Effectiveness of the HEAR-Aware App for Adults Not Ready for Hearing Aids, but Open to Self-Management Support: Results of a Randomized Controlled Trial.

There was no sham or alternative activity for the control group, and no blinding, so people's expectations could have shaped their answers. The app group also had contact with the researchers, who helped them install the app and answered questions, so part of any effect could come from that attention rather than from the app itself. Control participants were told at the start that they would get the app once the study finished, which may have changed how they answered during the study. Questionnaires were only partly completed by some participants and results are missing at the follow-up points, so the number of people behind each analysis varies. The app period and the follow-up were each only 4 weeks, so nothing is known about longer-term effects. The researchers ran a large number of statistical tests and warn that some of the significant results may be chance findings. The group that used the app enough for the extra analysis was small (21 people), which makes those results hard to rely on. No process evaluation was carried out, so the authors cannot say why some people liked the app and others did not.

Co-funded by Sonova AG, a hearing technology company, by Schoonenberg HoorSupport, the hearing aid retailer that recruited the participants and whose call centre staff approached them, and by the Dutch Ministry of Economic Affairs through Health-Holland. Three of the authors (J.B., C.P. and B.H.B.T.) are employed by Sonova and/or its subsidiaries. The remaining authors declared no conflict of interest.

Do not read the emotional coping result as proof the app works. It was one of several secondary outcomes, the main measure showed no difference between the groups, and the gain had gone by the later follow-up. The authors themselves warn that with this many statistical tests some findings may be chance.