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Shah R, Wilkins SG, Panth N, Tyagi S, Dunn H, Bell MD, Norgaard S, Guyer E, Schwartz N. Over-The-Counter Hearing Aids: Are They Safe and Effective? Otolaryngol Head Neck Surg 2024. [PMID: 38769863 DOI: 10.1002/ohn.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/07/2024] [Accepted: 04/13/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE In 2022, the Food and Drug Administration established a new regulatory category for over-the-counter (OTC) hearing aids for mild to moderate hearing loss. Herein, we aim to better compare the safety and efficacy of these devices to that of prescription hearing aids. STUDY DESIGN Comparative-effectiveness model. SETTING Academic Audiology Center. METHODS The safety and efficacy of prescription and OTC hearing aids was compared using the AudioScan Verifit 2 Testbox software. Three types of hearing loss (downsloping, sharp downsloping, and reverse sloping) were analyzed. Efficacy was tested at 3 volume inputs and was measured by calculating the average difference in test points (produced by the devices) and target points (estimated by the software). Safety was assessed by calculating the average difference in test points and the maximally safe hearing level (produced by the software). RESULTS Prescription hearing aids were found to have a better safety profile by being further from the safety threshold compared to OTC devices at the 8000 Hz frequency for the 2 types of downsloping hearing loss patterns studied (48 vs 30.5 dB, P = .04; 51 vs 32.5 dB, P = .03). Prescription hearing aids also carried a statistically significant advantage at 3 test points. OTC hearing aids generally had a greater difference between test and target points. CONCLUSION OTC and prescription hearing aids are comparably safe, though OTC hearing aids are slightly less efficacious. Further evaluation of the OTC hearing aid efficacy is warranted to ensure it provides the gain of benefit needed for different types of hearing loss.
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Affiliation(s)
- Rema Shah
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sarah G Wilkins
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Neelima Panth
- Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sidharth Tyagi
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hannah Dunn
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Moira D Bell
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sophie Norgaard
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Elizabeth Guyer
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nofrat Schwartz
- Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
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Venkitakrishnan S, Urbanski D, Wu YH. Efficacy and Effectiveness of Evidence-Based Non-Self-Fitting Presets Compared to Prescription Hearing Aid Fittings and a Personal Sound Amplification Product. Am J Audiol 2023; 33:1-24. [PMID: 37956699 PMCID: PMC11001427 DOI: 10.1044/2023_aja-23-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/15/2023] Open
Abstract
PURPOSE In this study, we compare the efficacy and effectiveness of gain-frequency responses of evidence-based presets developed by our lab for over-the-counter hearing aids to conventional National Acoustic Laboratories' nonlinear fitting procedure, version 2 (NAL-NL2) gain-frequency response and to gain-frequency response of a personal sound amplification product (PSAP). We hypothesized that the hearing aids with our presets would perform better than a PSAP with poor frequency response and comparably to the hearing aid with NAL-NL2 frequency response. METHOD We used a single-blinded, randomized cross-over design to compare audibility, speech recognition, sound quality, listening effort, and subjective preferences in 37 participants in laboratory settings and following field trials. RESULTS The presets developed in our lab showed comparable outcomes to the hearing aids with NAL-NL2 gain-frequency response in most measured domains. Performance with the presets was better than the PSAP gain-frequency response in the domains of listening effort and sound quality in laboratory testing and speech recognition in our real-world measures. We also found that most participants (54.05%) preferred our presets over the PSAPs and were willing to pay significantly more to purchase the hearing aids with our presets. CONCLUSION Our evidence-based presets have better outcomes than a PSAP with a single, poorly suited frequency response while performing comparably to the clinical best-practice National Acoustic Laboratories condition.
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Affiliation(s)
- Soumya Venkitakrishnan
- Department of Communication Sciences and Disorders, California State University, Sacramento
| | - Dana Urbanski
- Department of Communication Sciences and Disorders, University of Minnesota Duluth
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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3
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Kokkonen J, Kaski H, Mäkinen S, Svärd F. Remote hearing aid renewal using pre-existing audiograms during the covid-19 pandemic. Int J Audiol 2023; 62:767-775. [PMID: 35675896 DOI: 10.1080/14992027.2022.2082329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE During the ongoing Covid-19 pandemic, many patients cancelled their scheduled hearing aid renewal. We offered to send them new hearing aids programmed according to the audiometric data on file. In this study we compared remote hearing aid renewal to a conventional renewal with a recent audiogram based on scores from the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. We also examined the need for a physical visit for hearing aid adjustment in the remote group and analysed the accuracy of the pre-existing audiogram correction method using data from the control group. DESIGN Retrospective chart review. STUDY SAMPLE 51 patients who underwent remote hearing aid renewal and 22 control patients who received office-based hearing aid renewal. RESULTS IOI-HA scores were lower in the remote fitted group, but comparison with data from a Swedish nationwide database had no clinically significant differences. A follow-up physical appointment was required in only 20% of the remote group. The intraclass correlation coefficient (ICC) between the pure tone averages of the corrected former audiogram and measured audiogram was high. CONCLUSIONS Remote hearing aid renewal using existing audiometric data is feasible, and most physical visits can be avoided.
