User Awareness and Perspectives Survey on Privacy, Security and Usability of Auditory Prostheses

TL;DR

This study investigates user awareness of privacy and security and the factors influencing purchasing decisions for cochlear implants and hearing aids amid increasing device connectivity. A REDCap-based survey (n=27) quantified satisfaction, feature importance, and privacy knowledge, revealing strong satisfaction with performance but limited user understanding of privacy practices. Findings show performance and reliability as primary purchase drivers, with notable gaps in privacy education, underscoring the need for education and privacy-by-design enhancements. The work informs manufacturers, clinicians, and policymakers about strengthening safety, usability, and adoption of auditory prostheses.

Abstract

According to the World Health Organization, over 466 million people worldwide suffer from disabling hearing loss, with approximately 34 million of these being children. Hearing aids (HA) and cochlear implants (CI) have become indispensable tools for restoring hearing and enhancing the quality of life for individuals with hearing impairments. Clinical research and consumer studies indicate that users of HAs and CIs report significant improvements in their daily lives, including enhanced communication abilities and social engagement and reduced psychological stress. Modern auditory prosthetic devices are more advanced and interconnected with digital networks to add functionality, such as streaming audio directly from smartphones and other devices, remote adjustments by audiologists, integration with smart home systems, and access to artificial intelligence-driven sound enhancement features. With this interconnectivity, issues surrounding data privacy and security have become increasingly pertinent. There is limited research on the usability perceptions of current HA and CI models from the perspective of end-users. In addition, no studies have investigated consumer mental models during the purchasing process, particularly which factors they prioritize when selecting a device. In this study, we assessed participants' satisfaction levels with various features of their auditory prostheses. This work contributes to the field by addressing gaps in user perceptions of HA and CI usability, identifying key factors in consumer purchasing decisions, and highlighting the need for improved privacy and security awareness and education among users.

Figures (5)

• Figure 1: Participants’ responses when asked questions on device privacy and security: Have you come across any information regarding privacy and security practices (like usage of passwords, and information on data protection) associated with your cochlear implant or hearing aid? (top) and What do you believe could be done to enhance consumer awareness and education regarding privacy and security issues associated with cochlear implants or hearing aids? (bottom)
• Figure A.1: Participants demographics. Gender (left) and age-groups of the participants (right).
• Figure A.2: Distribution of participants across various brands of cochlear implants and hearing aid devices (left) and duration of device usage among participants (right).
• Figure A.3: Survey participants’ responses when asked: How satisfied are you with the features of your current cochlear implant or hearing aid?
• Figure A.4: Survey participants’ responses when asked: When deciding to purchase a cochlear implant or hearing aid, what factors are most important to you? Please rank them in order of importance, with 1 being the most important and 9 being the least important. Please assign a unique rank to each option.