Fitting a Hearing Aid on the Better Ear, Worse Ear, or Both: Associations of Hearing-aid Fitting Laterality with Outcomes in a Large Sample of US Veterans.
Oliver Zobay, Graham Naylor, Gabrielle H Saunders and 1 others
PMID 37615317WHAT IT FOUND
Bilateral hearing aid fittings had better long-term use than unilateral ones.
If fitting only one ear, the better ear persisted in use more than the worse ear, though satisfaction scores were slightly lower than bilateral. Symmetric hearing loss users persisted least with unilateral devices.
Key findings
01Long-term hearing aid use persistence was significantly lower for worse-ear fittings and unilateral fittings in symmetric hearing loss compared to bilateral and better-ear fittings.
02There was no significant difference in persistence between bilateral and better-ear fittings, but better-ear fittings had slightly lower total satisfaction scores (IOI-HA) than bilateral fittings.
03Self-reported short-term usage (hours per day) did not differ significantly between bilateral and unilateral fitting categories.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is observational and cannot prove causation; patient preference or clinical judgment influenced the choice of fitting. The sample consisted mostly of male US Veterans, which may limit generalizability to other populations. Persistence was measured indirectly via battery orders, which may misclassify patients who use rechargeable aids or have imperfect calibration. IOI-HA data was self-selected and likely biased toward patients who attended follow-up appointments and were more engaged in care.
Declared interests
The authors declared no potential conflicts of interest. The work was supported by the US Department of Veterans Affairs and NIH grants.
The easy way to misread this
Do not interpret the lower satisfaction scores for better-ear fittings as a reason to avoid them. The study shows that better-ear fittings have long-term use persistence statistically similar to bilateral fittings, whereas worse-ear and unilateral fittings in symmetric loss have significantly worse adherence. The slight drop in IOI-HA score is small (0.6-0.7 points) compared to the risk of the patient abandoning the device entirely.