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

Abstract

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 to basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared to basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium-feature 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 one 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 4 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 current 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 hearin...

Impact of Hearing Aid Technology on Outcomes in Daily Life III: Localization

“…Specifics about the research design, participants, and hearing aid fitting have been described in detail in the first paper of this series (Cox, Johnson, & Xu, 2016) and are described briefly here. Study procedures were reviewed and approved by the University of Memphis Institutional Review Board.…”

“…Three manually selectable programs were provided: (1) an automatic program (the default setting); (2) the strongest fixed front-facing directional program (manually selectable); and (3) the program with the most effective technology for detecting speech signals originating from different directions (manually selectable) 1 . Further details of these three programs can be found in Cox et al (2016). For each pair of hearing aids, a remote control was provided to allow for adjustments of volume and program as needed.…”

“…The rationale for choosing this effect size has been discussed in Cox et al (2016). With 45 participants, this research had greater than 98% power to detect a medium effect favoring premium-feature hearing aids (computed using G*power 3 [Faul et al 2007]).…”

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

“…Study procedures were reviewed and approved by the University of Memphis Institutional Review Board. Details about the overall design of the study are provided in Cox et al (2016).…”

Self-determination theory and hearing rehabilitation: The role of motivation in help-seeking, hearing aid adoption and hearing aid fitting outcomes

“…For each form of intervention there has been evidence of benefit (Takahashi et al, 2007;Johnson, Danhauer, Ellis, & Jilla, 2016;Chisolm, Noe, McArdle, & Abrams, 2007b;Hawkins, 2005;Sweetow & Palmer, 2005;Jennings, 2009) and improved quality of life (Chisolm et al, 2007a;Cox, Johnson, & Xu, 2016;Chisolm et al, 2007b;Hickson, Worrall, & Scarinci, 2006;Kramer, Allessie, Dondorp, Zekveld, & Kapteyn, 2005;Preminger & Yoo, 2010). Among these interventions, hearing aid fitting has been the most commonly recommended by audiologists .…”