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Affiliation(s)
- Jukka Kokkonen
- Department of Otorhinolaryngology, North Karelia Central Hospital, Joensuu, Finland
| | - Heidi Kaski
- Department of Otorhinolaryngology, North Karelia Central Hospital, Joensuu, Finland
- Department of Otorhinolaryngology - Head and Neck Surgery, Oulu University Hospital, Oulu, Finland
| | - Sampo Mäkinen
- Department of Otorhinolaryngology, North Karelia Central Hospital, Joensuu, Finland
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Fanni Svärd
- Department of Otorhinolaryngology, North Karelia Central Hospital, Joensuu, Finland
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Manchaiah V, Swanepoel DW, Sharma A. Prioritizing research on over-the-counter (OTC) hearing aids for age-related hearing loss. FRONTIERS IN AGING 2023; 4:1105879. [PMID: 37033402 PMCID: PMC10078955 DOI: 10.3389/fragi.2023.1105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
Hearing aids are the most commonly used treatment for people with age-related hearing loss, however, hearing aid uptake is low, primarily due to high cost of the device, stigma, and a lack of perceived need. To address accessibility and affordability issues, the U.S. Food and Drug Administration created a new over-the-counter (OTC) hearing aid category. Various types of hearing devices are available for both individuals with hearing loss and for those with normal hearing, as hearing enhancement devices. Hearing aids (i.e., prescription hearing aids, self-fitting OTC hearing aids, and pre-set OTC hearing aids) are regulated by the FDA. The purpose of this article is to (a) provide a summary of existing research on direct-to-consumer (DTC) hearing devices such as Personal Sound Amplification Products (PSAPs) that informs OTC service delivery models; (b) provide an update on existing and ongoing randomized controlled trials on currently marketed OTC hearing aids; and (c) highlight the need for immediate research on OTC hearing aids and service delivery models to inform policy and clinical care. It remains to be seen what effect OTC hearing aids have on improving the uptake of hearing aids by individuals with mild-to-moderate hearing loss. However, there is scant research on all aspects of OTC hearing aids that are currently on the market. We conclude that high quality independent research must be prioritized to supplement evidence provided by the OTC hearing aid manufacturers for regulatory approval purposes.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Virtual Hearing Lab, Collaborative Initiative Between The University of Colorado and The University of Pretoria, Aurora, CO, United States
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - De Wet Swanepoel
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- Virtual Hearing Lab, Collaborative Initiative Between The University of Colorado and The University of Pretoria, Aurora, CO, United States
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Perth, WA, Australia
| | - Anu Sharma
- Brain and Behavior Laboratory, Department of Speech Language and Hearing Sciences, Institute of Cognitive Science, Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
- *Correspondence: Anu Sharma,
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5
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Graf L, Lochner J, Mojallal H, Arnold A, Honegger F, Stieger C. Comparison between incus short process and long process coupling of the vibrant soundbridge in human temporal bones. Int J Audiol 2023; 62:192-198. [PMID: 35174741 DOI: 10.1080/14992027.2022.2031317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The Vibrant Soundbridge (VSB) is one of the most widely used implantable hearing devices. It consists of a vibrating floating mass transducer (FMT) that is connected to a middle ear structure. The standard coupling devices for sensorineural hearing loss are short process (SP) or long process (LP) couplers. DESIGN AND STUDY SAMPLE This study directly compared the electro-mechanical performance of the SP- and LP-coupled FMT of the VSB in the same temporal bone specimen (n = 10). We measured velocity magnitudes and total harmonic distortions (THD) of the stapes (ST) and the round window (RW) using laser Doppler Vibrometry (LDV). RESULTS Comparison shows a maximally 10 dB higher magnitude for the LP coupler at ST and RW for frequencies below 600 Hz, whereas the SP coupler shows a maximally 20 dB higher magnitude at the ST and RW for frequencies above 600 Hz. THD show similar behaviour with less distortion at 500 Hz for the LP coupler and less distortions for the SP coupler in higher frequencies. CONCLUSIONS Our experiments showed that the SP coupling may be mechanically favourable, in terms of magnitude and distortion, for the transmission of FMT vibrations at higher frequencies.
