Evidence map›Paper›PMID 39058421›Full record

ArticleJournal of the American Geriatrics Society2024

The Medicare annual wellness visit: An opportunity to improve health system identification of hearing loss?

Danielle S Powell, Mingche M J Wu, Stephanie Nothelle, Jamie M Smith, Kelly Gleason, Esther S Oh, Hillary D Lum, Nicholas S Reed, Jennifer L Wolff

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Documented follow-up to memory concerns reported at the Medicare Annual Wellness Visit.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Danielle S PowellDepartment of Hearing and Speech Sciences, University of Maryland, College Park, Maryland, USA.ORCID https://orcid.org/0000-0003-3447-4450
Mingche M J WuDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Stephanie NothelleDivision of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jamie M SmithSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Kelly GleasonSchool of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Esther S OhDivision of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Hillary D LumDivision of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.ORCID https://orcid.org/0000-0001-5637-3912
Nicholas S ReedDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Jennifer L WolffDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Funding

Technological Assessment and Solutions Core - RC4P30AG021334 · NIA · JOHNS HOPKINS UNIVERSITY · PI Jeremy D Walston · 2003 to 2026
$33.2M
Utilizing Technology and AI Approaches to Facilitate Independence andResilience in Older AdultsP30AG073104 · NIA · JOHNS HOPKINS UNIVERSITY · PI Alexis Battle · 2021 to 2026
$31.2M
Consumer Health Information Technology to Engage and Support ADRD Caregivers: Research Program to Address ADRD Implementation MIlestone 13.IR35AG072310 · NIA · JOHNS HOPKINS UNIVERSITY · PI WOLFF, JENNIFER L. · 2021 to 2025
$4.3M
Addressing Hearing Loss as a Common Unmet Contributor to Neuropsychiatric SymptomsR01AG076525 · NIA · JOHNS HOPKINS UNIVERSITY · PI CARRIE L NIEMAN, Esther Seunghee Oh · 2022 to 2026
$3.9M
Health Services and Outcomes Research for Aging PopulationsT32AG066576 · NIA · JOHNS HOPKINS UNIVERSITY · PI CYNTHIA Melinda BOYD, Jennifer L. Wolff · 2020 to 2026
$3.8M
Novel Blood Biomarker of Alzheimer's disease Using Oral Glucose ToleranceR01AG057725 · NIA · JOHNS HOPKINS UNIVERSITY · PI OH, ESTHER SEUNGHEE · 2017 to 2021
$2.4M
Does vestibular loss predict falls in patients with Alzheimer's Disease?R01AG057667 · NIA · JOHNS HOPKINS UNIVERSITY · PI OH, ESTHER SEUNGHEE · 2018 to 2022
$1.8M
Primary care based collaborative approach to care management for older adults with dementiaK23AG072037 · NIA · JOHNS HOPKINS UNIVERSITY · PI NOTHELLE, STEPHANIE · 2021 to 2025
$946k
The Role of Hearing Loss in Health Care Outcomes.K23AG065443 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI REED, NICHOLAS SALVATORE · 2020 to 2024
$943k
Role and Mechanism of Hearing Impairment in Cognitive Decline and DementiaK01AG054693 · NIA · JOHNS HOPKINS UNIVERSITY · PI DEAL, JENNIFER ANNE · 2017 to 2022
$773k
Alzheimer's Association 23AARF-1030303NIA NIH HHS K01 AG054693NIA NIH HHS K01AG054693NIA NIH HHS K23 AG065443NIA NIH HHS K23AG065443NIA NIH HHS K23 AG072037NIA NIH HHS P30 AG021334NIA NIH HHS P30AG021334NIA NIH HHS P30 AG073104NIA NIH HHS P30AG073104NIA NIH HHS R01 AG057667NIA NIH HHS R01AG057667NIA NIH HHS R01 AG057725NIA NIH HHS R01AG057725NIA NIH HHS R01 AG076525NIA NIH HHS R01AG076525NIA NIH HHS R35 AG072310NIA NIH HHS R35AG072310NIA NIH HHS T32 AG066576NIA NIH HHS T32AG066576
6 · The paper itself

Abstract

backgroundHearing loss is prevalent and consequential but under-diagnosed and managed. The Medicare Annual Wellness Visit (AWV) health risk assessment elicits patient-reported hearing concerns but whether such information affects documentation, diagnosis, or referral is unknown.

methodsWe use 5 years of electronic medical record (EMR) data (2017-2022) for a sample of 13,776 older primary care patients. We identify the first (index) AWV indication of hearing concerns and existing and subsequent hearing loss EMR diagnoses (visit diagnoses or problem list diagnoses) and audiology referrals. For a 20% random sample of AWV notes (n = 474) we compared hearing loss EMR diagnoses to documentation of (1) hearing concerns, (2) hearing loss/aid use, and (3) referrals for hearing care.

resultsOf 3845 (27.9%) older adults who identified hearing concerns (mean age 79.1 years, 57% female, 75% white) 24% had an existing hearing diagnosis recorded. Among 474 patients with AWV clinical notes reviewed, 90 (19%) had an existing hearing loss diagnosis. Clinicians were more likely to document hearing concerns or hearing loss/aid use for those with (vs. without) an existing EMR diagnosis (50.6% vs. 35.9%, p = 0.01; 68.9% vs. 37.5%, p < 0.001, respectively). EMR diagnoses of hearing loss were recorded for no more than 40% of those with indicated hearing concerns. Among those without prior diagnosis 38 (9.9%) received a hearing care referral within 1 month. Subgroup analysis suggest greater likelihood of documenting hearing concerns for patients age 80+ (OR:1.51, 95% confidence interval [CI]: 1.03, 2.19) and decreased likelihood of documenting known hearing loss among patients with more chronic conditions (OR: 0.49, 95% CI: 0.27, 0.9), with no differences observed by race.

conclusionDocumentation of hearing loss in EMR and AWV clinical notes is limited among older adults with subjective hearing concerns. Systematic support and incorporation of hearing into EMR and clinical notes may increase hearing loss visibility by care teams.

Indexed as

Electronic Health RecordsHearing LossMedicareAgedAged, 80 and overFemaleHumansMalePrimary Health CareReferral and ConsultationRisk AssessmentUnited Statesannual wellness visithearingMedicare

Identifiers

PMID39058421
PMCPMC11461099

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.