Outcomes With a Self-Fitting Hearing Aid.
Gitte Keidser, Elizabeth Convery
PMID 29716438WHAT IT FOUND
For most outcomes, self-fitted hearing aids were no different from assisted fittings.
Experienced users still preferred their own conventional aids and found self-fitted aids harder to manage.
Key findings
01When degree of hearing loss and cognitive function were taken into account, user-driven and clinician-driven fittings produced similar coupler gain, speech recognition in noise, and self-reported benefit and satisfaction.
02Experienced users with self-directed fittings reported lower satisfaction with the self-fitted aid than with their own conventional hearing aid, especially for sound naturalness, appearance, and aversive sounds.
03Managing the self-fitted aid was harder than managing a conventional aid, and poorer cognitive function was associated with worse handling; people who needed clinician-driven fitting also managed the self-fitted aid less well.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not randomize participants to self-fitting or conventional fitting, so the groups differed in hearing loss, age, and cognitive function. The comparison with conventional hearing aids was limited to 22 experienced users who had user-driven fittings. The clinical assistant had no audiological qualifications and support was available during setup and the trial, so results may not apply to fully unsupported self-fitting. The test aid was one proprietary model with a large battery, Bluetooth app, fixed maximum output, and limited dome options, so device design may explain several negative findings. Five participants withdrew during the 12-week trial, and some problems with app use or discomfort were not fully captured in the remaining outcomes. The article reports several outcomes without naming one primary endpoint, so the most important result is not clearly defined. Older participants and those with lower cognitive scores may have been less able to manage the aid, so results may not apply to all clients.
Declared interests
Funding was provided by the HEARing CRC and the Australian Commonwealth Department of Health and Ageing. The authors designed the self-fitting instructions in collaboration with the manufacturer, SoundWorld Solutions. The article text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that self-fitting hearing aids are ineffective or that clinicians should avoid them. The study found similar speech and benefit outcomes between fitting types, but this particular device had handling, satisfaction, and design problems that may not apply to other self-fitting hearing aids.