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Affiliation(s)
- Lukas Graf
- ENT Department, University Basel Hospital, Basel, Switzerland
| | | | | | - Andreas Arnold
- ENT Department, Spital Münsingen, Münsingen, Switzerland.,ENT Department, Inselspital, University of Bern, Bern, Switzerland
| | - Flurin Honegger
- ENT Department, University Basel Hospital, Basel, Switzerland
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Han JS, Park YH, Song JJ, Moon IJ, Lee W, Kim Y, Cho YS, Seo JH, Park MK. Knowledge and Expectations of Hearing Aid Apps Among Smartphone Users and Hearing Professionals: Cross-sectional Survey. JMIR Mhealth Uhealth 2022; 10:e27809. [PMID: 34994699 PMCID: PMC8783272 DOI: 10.2196/27809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/06/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background Despite the increasing prevalence of hearing loss, the cost and psychological barriers to the use of hearing aids may prevent their use in individuals with hearing loss. Patients with hearing loss can benefit from smartphone-based hearing aid apps (SHAAs), which are smartphone apps that use a mobile device as a sound amplifier. Objective The aim of this study is to determine how ear, nose, and throat outpatients perceive SHAAs, analyze the factors that affect their perceptions, and estimate the costs of an annual subscription to an app through a self-administered questionnaire survey of smartphone users and hearing specialists. Methods This study used a cross-sectional, multicenter survey of both ear, nose, and throat outpatients and hearing specialists. The questionnaire was designed to collect personal information about the respondents and their responses to 18 questions concerning SHAAs in five domains: knowledge, needs, cost, expectations, and information. Perception questions were rated on a scale of 1 (strongly disagree) to 5 (strongly agree). Questions about the expected cost of SHAAs were included in the questionnaire distributed to hearing experts. Results Among the 219 smartphone users and 42 hearing specialists, only 8 (3.7%) respondents recognized SHAAs, whereas 18% (47/261) of respondents reported considering the use of an assistive device to improve their hearing capacity. The average perception score was 2.81 (SD 1.22). Among the factors that shaped perceptions of SHAAs, the needs category received the lowest scores (2.02, SD 1.42), whereas the cost category received the highest scores (3.29, SD 1.14). Age was correlated with the information domain (P<.001), and an increased level of hearing impairment resulted in significantly higher points in the needs category (P<.001). Patients expected the cost of an annual app subscription to an SHAA to be approximately US $86, and the predicted cost was associated with economic status (P=.02) and was higher than the prices expected by hearing specialists (P<.001). Conclusions Outpatients expected SHAAs to cost more than hearing specialists. However, the perception of the SHAA was relatively low. In this regard, enhanced awareness is required to popularize SHAAs.
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Affiliation(s)
- Jae Sang Han
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
- Brain Research Institute, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Woojoo Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yoonjoong Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Young Sang Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hyun Seo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology, Head & Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- Sensory Organ Research Institute, Seoul National University, Medical Research Center, Seoul, Republic of Korea
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7
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Almufarrij I, Dillon H, Munro KJ. Does Probe-Tube Verification of Real-Ear Hearing Aid Amplification Characteristics Improve Outcomes in Adults? A Systematic Review and Meta-Analysis. Trends Hear 2021; 25:2331216521999563. [PMID: 33899603 PMCID: PMC8083001 DOI: 10.1177/2331216521999563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This systematic review, the first on this topic, aimed to investigate if probe-tube verification of real-ear hearing aid amplification characteristics improves outcomes in adults. The review was preregistered in the Prospective Register of Systematic Reviews and performed in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. After assessing more than 1,420 records from seven databases, six experimental studies (published between 2012 and 2019) met the inclusion criteria; five were included in the meta-analyses. The primary outcome of interest (hearing-specific, health-related quality of life) was not reported in any study. There were moderate and statistically significant positive effects of probe-tube real-ear measurement (REM), compared with the manufacturer’s initial fit, on speech intelligibility in quiet settings (standardized mean difference [SMD]: 0.59) and user’s final preference (proportion difference: 52.2%). There were small but statistically significant positive effects of REM on self-reported listening abilities (SMD: 0.22) and speech intelligibility in noise (SMD: 0.15). The quality of evidence for these outcomes ranged from high to very low. The findings show that REMs improve outcomes statistically, but this is based on a small number of studies and a limited number of participants. It is currently unclear if the benefits are of material importance because minimum clinically important differences have not been established for most of the outcomes. Ultimately, there needs to be a cost-effectiveness analysis to show that statistically significant benefits, which exceed the minimum clinically important difference, are worth the cost involved.
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Affiliation(s)
- Ibrahim Almufarrij
- Manchester Centre for Audiology and Deafness, School of Health Sciences, Manchester, United Kingdom.,Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Harvey Dillon
- Manchester Centre for Audiology and Deafness, School of Health Sciences, Manchester, United Kingdom.,Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
| | - Kevin J Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, Manchester, United Kingdom.,Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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8
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Urbanski D, Hernandez H, Oleson J, Wu YH. Toward a New Evidence-Based Fitting Paradigm for Over-the-Counter Hearing Aids. Am J Audiol 2021; 30:43-66. [PMID: 33264578 PMCID: PMC8632515 DOI: 10.1044/2020_aja-20-00085] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This dual-aim study was intended to develop and validate a new fitting paradigm for over-the-counter (OTC) hearing aids. Aim 1 was undertaken to create a limited set of evidence-based preconfigured gain-frequency responses ("presets") for use in OTC devices. Aim 2 tested the efficacy of the presets relative to best-practice verification and determined the best method(s) for older adults to self-select amplification from the set. Method In Aim 1, audiometry data from 267 older adults with mild-to-moderate sensorineural hearing loss were obtained from the National Health and Nutrition Examination Survey database. Using these data and the National Acoustic Laboratories-Non-Linear 2 (NAL-NL2) prescriptive formula, a set of four presets were created that can fit a large percentage of older Americans with presbycusis. In Aim 2, 37 older adults with hearing loss used five methods to select presets. The selection methods were select-by-audiogram, select-by-self-test, select-by-trying, select-by-questionnaire, and random assignment. Using a crossover design, each participant completed speech recognition testing and sound quality ratings in quiet and noise for all selection methods and a verified NAL-NL2 condition. Results The set of presets can fit 67.9% of older Americans with mild-to-moderate hearing loss (Aim 1). Controlling for hearing thresholds and sound quality ratings, liner mixed-effects models indicated that speech recognition scores for select-by-audiogram, select-by-self-test, and select-by-trying were not statistically different from the NAL-NL2 condition. Statistical analysis indicated that select-by-self-test produced outcomes most consistent with individual outcomes for the NAL-NL2 condition (Aim 2). Conclusion This newly developed fitting paradigm may provide efficacy comparable to best-practice verification and could be used in OTC hearing aids.
