SLPRCTAmerican journal of audiology2019

A Follow-Up Clinical Trial Evaluating the Consumer-Decides Service Delivery Model.

Larry E Humes, Dana L Kinney, Anna K Main and 1 others

PMID 30938563

WHAT IT FOUND

Older adults who chose amplified hearing aids reported more benefit on one main measure than those who chose no-gain devices.

Other measures were less clear. When 32 participants later received audiologist-based fitting, outcomes improved.

Key findings

01On the primary self-report hearing aid benefit measure, amplified-device choosers scored higher than no-gain-device choosers (p < .05), but other outcome analyses did not show clear differences.

02When 32 participants later received audiologist-based fitting, outcomes improved compared with self-selection on all measures shown.

03The lower speech-in-noise benefit in this unscreened group came from higher unaided scores, not worse aided scores.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The no-gain group was created by participant choice, not by random assignment, so the groups were not equivalent for a causal comparison. Only 14 participants chose no-gain devices for both ears, which made comparisons with the amplified group less stable. The sample was small and one participant withdrew early, leaving 40 analysed. Compared with the earlier trial, this sample had more varied hearing loss, and some participants would not have met the earlier inclusion criteria. The speech-in-noise difference between this group and the earlier group was explained by higher unaided scores, so it did not show poorer aided performance. The audiologist-based follow-up was optional, and 7 participants returned their hearing aids before it. The follow-up audiologist-based services were provided at no cost, so real-world uptake may differ.

Declared interests

Funding came from the National Institute on Deafness and Other Communication Disorders grant R01 DC011771, awarded to Indiana University and the first author.

The easy way to misread this

Do not conclude that consumer-decides self-selection works as well as audiologist-based fitting. The no-gain group was chosen by participants, not randomly assigned, and the later audiologist-based fitting produced better outcomes on all measures shown.

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