communication, which can lead to frustration and antagonism between partners. Untreated HINIHI can impact job effectiveness, promotion opportunities and lifetime earning power. Figure 1. Adaptation of QoL definition by Patrick (1993). Photo 1. Photo courtesy of U.S. Marine Corps. UTSPH IRB: HSC-SPH-12-0628 USAMRMC IRB: 392796 WRNMMC IRB: 399695 USAMRMC HRPO: A- 18329.A; A- 18329.B IRB Approvals: Figure 2. Domains Covered by the 19 studies included in the review. Figure 3. Model of restrictions due to HINIHI, adapted from Hetu (2011). Results: 7 4 8