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Affiliation(s)
- Dana Urbanski
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Helin Hernandez
- Department of Biostatistics, The University of Iowa, Iowa City
| | - Jacob Oleson
- Department of Biostatistics, The University of Iowa, Iowa City
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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9
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Kim GY, Kim JS, Jo M, Seol HY, Cho YS, Moon IJ. Feasibility of Personal Sound Amplification Products in Patients with Moderate Hearing Loss: A Pilot Study. Clin Exp Otorhinolaryngol 2021; 15:60-68. [PMID: 33541032 PMCID: PMC8901943 DOI: 10.21053/ceo.2020.02313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/27/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives This study was conducted to investigate the electroacoustic characteristics of personal sound amplification products (PSAPs), to identify whether PSAPs provide adequate gain and output for three common hearing loss (HL) configurations, and to compare the benefits of a representative PSAP (RPSAP) and a conventional hearing aid (HA) for clinical hearing outcomes as a pilot study. Methods The study comprised three phases: electroacoustic analysis, simulated real-ear measurements (REMs), and clinical hearing experiments. Electroacoustic analysis and simulated REMs were performed for three basic PSAPs (BeethoSOL, EarJJang, and Geniesori2) and three high-end PSAPs (Hearing Able, Olive Smart Ear, and SoriIn) using the Aurical Hearing Instrument Test box with a 2-mL coupler. Four electroacoustic characteristics (maximum output sound pressure level at 90 dB SPL, frequency range, equivalent input noise, and total harmonic distortion) were investigated. By simulated REMs, appropriate levels of the six PSAPs for three common HL configurations (mild-to-moderate high-frequency HL, moderate to moderately severe sloping HL, and moderate flat HL) were determined. Clinical experiments compared the performance of RPSAP to HA, both of which were fitted by audiologists using REMs. Clinical experiments were administered using functional gain, a word recognition test, and the Korean version of the Hearing in Noise Test in six participants with bilateral moderate sensorineural HL. Results The two high-end devices met all tolerances. One basic and two high-end PSAPs showed appropriate levels for three common HL configurations. In the clinical experiments, the RPSAP showed better performance than unaided, but slightly worse than HA under all test conditions. Conclusion Certain PSAPs met all specified tolerances for electroacoustic analysis and approximated prescriptive targets in well-controlled laboratory conditions. The pilot clinical experiments explored the possibility that the RPSAP could serve as a hearing assistive device for patients with moderate HL.
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Affiliation(s)
- Ga-Young Kim
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Jong Sei Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mini Jo
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Hye Yoon Seol
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Young Sang Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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10
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Maidment DW, Amlani AM. Argumentum ad Ignorantiam: Smartphone-Connected Listening Devices. Semin Hear 2020; 41:254-265. [PMID: 33364675 DOI: 10.1055/s-0040-1718711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
In this article, we review the current literature assessing the application and benefits of connected hearing technologies, as well as their potential to improve accessibility to and affordability of hearing healthcare. Over the past decade, there has been a proliferation of hearing devices that connect wirelessly to smartphone technologies via Bluetooth. These devices include (1) smartphone-connected hearing aids that must be obtained from a licensed audiologist or hearing aid dispenser; (2) direct-to-consumer devices, such as personal sound amplification products; and (3) smartphone-based hearing aid applications (or apps). Common to all these connected devices is that they permit the user to self-adjust and customize their device programs via an accompanying smartphone app. There has been a growing body of literature assessing connected hearing devices in adults living with hearing loss. Overall, the evidence to date supports the notion that all connected hearing devices can improve accessibility to and affordability of amplification. It is unclear, however, whether connected technologies are a clinically effective alternative to traditional hearing aids. Even so, the impact of connectivity is especially pertinent given the sudden disruption caused by the recent global COVID-19 pandemic, whereby connected technologies enable patients to receive treatment through mobile-based, tele-audiology platforms.
