PP107 - Comparison of Hearing Devices: Over-the-Counter, Personal Sound Amplification Products, and Prescription Hearing Aids

Abstract:
This study investigated the differences among the current amplification devices. Adults with mild-to-moderate sensorineural-hearing-loss self-fitted three-pair OTCs and one-pair PSAPs and professional-fitted one-pair prescription hearing aids (HAs) in a randomized sequence. Real ear measures and personal perceptions regarding the devices were recorded. Results revealed significant impacts of the device on sound level in the ear canal, device operation, sound perception, and self-perceived aided benefit. Prescription HAs provided the highest sound level at mid-high frequencies and were perceived the best. The ranking in different aspects and perception of the devices were reported/discussed providing useful information for professionals and patients.

Summary:
Over-the-counter (OTC) hearing aids (HAs) and personal sound amplification product devices (PSAPs), possible alternatives to prescription HAs, have become more popular due to their relatively cheaper prices. A study by Keidser and Convery in 2016 found that participants reported overall greater satisfaction with sound quality when fitted with prescription HAs than with OTCs or PSAPs. Other studies (e.g., Chan & McPherson, 2015) on the textbox and simulated real-ear measures revealed that OTC HAs were not appropriate for patients with presbycusis mostly due to poor electroacoustic performance and ineffective functional controls. Technology has advanced and more OTC HAs are available in the market since FDA approval in 2022. However, little is known about the current OTC HAs and PSAPs, especially how they apply amplification to each ear. This study compared the acoustic fit and personal perceptions of the OTCs, PSAPs, and prescription HAs to gain a better understanding of those devices.

Adults aged 18 years or older with bilateral mild to moderate sensorineural hearing loss participated in this study. A comprehensive hearing evaluation was completed before the experiment to determine the candidacy. Each participant then self-fitted with a pair of Jabra Enhance, AirPod Pro, and SONY CRE-E10, and was fitted Oticon More HAs by an audiology professional in a randomized sequence. Information obtained from each fitting included real-ear aided gain and output for three input levels and maximum power output (MPO), pre-and post-fit Client Oriented Scale of Improvement (COSI) questionnaire in four simulated environments (playground, street, home with spouse, and restaurant), and a personal perception questionnaire regarding own and other’s voices, device operation, and physical fit of the devices. Note that the AirPod Pros was programmed both as a sound amplifier (AirpodPSAP) and as a hearing aid (AirpodOTC). Data collected were analyzed using Matlab and JMP pro.

Results revealed significant sound level differences in the ear canal among the devices for all input levels (p < .0001). The prescription HAs had the highest MPO and outputs (for all inputs), which were the closest to the verifit NAL-NL2 targets. SONY outputs were similar to those from prescription aids, and the outputs decreased in the sequence of Jabra, AirpodOTC, and AirpodPSAP with the output-difference-to-prescriptionAid as 5-11/8.5-12.5/10.7-23dB at 2-8kHz for 55dB input, respectively. Overall, the device had a significant impact on the device operation, sound perception, and self-perceived aided benefit (p=0.0033). Although the self-fit devices were set up within a reasonable time frame, all needed assistance from a professional, except AirpodPSAP was set up with no assistance by one participant. There were complaints and satisfaction regarding self-fit devices. Sony and Jabra aids were perceived as louder but with less sound quality and comfort compared to prescription aids. Airpods were rated the lowest, although with inputting participants’ audiogram, AirpodOTC aids were rated louder but with less sound quality and comfort than AirpodPSAP. For all simulated listening environments, participants perceived much better, better, slightly better aided benefit from prescription aids, Sony/Jabra, AirpodOTC/PSAP, respectively. Both Airpod forms were perceived no aided benefit at home and restaurant environments. Information obtained will be useful for audiology professionals and patients.