Knowesis provides system engineering, system security and deployment, information management, analytics, and program management support to HCE. One of HCE’s highest priorities is to ensure hearing loss and auditory injury patient data are captured and tracked in the Joint Hearing Loss and Auditory System Injury Registry (JHASIR). Knowesis provides user acceptance testing and deployment of new production versions as well as database administration and preparation of Risk Management Framework certification packages. In addition, our engineers support the operation and sustainment of the Enterprise Clinical Audiology Application (ECAA). This enterprise application captures clinical audiograms and is a primary data source in JHASIR. Our team has managed and assisted in the deployment of ECAA to over 100+ military treatment facilities.
Knowesis’ clinical data analysts act as subject matter experts to audiologists, researchers and leadership recommending data and methods to support a variety of research activities, performance metrics, and disease prevalence.
In analyzing, evaluating, and proposing recommendations on data collection and information architecture methodologies and protocols, Knowesis staff assist in refining and strengthening research and clinical informatics effectiveness within the HCE. Knowesis supported the research protocol on Longitudinal Study of Hearing in the Military, collecting, de-identifying, and analyzing audiograms from the Defense Occupational and Environmental Health Readiness System (DOEHRS-HC) to determine how the hearing abilities of Service members change over time. Statistical modeling was utilized to determine the relative risk of suffering a future decrease in hearing abilities based on current hearing abilities while controlling for confounders such as age, gender, and occupation. From this information, we conducted a comprehensive analysis to report demographic, medical, and socioeconomic parameters associated with injury to the auditory system from a multitude of clinical and patient data sources, to include DOERHS-HC, the Joint Trauma Registry, the DoD Trauma Registry (DODTR), the Health Affairs registry, and other DoD/VA registries and sanitized data repositories. Additional aims include examining noise exposure data to explore associations between environmental exposures and hearing loss to create a job exposure matrix, and implementing a framework to estimate the economic burden of hearing loss borne by the DoD.
Defense Health Agency, Hearing Center of Excellence
The Defense Health Agency (DHA) Hearing Center of Excellence (HCE) fosters and promotes the prevention, diagnosis, mitigation, treatment, rehabilitation, and research of hearing loss and auditory impairment, including audio-vestibular dysfunction related to traumatic brain injury. The mission is to optimize operational performance, heighten medical readiness, and enhance quality of life through collaborative leadership and advocacy for hearing and balance health initiatives. In addition, the goal is to reduce both tangible and intangible costs of hearing loss and auditory injuries among U.S. military personnel and Veterans. The HCE collaborates with the Department of Veterans Affairs (VA) and leads the cooperative effort to meet its mission and goal. DHA HCE is aligned within the Research and Development Directorate (J-9).