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Affiliation(s)
- David W Maidment
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
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11
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Sinha S, Irani UD, Manchaiah V, Bhamla MS. LoCHAid: An ultra-low-cost hearing aid for age-related hearing loss. PLoS One 2020; 15:e0238922. [PMID: 32966301 PMCID: PMC7510997 DOI: 10.1371/journal.pone.0238922] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 08/26/2020] [Indexed: 11/19/2022] Open
Abstract
Hearing aids are the primary tool in non-medical rehabilitation for individuals with hearing loss. While the costs of the electronic components have reduced substantially, the cost of a hearing aid has risen steadily to the point that it has become unaffordable for the majority of the population with Age-Related Hearing Loss (ARHL) especially for those residing in low- and middle-income countries. Here, we present an ultra-low-cost, affordable and accessible hearing aid device ('LoCHAid'), specifically targeted towards treating ARHL in elderly patients. The LoCHAid components cost 98 cents (< $1) when purchased in bulk for 10,000 units and can be personalized for each user through a 3D-printable case. It is designed to be an over-the-counter (OTC) self-serviceable solution for elderly individuals with ARHL. Electroacoustic measurements show that the device meets most of the targets set out by the WHO Preferred Product Profile and Consumer Technology Association for hearing aids. The frequency response of the hearing aid shows selectable gain in the range of 4-8 kHz, and mild to moderate gain between 200-1000 Hz, and shows very limited total distortion (1%). Simulated gain measurements show that the LoCHAid is well fitted to a range of ARHL profiles for males and females between the ages of 60-79 years. Overall, the measurements show that the device offers the potential to benefit individuals with ARHL. Thus, our proposed design has the potential to address the challenge of affordable and accessible hearing technology for hearing impaired elderly individuals especially in low- and middle-income countries.
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Affiliation(s)
- Soham Sinha
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Urvaksh D. Irani
- School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States of America
| | - M. Saad Bhamla
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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12
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Jensen J, Vyas D, Urbanski D, Garudadri H, Chipara O, Wu YH. Common Configurations of Real-Ear Aided Response Targets Prescribed by NAL-NL2 for Older Adults With Mild-to-Moderate Hearing Loss. Am J Audiol 2020; 29:460-475. [PMID: 32693613 DOI: 10.1044/2020_aja-20-00025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study investigates common real-ear aided response (REAR) configurations prescribed by the NAL-NL2 algorithm for older adults with hearing loss. Method A data set that is representative of the older adult U.S. population with mild-to-moderate sensorineural hearing loss was constructed from the audiometric data of 934 adults (aged 55-85 years) from the National Health and Nutrition Examination Survey years 1999-2012. Two clustering approaches were implemented to generate common REAR configurations for eight frequencies (0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz) at three input levels (55, 65, and 75 dB SPL). (a) In the REAR-based clustering approach, the National Health and Nutrition Examination Survey audiograms were first converted to REAR targets and then clustered to generate common REAR configurations. (b) In the audiogram-based clustering approach, the audiograms were first clustered into common hearing loss profiles and then converted to REAR configurations. The trade-off between the number of available REAR configurations and the percentage of the U.S. population whose hearing loss could be fit by at least one of them (i.e., percent coverage) was evaluated. Hearing loss fit was defined as less than ± 5-dB difference between an individual's REAR targets and those of the clustered REAR configuration. Results Percent coverage increases with the number of available REAR configurations, with four configurations resulting in 75% population coverage. Overall, REAR-based clustering yielded 5 percentage points better coverage on average compared to audiogram-based clustering. Conclusions The common REAR configurations can be used for programming the gain frequency responses in preconfigured over-the-counter hearing aids and provide clinically appropriate amplification settings for older adults with mild-to-moderate hearing loss.
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Affiliation(s)
- Justin Jensen
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Dhruv Vyas
- Department of Computer Science, The University of Iowa, Iowa City
| | - Dana Urbanski
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | | | - Octav Chipara
- Department of Computer Science, The University of Iowa, Iowa City
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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13
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Almufarrij I, Munro KJ, Dawes P, Stone MA, Dillon H. Direct-to-Consumer Hearing Devices: Capabilities, Costs, and Cosmetics. Trends Hear 2019; 23:2331216519858301. [PMID: 31280709 PMCID: PMC6614949 DOI: 10.1177/2331216519858301] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Direct-to-consumer (DTC) hearing devices can be purchased without consulting a
hearing health professional. This project aims to compare 28 DTC devices with
the most popular hearing aid supplied by the U.K. National Health Service (NHS).
The comparison was based on technical performance, cosmetic acceptability, and
the ability to match commonly used gain and slope targets. Electroacoustic
performance was evaluated in a 2-cc coupler. Match to prescription target for
both gain and slope was measured on a Knowles Electronic Manikin for Acoustic
Research using a mild and also a moderate sloping hearing loss. Using an online
blinded paired comparison of each DTC and the NHS reference device, 126
participants (50 were hearing aid users and 76 were nonhearing aid users)
assessed the cosmetic appearance and rated their willingness-to-wear the DTC
devices. The results revealed that higher purchase prices were generally
associated with a better match to prescribed gain–frequency response shapes,
lower distortion, wider bandwidth, better cosmetic acceptability, and higher
willingness-to-wear. On every parameter measured, there were devices that
performed worse than the NHS device. Most of the devices were rated lower in
terms of aesthetic design than the NHS device and provided gain–frequency
responses and maximum output levels that were markedly different from those
prescribed for commonly encountered audiograms. Because of the absence or
inflexibility of most of the devices, they have the potential to deliver poor
sound quality and uncomfortably loud sounds. The challenge for manufacturers is
to develop low-cost products with cosmetic appeal and appropriate
electroacoustic characteristics.
