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

Keywords:
Adult-onset sensorineural hearing loss, Advanced hearing aid technology, Hearing aids, Laboratory speech understanding, Older listeners, Standardized questionnaires
1.
Summer L, O'Neill G, Shirey L: Chronic Conditions: A Challenge for the 21st Century. Washington, National Academy on an Aging Society, 1999, No 1.
2.
Lin F, Niparko J, Ferrucci L: Hearing loss prevalence in the United States. Arch Intern Med 2011;171:1851-1852.
3.
Roth T, Hanebuth D, Probst R: Prevalence of age-related hearing loss in Europe: a review. Eur Arch Otorhinolaryngol 2011;268:1101-1107.
4.
Ciorba A, Bianchini C, Pelucchi S, Pastore A: The impact of hearing loss on the quality of life of elderly adults. Clin Interv Aging 2012;7:159-163.
5.
Swan IRC, Guy FH, Akeroyd MA: Health-related quality of life before and after management in adults referred to otolaryngology: a prospective national study. Clin Otolaryngol 2012;37:35-43.
6.
Chien W, Lin F: Prevalence of hearing aid use among older adults in the United States. Arch Intern Med 2012;172:292-293.
7.
Hougaard S, Ruf S, Egger C: Eurotrak + Japantrak 2012: societal and personal benefits of rehabilitation with hearing aids. Hear Rev 2013;20:16-26.
8.
Kochkin S, Marketrak VI: On the issue of value: hearing aid benefit, price, satisfaction, and repurchase rates. Hear Rev 2003;10:12-26.
9.
Newman CW, Sandridge SA: Benefit from, satisfaction with, and cost-effectiveness of three different hearing aid technologies. Am J Audiol 1998;7:115-128.
10.
Meyer C, Hickson L: What factors influence help-seeking for hearing impairment and hearing aid adoption in older adults? Int J Audiol 2012;51:66-74.
11.
Dillon H: What's new from NAL in hearing aid prescriptions? Hear J 2006;59:10-16.
12.
Cohen J: Statistical Power Analysis for the Behavioral Sciences, ed 2. Hillsdale/NJ, Erlbaum Associates, 1988.
13.
Grissom RJ: Probability of the superior outcome of one treatment over another. J Appl Psychol 1994;79:314-316.
14.
Faul F, Erdfelder E, Lang AG, Buchner A: G*Power 3: a flexible statistical power analysis for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-191.
15.
Committee on Hearing, Bioacoustics, Biomechanics: Speech understanding and aging. J Acoust Soc Am 1988;83:859-895.
16.
Kochkin S: Consumers rate improvements sought in hearing instruments. Hear Rev 2002;9:18-22.
17.
Bridges JFP, Lataille AT, Buttorff C, White S, Niparko JK: Consumer preferences for hearing aid attributes: a comparison of rating and conjoint analysis methods. Trends Amplif 2012;16:40-48.
18.
Foster JR, Haggard MP: The four alternative auditory feature test (FAAF) - linguistic and psychometric properties of the material with normative data in noise. Br J Audiol 1987;21:165-174.
19.
Xu J, Cox RM: Recording and evaluation of an American dialect version of the four alternative auditory feature test. J Am Acad Audiol, in press.
20.
Cox RM, Alexander GC: The abbreviated profile of hearing aid benefit. Ear Hear 1995;16:176-186.
21.
Gatehouse S, Noble W: The Speech, Spatial and Qualities of Hearing Scale (SSQ). Int J Audiol 2004;43:85-99.
22.
Jensen NS, Akeroyd MA, Noble W, Naylor G: The Speech, Spatial and Qualities of Hearing Scale (SSQ) as a benefit measure: Fourth NCRAR International Conference, Portland/OR, 2009.
23.
Cox RM, Alexander GC, Xu J: Development of the Device-Oriented Subjective Outcome (DOSO) Scale. J Am Acad Audiol, in press.
24.
Juniper EF, Guyatt GH, Willan A, Griffith LE: Determining a minimal important change in a disease-specific quality of life questionnaire. J Clin Epidemiol 1994;47:81-87.
25.
Knudsen LV, Laplante-Levesque A, Jones L, Preminger JE, Nielsen C, Lunner T, Hickson L, Naylor G, Kramer SE: Conducting qualitative research in audiology: a tutorial. Int J Audiol 2012;51:83-92.
26.
Rosenthal R, Rosnow R: Contrast Analysis: Focused Comparisons in the Analysis of Variance. Cambridge, Cambridge University Press, 1985.
27.
Buckless FA, Ravenscroft SP: Contrast coding: a refinement of ANOVA in behavioral analysis. Account Rev 1990;65:933-945.
28.
Larson VD, Williams DW, Henderson WG, Luethke LE, Beck LB, Noffsinger D, Wilson RH, Dobie RA, Haskell GB, Bratt GW, Shanks JE, Stelmachowicz P, Studebaker GA, Boysen AE, Donahue A, Canalis R, Fausti SA, Rappaport BZ: Efficacy of three commonly used hearing aid circuits: a crossover trial. JAMA 2000;284:1806-1813.
29.
Kochkin S: Marketrak VIII: patients report improved quality of life with hearing aid usage. Hear J 2011;64:25-32.
30.
Woods WS, Van Tasell DJ, Rickert ME, Trine TD: SII and fit-to-target analysis of compression system performance as a function of number of compression channels. Int J Audiol 2006;45:630-644.
31.
Yund EW, Buckles KM: Multichannel compression hearing aids: effect of number of channels on speech discrimination in noise. J Acoust Soc Am 1995;97:1206-1223.
32.
Bor S, Souza P, Wright R: Multichannel compression: effects of reduced spectral contrast on vowel identification. J Speech Lang Hear Res 2008;51:1315-1327.
33.
Cord MT, Surr RK, Walden BE, Dyrlund O: Relationship between laboratory measures of directional advantage and everyday success with directional microphone hearing aids. J Am Acad Audiol 2004;15:353-364.
34.
Gnewikow D, Ricketts T, Bratt GW, Mutchler LC: Real-world benefit from directional microphone hearing aids. J Rehabil Res Dev 2009;46:603-618.
35.
Buchler M, Allegro S, Launer S, Dillier N: Sound classification in hearing aids inspired by auditory scene analysis. EURASIP J Appl Signal Process 2005;18:2991-3002.
36.
Keidser G: Many factors are involved in optimizing environmentally adaptive hearing aids. Hear J 2009;62:26-31.
37.
Wu YH, Stangl E, Bentler RA, Stanziola RW: The effect of hearing aid technologies on listening in an automobile. J Am Acad Audiol 2013;24:474-485.
38.
Kirkwood DH: Research firm analyzes market share, retail activity, and prospects of major hearing aid manufacturers. Accessed July 10, 2013. http://hearinghealthmattersorg/hearingnewswatch/2013/research-firm-analyzes-market-share-retail-stores-prospects-of-major-hearing-aid-makers/.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.