Toward a New Evidence-Based Fitting Paradigm for Over-the-Counter Hearing Aids.

Aim 2 was a tightly controlled laboratory study; participants did not handle device insertion, maintenance, or physical fitting, so real-world usability is unknown. All hearing aid features (noise reduction, directional mics) were turned off, which does not reflect typical device settings. The study excluded individuals with steeply sloping hearing losses or those with thresholds poorer than 65 dB HL, limiting generalizability to more severe or specific audiometric profiles. Socioeconomic and racial diversity of the Aim 2 participants was not collected and likely did not reflect the target OTC population. The preset development only considered gain for a 65 dB SPL speech signal, not soft or loud sounds.

The study was supported by the Retirement Research Foundation and the National Institute on Deafness and Other Communication Disorders (NIDCD). No specific commercial conflicts of interest were declared in the provided text.

Do not assume that all OTC devices are equally effective or that any self-selection method works. The study found that random selection and questionnaire-based selection produced significantly poorer outcomes than clinical fitting or active listening/self-tests. Additionally, the results apply only to mild-to-moderate hearing losses within a specific audiometric range and do not account for real-world device handling or feature use.