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Affiliation(s)
- Ibrahim Almufarrij
- 1 Manchester Centre for Audiology and Deafness, School of Health Sciences, UK.,2 Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Kevin J Munro
- 1 Manchester Centre for Audiology and Deafness, School of Health Sciences, UK.,3 Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Piers Dawes
- 1 Manchester Centre for Audiology and Deafness, School of Health Sciences, UK.,3 Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Michael A Stone
- 1 Manchester Centre for Audiology and Deafness, School of Health Sciences, UK.,3 Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Harvey Dillon
- 1 Manchester Centre for Audiology and Deafness, School of Health Sciences, UK.,4 National Acoustic Laboratories, Sydney, Australia.,5 Macquarie University, Sydney, Australia
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14
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Yong M, Willink A, McMahon C, McPherson B, Nieman CL, Reed NS, Lin FR. Access to adults' hearing aids: policies and technologies used in eight countries. Bull World Health Organ 2019; 97:699-710. [PMID: 31656335 PMCID: PMC6796668 DOI: 10.2471/blt.18.228676] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/10/2019] [Accepted: 05/24/2019] [Indexed: 01/12/2023] Open
Abstract
As the proportion of older adults in the world’s total population continues to grow, the adverse health outcomes of age-related hearing loss are becoming increasingly recognized. While research has shown that age-related hearing loss is the single greatest modifiable risk factor for dementia, use of hearing aids remains low worldwide, even in many middle- and high-income countries. Reasons for poor uptake of hearing aids are likely to involve a combination of factors, ranging from increasing costs of hearing aid technology to a widespread lack of insurance coverage. This article aims to identify the current state of access to hearing aids, focusing on eight middle- and high-income countries. We discuss how to facilitate greater access to hearing aids for patients by addressing changes in how devices are regulated, technological advancements in hearing devices, the need to adjust reimbursement schemes and the importance of adaptation among the community workforce for hearing-care.
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Affiliation(s)
- Michael Yong
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E Monument St. Suite 2-700 Baltimore, Maryland, United States of America
| | - Amber Willink
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E Monument St. Suite 2-700 Baltimore, Maryland, United States of America
| | | | | | - Carrie L Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E Monument St. Suite 2-700 Baltimore, Maryland, United States of America
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E Monument St. Suite 2-700 Baltimore, Maryland, United States of America
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E Monument St. Suite 2-700 Baltimore, Maryland, United States of America
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15
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Manchaiah V, Amlani AM, Bricker CM, Whitfield CT, Ratinaud P. Benefits and Shortcomings of Direct-to-Consumer Hearing Devices: Analysis of Large Secondary Data Generated From Amazon Customer Reviews. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1506-1516. [PMID: 31034320 DOI: 10.1044/2018_jslhr-h-18-0370] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The current study was aimed at understanding the benefits and shortcomings of direct-to-consumer hearing devices (DCHDs) by analyzing the large text corpus of secondary data generated from Amazon customer reviews. Method Secondary data were generated manually by gathering user feedback for 62 different DCHDs (cost range: $9.95-$635) on the Amazon.com website, which included 11,258 unique Amazon-verified customer reviews. The data were analyzed using both quantitative and qualitative analyses methods. Results The cluster analysis of large data corpus resulted in 7 unique clusters, which were labeled as (a) Issues related to fit and comfort (15%), (b) Friends and family recommendations (11.8%), (c) Issues related to sound quality (11.9%), (d) Listening and conversation (16.1%), (e) Positive customer service (12.1%), (f) General usage and customer service (14.7%), and (g) Cost and affordability (17.3%). Exploratory analysis also revealed an association between customer ratings and cost in relation to these clusters (i.e., customer reviews). For example, customer reviews about cheaper DCHDs are related to issues about sound quality, whereas reviews about expensive DCHDs are related to cost and affordability of the device. The qualitative content analysis resulted in 8 main themes, which include (a) intrinsic factors, (b) extrinsic factors, (c) supplemental items, (d) ease of use, (e) interaction with support services, (f) reasons for purchase, (g) experiences, and (h) general information. Conclusions The study using the text mining techniques highlights the benefits and shortcomings of DCHDs that are currently available in the U.S. market. Our findings relate well to the published study results of electroacoustic analysis on similar products, which provide clinicians with knowledge related to DCHDs that they can convey to consumers during clinical consultations. The findings may also be of interest to the hearing instrument industry from the perspective of developing products based on user feedback.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
- Audiology India, Mysore, Karnataka
| | - Amyn M Amlani
- Department of Audiology and Speech Pathology, College of Health Professions, University of Arkansas for Medical Sciences, Little Rock
| | | | - Clayton T Whitfield
- Department of Audiology and Speech Pathology, College of Health Professions, University of Arkansas for Medical Sciences, Little Rock
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16
