Messages from the NIDCD Director

In vitro models are foundational to biological research. These tools accelerate basic science and enable screening at great scale, which in turn allows for rapid identification of potential therapeutic targets and interventions. Increasingly, they are part of a broader shift toward new approach methodologies (NAMs) —an evolving set of tools that includes cell-based in vitro models, in silico and computational models, tissue chips, and other human-based platforms that can complement, and in some cases reduce reliance on, traditional animal models. As NAMs enable new in silico and human-based platforms, in vitro models themselves are undergoing innovation while also driving it. As a reflection of this model’s importance, NIDCD has outlined its commitment to basic science within our 2023–2027 Strategic Plan, specifically within Theme 2, Goal 2: Develop in vitro models to accelerate basic studies and high-throughput screening.

In communication sciences and across biomedical research, there is a significant gap between the number of discoveries being made and how many of those discoveries are actually applied to clinical care. This gap between what we know and what we do reflects system-level and behavioral barriers that have profound impacts on patient health. It can take an average of 17 years for new science to reach routine clinical use, and many patients commonly receive only half of the recommended care. Bridging this “know-do” gap requires coordinated effort and engagement across providers, systems, and researchers to not only disseminate scientific discovery but to implement it as well.

Enabling access to large-scale multimodal databases is essential to advancing science across all institutes at NIH. As both datasets and analytical methods become more complex, proper data infrastructure can enable multidisciplinary research efforts at a scale greater than that of individual studies alone. In line with NIH-wide strategic plans, NIDCD is making investments in data science that address long-standing research gaps, provide important resources for the research community, and preserve and protect participant privacy and data security.

Current technologies do not support imaging of the living human peripheral and central olfactory system with high spatial and temporal resolution. Certain anatomical and functional characteristics of the olfactory system, such as restricted accessibility, multiple cell types, and low signal resolution, create unique technological challenges. Clinicians often resort to invasive surgical biopsies to assess the olfactory epithelium within the nasal cavity. Recent advances in non-invasive and minimally invasive imaging technologies offer innovative opportunities to produce detailed, real-time images of human olfactory epithelium, potentially reducing the need for invasive biopsies and improving diagnostic accuracy.

Hearing loss can make it difficult to participate in daily conversations, which can lead to frustration, social isolation, depression, anxiety, and other issues that negatively impact quality of life. Assistive technologies such as hearing aids and cochlear implants can improve communication for those with hearing loss, but these devices are used by only a small percentage of those who could benefit from them.

Clinical trials are at the heart of all advances in medical care. They involve prospectively assigning human participants to one or more interventions to evaluate the impact on health-related biomedical or behavioral outcomes. Findings from NIDCD clinical trials help to advance new approaches to preventing, diagnosing, and treating disorders of hearing, balance, taste, smell, voice, speech, and language that affect millions of people in the United States.

NIDCD's extramural research program funds extensive research and training opportunities at universities, medical centers, and other institutions through research grants, career development awards, and other funding mechanisms. To ensure that NIDCD supports research that meets the highest level of scientific and ethical standards to improve the lives of millions of people with communication disorders, we depend on an informed and inclusive peer review process.

More than 30 million adults in the U.S. are estimated to have some degree of hearing loss. Audiologists and other health professionals use several tools to diagnose adult hearing loss, but these tools do not, in large part, assess individuals’ perceptions of their own hearing function or the impact that hearing impairment has on their quality of life. In this director’s message, I describe NIDCD’s efforts to support the development of standard measurement outcomes in adult hearing health care that are meaningful to both the individual with hearing loss and their clinician, and how this may inform data standards for centralized repositories.

Initiatives that attract and retain early stage investigators (ESIs) are vital in ensuring the well-being and stability of the biomedical research workforce. In this director’s message, I describe NIDCD’s efforts to encourage talented ESIs to advance their research careers within the institute’s mission areas.

The NIH Small Business Innovation Research (SBIR) and Small Business Technology Transfer Research (STTR) programs—managed together at NIH under an umbrella program known as SEED (Small business Education and Entrepreneurial Development)—empower small businesses and academic innovators to develop and bring to market new technologies that improve health. In this director’s message, I describe these vital NIH programs and NIDCD’s efforts to support research leading to commercialization of novel products and to advances in pharmaceuticals and devices in our mission areas.

Today, I am pleased to announce the release of the 2023-2027 NIDCD Strategic Plan: Advancing the Science of Communication to Improve Lives. The National Institute on Deafness and Other Communication Disorders (NIDCD) will use the plan to guide research investments in our mission areas of hearing, balance, taste, smell, voice, speech, and language over the next five years.

The NIH INCLUDE Project (INvestigation of Co-occurring conditions across the Lifespan to Understand Down syndromE) aims to address critical health and quality-of-life needs of people with Down syndrome. Individuals with Down syndrome can face significant health challenges, including hearing problems and difficulty with speech and language. In this director’s message, I describe this important NIH program, which offers opportunities for support for the NIDCD research community. I also provide a brief summary of topics discussed at our most recent National Deafness and Other Communication Disorders (NDCD) Advisory Council Meeting in September.

The United States marks a significant milestone in advancing hearing health care, as the Food and Drug Administration (FDA) issued its final rule establishing guidelines for over-the-counter (OTC) hearing aids. This landmark rule, released on August 16, 2022, is part of a broader effort to expand access to high-quality, affordable health care for all Americans. OTC hearing aids are intended to address perceived mild to moderate hearing loss in people 18 or older. Now, millions of adults who have trouble hearing will be able to buy less expensive hearing aids without a medical exam, prescription, or fitting by an audiologist.

