Genetic Literacy Among Hearing Health Providers

Objectives: Genetic testing to identify an underlying etiology of sensorineural hearing loss is increasingly important in an evolving landscape of precision medicine. However, little is known about hearing health providers’ genetic literacy, perceived importance of genetic testing, or comfort with implementation of genetic testing in clinical practice. In this study, we sought to assess these domains among providers caring for patients with hearing loss and examine differences across clinical training and patient populations served. Design: A cross-sectional online survey was distributed to hearing health providers across clinical settings. The survey included demographic and practice characteristics, the Genetic Literacy and Comprehension assessment, perceived importance of genetic testing, current and desired use of testing, scope of practice, and comfort with ordering and interpreting genetic tests. Respondents were categorized by clinical degree (audiology, medical degree, other) and by patient population (primarily pediatric versus primarily adult). Group differences were evaluated using Fisher’s exact tests. Results: Ninety-six respondents were included. Genetic literacy was high across providers, with accuracy scores on the Genetic Literacy and Comprehension assessment exceeding 96% and no significant differences by clinical degree. Pediatric providers rated genetic testing as significantly more important than adult providers (87 versus 41% reported genetic testing as extremely or very important/useful, respectively) and reported higher rates of routine testing (55 versus 29%, respectively). Across all respondents, desired use of genetic testing exceeded current use, with 71% reporting that they desired to use genetic testing in their clinical practice and only 43% reporting they currently utilized genetic testing in their practice. Comfort with genetic testing was low, with more than half of the respondents reporting being uncomfortable ordering or interpreting genetic testing. However, there were provider-level differences in comfort, with medical doctors being significantly more comfortable than audiologists or other providers. Patterns of comfort were consistent with current ordering practice, in which medical doctors—particularly otolaryngologists—were most identified as ordering genetic testing. However, these patterns did not align with respondents’ preferences, as many indicated that both audiologists and medical doctors should be involved in ordering testing for patients with hearing loss. Conclusions: Despite high genetic literacy amongst respondents, gaps exist between the perceived importance of and provider comfort with genetic testing. Gaps also exist between current and desired use of genetic testing in clinical practice. Findings highlight the need for expanded practical training in clinical genetics and institutional support to facilitate broader integration of genetic testing into hearing healthcare.