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Brody L, Wu YH, Stangl E. A Comparison of Personal Sound Amplification Products and Hearing Aids in Ecologically Relevant Test Environments. Am J Audiol 2018; 27:581-593. [PMID: 30458521 DOI: 10.1044/2018_aja-18-0027] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/13/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this study was to compare the benefit of self-adjusted personal sound amplification products (PSAPs) to audiologist-fitted hearing aids based on speech recognition, listening effort, and sound quality in ecologically relevant test conditions to estimate real-world effectiveness. METHOD Twenty-five older adults with bilateral mild-to-moderate hearing loss completed the single-blinded, crossover study. Participants underwent aided testing using 3 PSAPs and a traditional hearing aid, as well as unaided testing. PSAPs were adjusted based on participant preference, whereas the hearing aid was configured using best-practice verification protocols. Audibility provided by the devices was quantified using the Speech Intelligibility Index (American National Standards Institute, 2012). Outcome measures assessing speech recognition, listening effort, and sound quality were administered in ecologically relevant laboratory conditions designed to represent real-world speech listening situations. RESULTS All devices significantly improved Speech Intelligibility Index compared to unaided listening, with the hearing aid providing more audibility than all PSAPs. Results further revealed that, in general, the hearing aid improved speech recognition performance and reduced listening effort significantly more than all PSAPs. Few differences in sound quality were observed between devices. All PSAPs improved speech recognition and listening effort compared to unaided testing. CONCLUSIONS Hearing aids fitted using best-practice verification protocols were capable of providing more aided audibility, better speech recognition performance, and lower listening effort compared to the PSAPs tested in the current study. Differences in sound quality between the devices were minimal. However, because all PSAPs tested in the study significantly improved participants' speech recognition performance and reduced listening effort compared to unaided listening, PSAPs could serve as a budget-friendly option for those who cannot afford traditional amplification.
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Affiliation(s)
- Lisa Brody
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| | - Elizabeth Stangl
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
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17
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Maidment DW, Barker AB, Xia J, Ferguson MA. A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss. Int J Audiol 2018; 57:721-729. [DOI: 10.1080/14992027.2018.1493546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- David W. Maidment
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Alexander B. Barker
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jun Xia
- Systematic Review Solutions Limited, Nottingham, UK
| | - Melanie A. Ferguson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
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18
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Tran NR, Manchaiah V. Outcomes of Direct-to-Consumer Hearing Devices for People with Hearing Loss: A Review. J Audiol Otol 2018; 22:178-188. [PMID: 30126260 PMCID: PMC6233940 DOI: 10.7874/jao.2018.00248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/07/2018] [Indexed: 11/22/2022] Open
Abstract
As the population of those with mild to moderate hearing loss increases the need remains for amplification solutions. There is a trend to offer alternative amplification options beyond traditional hearing aids. Due to reduced medical risk associated with the most common types of hearing loss (i.e., presbycusis and noise induced), many individuals with such audiological configurations may have success with direct-to-consumer hearing devices (DCHD). The current paper presents a literature review of studies focused on the outcomes of DCHDs for people with hearing loss. Search of electronic databases were used to identify relevant articles for review. Studies on outcomes of DCHDs mainly focused on older adults and reported consistently positive results in clinical and self-reported outcome measures. Improvements in auditory ability, communicative function, social engagement, quality of life, and reduction of self-reported hearing disability were observed. The nature of the direct-to-consumer method makes it challenging to design studies that will accurately represent outcomes for patients due to the extensive dissimilarities in patient journey and device selection options. Accordingly, a majority of the studies conducted on this topic are of low quality of evidence and only provide short-term (i.e., less than one year) outcomes. In addition, results may have been influenced by researcher and/or clinician involvement in choosing the devices and by provision of additional support (i.e., incorporation of a communication partner and communication strategies training). Overall, the literature suggests positive outcomes and self-reported benefit of DCHDs in older adults with hearing loss. However, additional research is needed in this area to verify outcomes.
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Affiliation(s)
- Nicole R Tran
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India.,Audiology India, Mysore, Karnataka, India
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19
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Jilla AM, Johnson CE, Danhauer JL. Disruptive Hearing Technologies and Mild Sensorineural Hearing Loss II: Current Research on Affordable Hearing Technologies and Direct-to-Consumer Models. Semin Hear 2018; 39:146-157. [PMID: 29915452 DOI: 10.1055/s-0038-1641741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Recently, President Trump signed into law the Food and Drug Administration (FDA) Reauthorization Act of 2017, which included the Over-the-Counter Hearing Aid Act designed to provide greater public accessibility to and affordability of amplification for individuals with self-identified mild and moderate hearing loss through the provision of over-the-counter (OTC) hearing aids (HAs) with a direct-to-consumer (DTC) delivery model. American Speech-Language-Hearing Association and American Academy of Audiology Position Statements on OTC HAs state that these devices should only be used for adults with mild hearing losses. DTC amplification and service delivery has been available to consumers in a variety of forms for a significant period of time. However, FDA-regulated OTC HAs will not be available as described in the new law until the FDA publishes the required guidance related to the technology, safety, and labeling of such devices. With the clear similarities in mind between present and future amplification options, a literature search was conducted to review studies assessing outcomes for low-cost and DTC HAs and service-delivery models to inform what we may expect as OTC HAs enter the market. Nine studies were identified which assessed: (1) electroacoustic capabilities of low-cost and DTC HAs, (2) use of these devices in field trials, or (3) efficacy of DTC models. None of the studies reported outcomes specifically for participants with mild hearing loss. The studies had poor external validity because none included all factors that would exist in realistic uses of OTC HAs within a DTC model. Additional research will be needed as OTC HAs become available and different delivery models are proposed.