NIH has had a longstanding commitment to recruiting talent from diverse groups and to removing barriers to professional advancement for underrepresented minorities. In keeping with this goal, I have made expanding diversity, equity, and inclusion within the NIDCD intramural and extramural workforces one of my chief aims since taking on the directorship of the institute in 2019. In this message, I update you on our ongoing efforts in this area. I also share details regarding an important new NIH policy: Effective in early 2023, grant applicants will be required to include a data management plan in their applications, and in most cases to make their data publicly available. Finally, I provide a brief summary of topics discussed at our latest National Deafness and Other Communication Disorders (NDCD) Advisory Council Meeting in May.

Collaboration between NIH institutes is a valuable way to integrate knowledge bases, expertise, methodologies, and infrastructures and apply them toward shared goals. These partnerships bring multidisciplinary approaches to important scientific questions and lead to innovative strategies for preventing, diagnosing, and treating a wide range of health conditions. In this director’s message, I share some of our collaborations with the NIH’s National Institute on Aging (NIA), illustrating the value of cooperation in advancing science in new directions. I also provide a brief summary of topics discussed at our most recent National Deafness and Other Communication Disorders (NDCD) Advisory Council Meeting in January.

Building on our commitment to growing the biomedical research workforce in the NIDCD’s research areas, the institute has launched new programs aimed at fostering the development of research skills among clinicians. In this director’s message, I describe these new initiatives, and provide a brief summary of topics discussed at our most recent National Deafness and Other Communication Disorders (NDCD) Advisory Council Meeting in September.

The quest to better understand otitis media (OM) has made great strides in recent years. Researchers—many supported by the NIDCD—have identified potential vaccine candidates, uncovered the role of bacterial biofilms in treatment resistance, developed OM animal models, and characterized the host immune response to the condition, among many other advances. To accelerate the translation of this strong foundational knowledge to clinical strategies for preventing and treating OM, last autumn the NIDCD convened a group of scientific experts online for the NIDCD Workshop on Otitis Media in Early Childhood. This message will give you a sense of the topics the participants discussed and the knowledge gaps they identified. I’ve also included highlights from the May meeting of the National Deafness and Other Communication Disorders (NDCD) Advisory Council Meeting.

The award-winning film “Sound of Metal” portrays a musician in recovery from substance use disorder who is confronted with sudden, complete hearing loss. The experience shatters his life. Lauded by some with hearing loss for its realistic depiction of this experience—the fear, the frustration, the uncertainty—the film’s creative use of sound earned it an Academy Award. Credit: "Academy Award Winner" by Dave B. is licensed under CC BY 2.0.

When it comes to the BRAIN Initiative, there is a lot to be excited about—a new director, an array of transformative advances, and the start of a new phase. In this director’s message, I describe this groundbreaking NIH program, which offers opportunities for support for the NIDCD neuroscience community. I have also provided a brief summary of topics discussed at our most recent National Deafness and Other Communication Disorders (NDCD) Advisory Council Meeting in January.

On March 1, 2021, Francis S. Collins, M.D., Ph.D., director of the National Institutes of Health, launched a new initiative, UNITE, to identify actions to address structural racism at NIH, the institutions we support, and anywhere NIH research activities take place, with the overall goal of ending racial inequities across the biomedical research enterprise.

The forthcoming trans-NIH Faculty Institutional Recruitment for Sustainable Transformation (FIRST) program will propose an innovative model to address faculty diversity and inclusion in biomedical research.

As I reflect on my one-year anniversary as NIDCD director, I am grateful for the institute’s talented and resilient scientists and staff and for our many outstanding grantees at research institutions across the country. Although the pandemic has upended our personal and professional lives in ways we never could have imagined, the continued commitment to the NIDCD’s mission inspires me. Thank you to all for the efforts to navigate a challenging road during the past months.

Urgent calls to confront systemic racism in our society are demanding our attention. In June, Francis S. Collins, M.D., Ph.D., Director of the National Institutes of Health, called upon each of us in the NIH community to “reaffirm our common resolve … to ensure we foster a culture of inclusion, equity, and respect for one another . ...” I write now to affirm the NIDCD’s commitment to inclusive excellence, and our resolve to both embrace and enable the contributions of a diverse scientific workforce.

Communication is an important and complex transaction that depends on visual and, often, auditory (hearing) cues. Factors that influence how well our spoken language is received include our eye contact and body language, whether we stand or sit while speaking, the tone of our voices and our facial expressions, and environmental lighting and background noise.

Approximately 15% of U.S. adults report some degree of hearing loss. Untreated hearing loss is a huge issue for human health. It may lead to isolation, and it has been associated with serious conditions such as depression, anxiety, low self-esteem, dementia, reduced mobility, and falls.

Approximately 466 million children and adults worldwide have disabling hearing loss, according to the World Health Organization (WHO). Unaddressed hearing loss costs an estimated US$750 billion annually worldwide and potentially interferes greatly with an individual’s physical, behavioral, and social functioning.

The NIDCD’s mission is to improve the lives of the millions of people with hearing loss and other communication disorders, spanning functions of hearing, balance, taste, smell, voice, speech, and language.