Impact of Advanced Hearing Aid Technology on Speech Understanding for Older Listeners with Mild to Moderate, Adult-Onset, Sensorineural Hearing Loss

Abstract

Background: Hearing loss is one of the most common chronic health conditions of older people. Hearing aids are the customary treatment and they improve quality of life in older adults. Even so, relatively few older adults with uncomplicated, mild to moderate, adult-onset, sensorineural hearing loss use hearing aids. One reason for this is a belief that hearing aids do not provide sufficient value to justify their expense. Although modern hearing aids are available at several price points, there is minimal evidence about the relative benefits of premium-level versus basic-level hearing aid technologies. Objective: This research was designed to demonstrate the relative effectiveness of premium hearing aids compared with basic hearing aids in improving speech understanding and quality of life. Methods: 25 participants, including both new and experienced hearing aid users, completed blinded month-long field trials with each of four pairs of hearing aids: two basic and two premium level. Outcomes were laboratory speech understanding tests, standardized questionnaires and open-ended diary items. Results: Participants reacted very positively to all the hearing aids. Both everyday speech understanding and quality of life were substantially improved with hearing aids. Results for both new and experienced users were consistent with a conclusion that there were no statistically significant or clinically important differences in improvement between the premium- and basic-level hearing aids. Conclusions: It should not be assumed that more costly hearing aids always produce better outcomes. With contemporary hearing aids from two major manufacturers, the subjects obtained as much improvement in speech understanding and quality of life from lower-cost basic-level instruments as from higher-cost premium-level instruments. Regardless of technology level, comprehensive best-practice fitting protocols should be followed to optimize results for every patient. © 2014 S. Karger AG, Basel

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

“…This is consistent with a value of Cohen’s d = 0.5. As we have noted previously (Cox, Johnson, & Xu, 2014), a medium effect size would result in about 20% of individuals who wear premium-feature hearing aids performing above the distribution for persons wearing basic-feature devices. Also, a difference equal to a medium effect would create a probability of about .64 that an individual would perform better with premium-feature hearing aids than with basic-feature hearing aids (keep in mind that with a zero effect, this probability would be .5) (Grissom, 1994).…”

“…Quality of life outcomes for 25 of these participants were presented in Cox et al (2014). The present article expands on those data with the additional power provided by 20 more participants as well as presenting previously unreported outcomes reflecting the patient’s perspective.…”

Impact of Hearing Aid Technology on Outcomes in Daily Life II: Speech Understanding and Listening Effort

“…A detailed description of participant demographics is provided in Cox et al (2016). Speech-understanding outcomes for the first 25 of these participants were presented in Cox et al (2014). The present article expands on those data with the additional power provided by 20 more participants and presents previously unreported outcomes in the domain of listening effort.…”

“…The rationales for the first four features listed in Table 1 and a brief review of the published independent research about their effectiveness in the domain of speech understanding can be found in Cox et al 2014. At the time of that writing there was a lack of independent literature indicating any real world advantages of the four premium features over the basic versions of those features in speech understanding.…”

Hearing Loss Health Care for Older Adults

“…The pricing structure for "high-end" versus "basic" hearing aids is of dubious benefit, however, with some literature suggesting little functional difference to justify the price disparity between these 2 levels of technology (generally several thousand dollars). 45 A second reason for the high cost of hearing aids is that they are obtained by audiologists at a high wholesale cost as a result of the low volume of hearing aid sales (ϳ20 units/month 43 ) for most providers. By contrast, the wholesale cost of a pair of mid-tier hearing aids when purchased by large-volume providers such as the Veterans Administration in the United States and the National Health Service in the United Kingdom is generally less than $300.…”