#352 Do-It-Yourself Hearing Aids
CLINICAL QUESTION
Do self-fitted hearing aids improve hearing for adults with mild to moderate-severe hearing loss?
BOTTOM LINE
Some, but not all, direct-to-consumer self-fitted hearing aids are likely comparable to conventional hearing aids fitted via audiogram, at a much lower cost. Access and guidance/regulations on direct-to-consumer self-fitted hearing aids is limited in Canada. See suggestions below.
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EVIDENCE
- 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.
CONTEXT
- 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
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Relevant in current economy
Very interesting.
Good article
I’m going to start recommending those now.
good
Very helpful as I had heard that the direct to consumer hearing aides were becoming available and want to know how to advise patients.
good to know
conventional hearing aids better but if cost is an issue the self adjusted will do
Conventional hearing aids are better than self fitted aids due to the process and professionals involved, however cost is also something to consider, so having a self fitted one is better than nothing
interesting
Vert interesting and useful analysis.
Interesting
good to know
Good article
h aids with audiograms are still very costly
thank you for article
Useful information
Clearly where cost is an issue the OTC aids may be a good option. Would be good to know if private insurance covers these, If not we will bw more likley to suggest convesntional products even though the more expensive option may not be required
Interesting
Interesting. OTC products better than I had previously believed to be the case. The data implies that the extra cost may not be worthwhile.