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DeciBHAL is a Markov microsimulation model of hearing loss natural history, diagnosis, and treatment across the lifespan. DeciBHAL was developed in conjunction with the Lancet Commission on Hearing Loss, and it can be used to project the clinical and economic outcomes of different hearing healthcare interventions to produce cost-effectiveness estimates and guide resource allocation. DeciBHAL is currently validated in Chile, India, Nigeria, and the US. However, DeciBHAL can be expanded other settings with the appropriate input data (link to parameter list – attached here), and we plan to further develop an online version of DeciBHAL to allow decision makers to tailor its use to their own policy questions.

Clinical Parameters
Hearing Loss Natural History

  • Life Tables: Probability of death by age
    • Potential source: United Nations Population Division
  • Prevalence of hearing loss at each decade
    • Potential source: Global Burden of Disease estimates
  • Prevalence of chronic suppurative otitis media
    • Potential source: World Health Organization CSOM report 2002
  • Acute otitis media incidence by age
    • Potential source: Monasta PLOS One 2012
  • Prevalence of hearing impairment due to otitis media by age
    • Potential source: Monasta PLOS One 2012

Hearing Loss Treatment Data
Among all persons with bilateral hearing loss:

  • Prevalence of hearing aid use at each decade
  • Prevalence of hearing aid use at age 1 and 5
  • Prevalence of cochlear implant use at each decade
  • Prevalence of cochlear implant use at ages 1 and 5


Economic Parameters
For pediatric and adult populations:

  • Hearing aid device cost
  • Proportion of hearing aid users that use bilateral hearing aids
  • Average number of years to replace hearing aids
  • Yearly hearing aid battery costs
  • Cochlear implant surgical costs
  • Cochlear implant device costs
  • Cochlear implant complication costs
  • Yearly speech and language pathology costs for cochlear implant users
  • Yearly deaf education costs