#352 Do-It-Yourself Hearing Aids

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- Conventional hearing aids: adjusted to the patient’s specific hearing characteristics using an audiogram (“audiogram-fitted”). Direct-to-consumer hearing aids: adjusted by patients themselves using smartphones/pre-programmed settings (“self-fitted”).
- Self-fitted direct-to-consumer devices versus audiogram-fitted conventional hearing-aids:
- Four systematic reviews.1-4 Most recent/relevant: Five randomized controlled trials (RCT) or cross-over studies (124 patients, mild-moderate hearing loss) testing direct-to-consumer devices (PS2500ampTM, CS50+ Sound World SolutionTM, FocusEar RS2TM, Tweak FocusTM, Etymotic BEANTM, Olive SmartEarTM):1
- Speech intelligibility: No difference.
- Additional cross-over study: 23 patients, moderate-severe hearing loss.5 Percentage words recognized (60% baseline) changed to:
- Conventional hearing aids: 76-88%.
- Direct-to-consumer devices: CS50+ Sound World SolutionTM 68%; Etymotic BEANTM 80%.
- No statistical analysis.
- Four systematic reviews.1-4 Most recent/relevant: Five randomized controlled trials (RCT) or cross-over studies (124 patients, mild-moderate hearing loss) testing direct-to-consumer devices (PS2500ampTM, CS50+ Sound World SolutionTM, FocusEar RS2TM, Tweak FocusTM, Etymotic BEANTM, Olive SmartEarTM):1
- Same hearing aids: Audiogram-fitted versus self-fitted.
- One systematic review: Five randomized, quasi-randomized, or cross-over studies (176 patients).6
- Speech intelligibility: No difference.
- Additional RCT, 64 patients, mild-moderate hearing loss (Lexie LumenTM), 6-weeks:7
- Self-assessed communication difficulties scale (ranges 1-99; lower=fewer difficulties): Baseline 34-37, improved to 19 self-fitted versus 24 audiogram-fitted (not statistically different).
- Speech intelligibility, quality of life: No difference.
- One systematic review: Five randomized, quasi-randomized, or cross-over studies (176 patients).6
- Audiogram-fitted: Direct-to-consumer devices versus conventional hearing aids.
- Cross-over RCT, 42 patients, mild-moderate hearing loss.8 Percentage words recognized (76% baseline) changed to:
- Conventional hearing aid: 88%.
- Direct-to-consumer devices:
- CS50+ Sound World SolutionTM, SoundhawkTM: 87% (no difference).
- Etymotic BEANTM (84%), Tweak FocusTM (81%), MSA Pro 30X Sound AmplifierTM (65%): All inferior to conventional hearing aids.
- Cross-over RCT, 42 patients, mild-moderate hearing loss.8 Percentage words recognized (76% baseline) changed to:
- Limitations: Randomization/blinding sometimes unclear; artificial setting (sound booth) often used; little quality of life information; unclear which patients would benefit from an audiogram; Canadian availability limited.
- Examples, direct-to-consumer devices available in Canada:
- CS50+ Sound World SolutionTM (~$300).9
- Etymotic BEANTM ($300).10
- Mild-moderate hearing loss (26-60dB): managed with hearing aids. Severe: managed with cochlear implants/alternative communication techniques.11
- Hearing aids ~$3,000; most provincial plans minimal coverage (example $500).12