Impact of Hearing Aid Technology on Outcomes in Daily Life I: The Patients’ Perspective

Objectives: One of the challenges facing hearing care providers when recommending hearing aids is the choice of device technology level. Major manufacturers market families of hearing aids that are described as spanning the range from basic technology to premium technology. Premium technology hearing aids include acoustical processing capabilities (features) that are not found in basic technology instruments. These premium features are intended to yield improved hearing in daily life compared with basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared with basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium- and basic-feature hearing aids in their daily lives. Design: This was a single-blinded, repeated, crossover trial in which the participants were blinded. All procedures were carefully controlled to limit researcher bias. Forty-five participants used carefully fitted bilateral hearing aids for 1 month and then provided data to describe the hearing improvements or deficiencies noted in daily life. Typical participants were 70 years old with mild to moderate adult-onset hearing loss bilaterally. Each participant used four pairs of hearing aids: premium- and basic-feature devices from brands marketed by each of two major manufacturers. Participants were blinded about the devices they used and about the research questions. Results: All of the outcomes were designed to capture the participant’s point of view about the benefits of the hearing aids. Three types of data were collected: change in hearing-related quality of life, extent of agreement with six positively worded statements about everyday hearing with the hearing aids, and reported preferences between the premium- and basic-feature devices from each brand as well as across all four research hearing aids combined. None of these measures yielded a statistically significant difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. Conclusions: It could reasonably be asserted that the patient’s perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the present research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient’s point of view. All of the research hearing aids were substantially, but equally, helpful. Further research is needed on this topic with other hearing aids and other manufacturers. In the meantime, providers should insist on scientifically credible independent evidence to support effectiveness claims for any hearing help devices.

[1]  Harvey Dillon.  What ’ s New in Prescriptive Fittings Down Under ? Gitte Keidser , .

[2]  F. Lin,et al.  Prevalence of hearing aid use among older adults in the United States. , 2012, Archives of internal medicine.

[3]  M. Asadi-lari,et al.  Patients' needs, satisfaction, and health related quality of life: Towards a comprehensive model , 2004, Health and quality of life outcomes.

[4]  G H Guyatt,et al.  Determining a minimal important change in a disease-specific Quality of Life Questionnaire. , 1994, Journal of clinical epidemiology.

[5]  S. de Lusignan,et al.  Interventions to improve hearing aid use in adult auditory rehabilitation. , 2016, The Cochrane database of systematic reviews.

[6]  R. Cox,et al.  Impact of Advanced Hearing Aid Technology on Speech Understanding for Older Listeners with Mild to Moderate, Adult-Onset, Sensorineural Hearing Loss , 2014, Gerontology.

[7]  R. Bentler,et al.  Digital noise reduction: Outcomes from laboratory and field studies , 2008, International journal of audiology.

[8]  Sanford Labovitz,et al.  Some Observations on Measurement and Statistics , 1967 .

[9]  S. Kochkin,et al.  Key to Graphs & Tables , 2022 .

[10]  Harvey Dillon,et al.  What'S new from NAL in hearing aid prescriptions? , 2006 .

[11]  L F Smith,et al.  Quality of life measures. , 1993, BMJ.

[12]  Craig W Newman,et al.  Benefit From, Satisfaction With, and Cost-Effectiveness of Three Different Hearing Aid Technologies. , 1998, American journal of audiology.

[13]  C. O'boyle,et al.  Measuring the quality of later life. , 1997, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[14]  Luigi Ferrucci,et al.  Hearing loss prevalence in the United States. , 2011, Archives of internal medicine.

[15]  Leonard R. Sussman,et al.  Nominal, Ordinal, Interval, and Ratio Typologies are Misleading , 1993 .

[16]  R. Grissom.  Probability of the superior outcome of one treatment over another. , 1994 .

[17]  Edgar Erdfelder,et al.  G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences , 2007, Behavior research methods.

[18]  William R. Corson,et al.  Consequences of Failure , 1973 .

[19]  Cas Smits,et al.  The Association Between Hearing Status and Psychosocial Health Before the Age of 70 Years: Results From an Internet-Based National Survey on Hearing , 2009, Ear and hearing.

[20]  J. Niparko,et al.  Consumer Preferences for Hearing Aid Attributes , 2012, Trends in amplification.

[21]  S. Kochkin.  MarkeTrak VIII Patients report improved quality of life with hearing aid usage , 2011 .

[22]  G. Naylor,et al.  Exploring the Effects of the Narrative Embodied in the Hearing Aid Fitting Process on Treatment Outcomes , 2015, Ear and hearing.

[23]  Stig Arlinger,et al.  Negative consequences of uncorrected hearing loss—a review , 2003, International journal of audiology.

[24]  G. Norman,et al.  Interpretation of Changes in Health-related Quality of Life: The Remarkable Universality of Half a Standard Deviation , 2003, Medical care.

[25]  Sergei Kochkin,et al.  The Impact of Untreated Hearing Loss on Household Income , 2005 .

[26]  Tim Schmitz,et al.  Contrast Analysis Focused Comparisons In The Analysis Of Variance , 2016 .

[27]  R. Cox.  Evidence-based practice in audiology. , 2005, Journal of the American Academy of Audiology.

[28]  J. Kirwan,et al.  OUTCOME SERIES SERIES EDITORS: D. L. SCOTT AND A. SILMAN QUALITY OF LIFE MEASURES , 1996 .

[29]  Diana Adler,et al.  Using Multivariate Statistics , 2016 .

[30]  E. Platz,et al.  Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999-2004. , 2008, Archives of internal medicine.

[31]  S. de Lusignan,et al.  Interventions to improve hearing aid use in adult auditory rehabilitation. , 2016, The Cochrane database of systematic reviews.

[32]  D A Bloch,et al.  Capturing the patient's view of change as a clinical outcome measure. , 1999, JAMA.

[33]  G A Studebaker,et al.  Efficacy of 3 commonly used hearing aid circuits: A crossover trial. NIDCD/VA Hearing Aid Clinical Trial Group. , 2000, JAMA.

[34]  Ruth A. Bentler,et al.  Comparison of Hearing Aids Over the 20th Century , 2000, Ear and hearing.

[35]  Sergei Kochkin,et al.  MarkeTrak VIII: Consumer satisfaction with hearing aids is slowly increasing , 2010 .

[36]  T. Donaldson.  Robustness of the F-Test to Errors of Both Kinds and the Correlation Between the Numerator and Denominator of the F-Ratio , 1968 .

[37]  G. Glass,et al.  Consequences of Failure to Meet Assumptions Underlying the Fixed Effects Analyses of Variance and Covariance , 1972 .