Clinical Performance Evaluation of a Personal Sound Amplification Product vs a Basic Hearing Aid and a Premium Hearing Aid
Young Sang Cho, MD1,2; Su Yeon Park, BS2; Hye Yoon Seol, AuD2; et al Ji Hyun Lim, BS3; Yang-Sun Cho, MD, PhD1,2; Sung Hwa Hong, MD, PhD2,4; Il Joon Moon, MD, PhD1,2
Author Affiliations Article Information
1Department of Otorhinolaryngology–Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
2Hearing Research Laboratory, Samsung Medical Center, Seoul, South Korea
3Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
4Department of Otorhinolaryngology–Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, South Korea
JAMA Otolaryngol Head Neck Surg. 2019;145(6):516-522. doi:10.1001/jamaoto.2019.0667
editorial comment icon Editorial
Comment
Key Points
Question  For adults with mild to moderately severe hearing loss, how does the performance of a personal sound amplification product (PSAP) compare with that of a basic hearing aid (HA) and a premium HA on a series of efficacy tests and patient self-reports?

Findings  In this cohort study of 56 adults, for those with mild and moderate hearing loss, there were no differences between PSAP, basic HA, and premium HA for speech perception, sound quality, listening effort, and user preference. However, for the group with moderately severe hearing loss, the premium HA had better performance across most tests, and 70% of these participants preferred to use the premium HA.

Meaning  A PSAP may be helpful for individuals with mild to moderate hearing loss, but if the degree of hearing loss is severe, a premium HA that can provide sufficient gain across all frequencies may be needed.

Abstract
Importance  Hearing loss is a highly prevalent condition with multiple negative associated outcomes, yet few persons with hearing loss have hearing aids (HAs). Personal sound amplification products (PSAPs) could be an alternative low-cost solution to HAs, but data are lacking on the performance of PSAPs.

Objective  To evaluate the clinical efficacy of a PSAP by comparing its performance with that of a basic HA and a premium HA in participants with mild, moderate, and moderately severe hearing impairment.

Design, Setting, and Participants  A prospective, single-institution cohort study was performed with a total of 56 participants, including 19 with mild hearing loss, 20 with moderate hearing loss, and 17 with moderately severe hearing loss. All participants underwent 4 clinical hearing tests with each of the PSAP, basic HA, and premium HA, and all completed an evaluative questionnaire.

Interventions  All hearing devices (PSAP, basic HA, and premium HA) were applied by a clinician to prevent bias and order effects; participants were blinded to the device in use, and sequence of devices was randomized.

Main Outcomes and Measures  The study used the Korean version of the hearing in noise test, the speech intelligibility in noise test, listening effort measurement using a dual-task paradigm, pupillometry, and a self-rating questionnaire regarding sound quality and preference. These tests were administered under the following 4 hearing conditions: unaided hearing, use of PSAP, use of basic HA, and use of premium HA.

Results  The study included 56 participants with a mean age of 56 years (interquartile range, 48-59 years); 29 (52%) were women. In the mild and moderate hearing loss groups, there was no meaningful difference between PSAP, basic HA, and premium HA for speech perception (Cohen d = 0.06-1.05), sound quality (Cohen d = 0.06-0.71), listening effort (Cohen d = 0.10-0.92), and user preference (PSAP, 41%; basic HA, 28%; premium HA, 31%). However, for the patients with moderately severe hearing loss, the premium HA had better performance across most tests (Cohen d = 0.60-1.59), and 70% of participants preferred to use the premium HA.

Conclusions and Relevance  The results indicate that basic and premium HAs were not superior to the PSAP in patients with mild to moderate hearing impairment, which suggests that PSAPs might be used as an alternative to HAs in these patient populations. However, if hearing loss is more severe, then HAs, especially premium HAs, should be considered as an option to manage hearing loss.