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

Abstract

Objectives Modern hearing aid (HA) devices include a collection of acoustic signal-processing features designed to improve listening outcomes in a variety of daily auditory environments. Manufacturers market these features at successive levels of technological sophistication. The features included in costlier premium hearing devices are designed to result in further improvements to daily listening outcomes compared to the features included in basic hearing devices. However, independent research has not substantiated such improvements. This research was designed to explore differences in speech-understanding and listening-effort outcomes for older adults using premium-feature and basic-feature HAs in their daily lives. Design For this participant-blinded, repeated, crossover trial 45 older adults (mean age 70.3 years) with mild-to-moderate sensorineural hearing loss wore each of four pairs of bilaterally fitted HAs for one month. HAs were premium-feature and basic-feature devices from two major brands. After each one month trial, participants’ speech-understanding and listening-effort outcomes were evaluated in the laboratory and in daily life. Results Three types of speech-understanding and listening-effort data were collected: measures of laboratory performance, responses to standardized self-report questionnaires, and participant diary entries about daily communication. The only statistically significant superiority for the premium-feature HAs occurred for listening effort in the loud laboratory condition and was demonstrated for only one of the tested brands. Conclusions The predominant complaint of older adults with mild-to-moderate hearing impairment is difficulty understanding speech in various settings. The combined results of all the outcome measures used in this research suggest that, when fitted using scientifically-based practices, both premium-feature and basic-feature HAs are capable of providing considerable, but essentially equivalent, improvements to speech understanding and listening effort in daily life for this population. For HA providers to make evidence-based recommendations to their clientele with hearing impairment it is essential that further independent research investigates the relative benefit/deficit of different levels of hearing technology across brands and manufacturers in these and other real-world listening domains.

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial

“…It should be noted, however, that we have failed previously to observe significant differences in hearing aid outcomes, for outcome measures similar to those in this study, for a wide range of hearing-aid technologies, including some that today would be representative of simpler OTC devices ( Humes, Ahlstrom, Bratt, & Peek, 2009 ). More recently, Cox and colleagues have demonstrated equivalent outcomes between basic and advanced contemporary hearing aids ( Cox, Johnson, & Xu, 2014 , 2016 ; Johnson, Xu, & Cox, 2016 ). Nonetheless, the results from this study using high-quality hearing aids cannot be generalized to other devices, including those more likely to be used in OTC approaches to hearing aid delivery.…”

Applying the COM-B Model to Assess the Usability of Smartphone-Connected Listening Devices in Adults with Hearing Loss

“…Participants reported that the perceived sound quality for made-for-smartphone hearing aids was superior in comparison with participant's existing conventional hearing aids. Although equivalent outcomes have been shown for ''basic'' and ''advanced'' hearing aids (Cox et al, 2016;Johnson et al, 2016), this finding likely arose because the made-for-smartphone hearing aids trialed could have been a much higher specification than participant's existing hearing aids. For the other smartphone-connected listening devices, participants expressed ambivalence concerning perceived sound quality.…”

Benefits from, Satisfaction with, and Self-Efficacy for Advanced Digital Hearing Aids in Users with Mild Sensorineural Hearing Loss

“…Johnson and colleagues 11 found that only 10 studies were available in the peer-reviewed literature that had reported HA outcomes for patients with MSNHL, and most of those investigations only involved low levels of evidence, were rather dated, and reported findings for analog and early digital devices. Cox et al and Johnson et al, [21][22][23] however, reported outcomes from studies that compared entry-to premium-level ADT HAs for patients with mild and moderate SNHL. Although the findings for persons with MSNHL were similar to those with moderate losses, outcomes were not reported separately for the group with MSNHL.…”