Does Probe-Tube Verification of Real-Ear Hearing Aid Amplification Characteristics Improve Outcomes in Adults? A Systematic Review and Meta-Analysis.
Ibrahim Almufarrij, Harvey Dillon, Kevin J Munro
PMID 33899603WHAT IT FOUND
Verifying hearing aid settings with real-ear measures leads to better speech understanding and higher user preference than relying on initial fit alone.
Patients prefer these verified fittings, though the clinical size of the benefit remains unclear.
Key findings
01Real-ear verification resulted in a statistically significant improvement in self-reported listening ability compared to initial fit.
02Real-ear verification resulted in a statistically significant improvement in speech intelligibility in quiet settings.
03A significantly higher proportion of participants preferred hearing aids fitted with real-ear verification compared to initial fit.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The primary outcome (hearing-specific health-related quality of life) was not reported in any included study. Most studies had small sample sizes and short follow-up periods (maximum 6 weeks). Two studies measured outcomes on the day of fitting, which does not allow for acclimatization. The minimum clinically important difference for most outcomes is not established, so the clinical significance of the small statistical effects is uncertain. Publication bias may exist, as studies with null or small effects are less likely to be published. The review excluded direct-to-consumer devices and hearables, which are increasingly common.
Declared interests
The authors declared no potential conflicts of interest. Funding was provided by the NIHR Manchester Biomedical Research Centre and the Deanship of Scientific Research at King Saud University.
The easy way to misread this
Do not assume that the statistically significant improvements in speech understanding translate to a clinically noticeable benefit for every patient. The absolute gains are small (e.g., 0.5 dB SNR in noise), and the minimum clinically important difference for these outcomes has not been established.