MedicalResearch.com Interview with:
Nicholas S. Reed, AuD
Instructor | Department of Otolaryngology-Head/Neck Surgery
PhD Candidate | Graduate Training Program in Clinical Investigation
Center on Aging and Health
Johns Hopkins University School of Medicine
Johns Hopkins University Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hearing Aids are medical devices regulated by the FDA which must be purchased through a licensed individual while personal sound amplification products (PSAPs) are essentially unregulated devices some of which can manipulate and increase sound similar to a hearing aid but cannot market themselves are devices for hearing loss. PSAPs can be purchased online or in the back of a store and are generally less expensive than hearing aids.
We aimed to explore a select group of PSAPs to see if they helped someone with mild to moderate hearing loss improve speech understanding (i.e. ability to repeat back sentences) in the presence of mild background noise (think a lunch crowd at a restaurant) as well as a hearing aid. We selected four PSAP devices that were technologically strong (i.e. meet many standards a hearing aid might be asked to meet) and one PSAP that was technologically fairly poor (i.e. lots of sound distortion) after an in-house electroacoustic analysis of devices. Our hearing aid was selected because it was a popular choice at a university audiology clinic. Forty-two people completed the speech testing unaided (i.e. with no device) and then with each of the five PSAPs and one hearing aid (order of devices was randomized).
We looked at improvement with the devices from unaided. We found that some PSAPs help people understand speech about as well as a hearing aid in this controlled environment while one PSAP actually hindered participants’ ability to understand speech due to sound distortion – imagine how difficult it can be when listening on a poor cell phone signal.
MedicalResearch.com: What should readers take away from your report?
Response: Some devices may be as capable as a hearing aid in improving one’s speech understanding in this environment while some less technologically advanced products may make it more difficult to hear. It is important to do one’s homework before purchasing a device. Of note, if the FDA regulated over-the-counter devices, a standard would be set that could prevent the sale of technologically inferior devices [there is currently a proposal in the Senate and House of Representatives to regulate over-the-counter hearing aids for adults with mild to moderate hearing loss]. There are limits though, this study was completed with an audiologist helping to customize each device for the participant’s hearing loss which is similar to what would be done in a hearing aid clinic while a person in the real-world may grab one of these devices and use it without any consultation or customization. It is unclear to what degree that would play a role in speech improvement as some of these devices use smart phones to customize the device to supplement some need for a professional. Furthermore, this was a controlled environment while the real world is full of unpredictable sound environments of differing degrees of difficulty. It is entirely possible that results could be different in a more difficult listening environment.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: There are already some really fantastic pioneers of hearing aid research out there that have looked into how different degrees of technology affects user preference and how different models of hearing healthcare delivery (over-the-counter, for example) impact user outcomes. We need larger randomized control trials so we know the impact of different technologies and hearing healthcare models. In direct relation to this study, we need research to show whether these results hold true in real-world listening environments. I believe more unbiased research in this area could help improve our ability to provide hearing healthcare to everyone.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: This research is the result of a collaboration between a fantastic interdisciplinary team who worked from conception to completion to provide the best explorative efficacy study possible – it wouldn’t have been possible without them.
Please consult your primary care physician or an audiologist if you believe you have hearing loss. I have no financial relationships or other disclosures to report.
Reed NS, Betz J, Kendig N, Korczak M, Lin FR. Personal Sound Amplification Products vs a Conventional Hearing Aid for Speech Understanding in Noise. JAMA. 2017;318(1):89-90. doi:10.1001/jama.2017.6905
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.