The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial.

The sample was mostly White, highly educated, and had median annual household income greater than $45,000, so results may not apply to more diverse or lower-income groups. One participant withdrew before Session 2 and nine withdrew after Session 2, leaving 154 participants for the main outcome analyses. Purchase price was not randomly assigned to each participant; the first half paid $3,600 and the second half $600, so price could be mixed with enrollment phase. The consumer self-selection model was only one simulated OTC approach, and all participants had a full audiological evaluation and medical clearance or waiver, so it does not validate OTC pathways that skip these steps. All participants received the same high-quality ReSound hearing aids, so results may not generalize to simpler OTC devices. The best-practices model did not include scheduled follow-up fine-tuning during the 6-week trial, although guidelines cited in the paper do not require it. The extended 4-week trial after Session 3 had possible order or experience bias because participants were not crossed back to self-selection or placebo.

This trial was supported by an NIDCD research grant, R01 DC011771. No funding was received from GN ReSound, and all hearing aids were purchased from the manufacturer at $100 per hearing aid.

Do not conclude that self-selected hearing aids are as good as professionally fitted hearing aids for every older adult. Both improved self-reported benefit more than placebo, but the self-selection group had lower satisfaction and only 55% planned to keep the hearing aids, compared with 81% of the best-practices group. The trial used one simulated OTC method, one hearing-aid model, and a mostly White, highly educated sample.