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Affiliation(s)
- Anna Marie Jilla
- Hearing Evaluation, Rehabilitation, and Outcomes (HERO) Laboratory, Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Carole E Johnson
- Hearing Evaluation, Rehabilitation, and Outcomes (HERO) Laboratory, Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jeffrey L Danhauer
- Department of Speech and Hearing Sciences, University of California, Santa Barbara, California
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20
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Manchaiah V, Taylor B, Dockens AL, Tran NR, Lane K, Castle M, Grover V. Applications of direct-to-consumer hearing devices for adults with hearing loss: a review. Clin Interv Aging 2017; 12:859-871. [PMID: 28553093 PMCID: PMC5441517 DOI: 10.2147/cia.s135390] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background This systematic literature review is aimed at investigating applications of direct-to-consumer hearing devices for adults with hearing loss. This review discusses three categories of direct-to-consumer hearing devices: 1) personal sound amplification products (PSAPs), 2) direct-mail hearing aids, and 3) over-the-counter (OTC) hearing aids. Method A literature review was conducted using EBSCOhost and included the databases CINAHL, MEDLINE, and PsycINFO. After applying prior agreed inclusion and exclusion criteria, 13 reports were included in the review. Results Included studies fell into three domains: 1) electroacoustic characteristics, 2) consumer surveys, and 3) outcome evaluations. Electroacoustic characteristics of these devices vary significantly with some meeting the stringent acoustic criteria used for hearing aids, while others producing dangerous output levels (ie, over 120-dB sound pressure level). Low-end (or low-cost) devices were typically poor in acoustic quality and did not meet gain levels necessary for most adult and elderly hearing loss patterns (eg, presbycusis), especially in high frequencies. Despite direct-mail hearing aids and PSAPs being associated with lower satisfaction when compared to hearing aids purchased through hearing health care professionals, consumer surveys suggest that 5%–19% of people with hearing loss purchase hearing aids through direct-mail or online. Studies on outcome evaluation suggest positive outcomes of OTC devices in the elderly population. Of note, OTC outcomes appear better when a hearing health care professional supports these users. Conclusion While some direct-to-consumer hearing devices have the capability to produce adverse effects due to production of dangerously high sound levels and internal noise, the existing literature suggests that there are potential benefits of these devices. Research of direct-to-consumer hearing devices is limited, and current published studies are of weak quality. Much effort is needed to understand the benefits and limitations of such devices on people with hearing loss.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,The Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Audiology India, Mysore.,Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, India
| | | | - Ashley L Dockens
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Nicole R Tran
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Kayla Lane
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Mariana Castle
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Vibhu Grover
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
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21
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Clinical evaluation of an over-the-counter hearing aid (TEO First®) in elderly patients suffering of mild to moderate hearing loss. BMC Geriatr 2016; 16:136. [PMID: 27392722 PMCID: PMC4938978 DOI: 10.1186/s12877-016-0304-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 06/17/2016] [Indexed: 12/03/2022] Open
Abstract
Background Presbycusis has a direct influence on autonomy of the elderly but hearing aids lack of affordability. Moreover a recent review demonstrate that electroacoustic characteristics of OTC hearing aids were generally not suitable for the elderly people. In our study, we assessed the clinical value of a new over-the-counter (OTC) hearing aid device (TEO First®) in the elderly. Method This prospective monocentric open label study included patients over 60 years of age with a mild to moderate presbycusis. Patients were assessed with acceptable noise level test (ANL), pure tone (PTA) and speech (SA) audiometry in silent and noisy environment, with and without TEO First®. A Glasgow Hearing Aid Benefit Profile, acceptability and satisfaction surveys were completed after one month of using the device. Results Thirty one patients were included. There was an improvement of hearing with TEO First® in silence (SA: +39.2 %, p < 0.01; PTA: -9.04 dB, p < 0.01) or in noise (SA +47.7 %, p < 0.01; PTA: -5.23 dB, p < 0.05). After one month of use of the device, quality of life has improved with regards to the following parameters: decrease of perceived hearing difficulties during conversation without background noise (-9.6 % p = 0.018), in conversation with several people (-16.2 % p = 0.0076), decrease of negative emotions while watching TV (-18.5 % p = 0.011), during conversation without background noise (-16.5 % p = 0.0024), during conversation in noisy background (-17.1 % p = 0.027) and during conversation with several people (-20 % p = 0.014). The acceptability of the device was low to moderate. Conclusion TEO First® is an effective OTC hearing aid that improves the patient’s quality of life. Trial registration Current Controlled Trials NCT01815788
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