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Meta-Analysis
. 2017 Sep 25;9(9):CD012023.
doi: 10.1002/14651858.CD012023.pub2.

Hearing aids for mild to moderate hearing loss in adults

Melanie A Ferguson  1 , Pádraig T Kitterick, Lee Yee Chong, Mark Edmondson-Jones, Fiona Barker, Derek J Hoare
Affiliations
Meta-Analysis

Hearing aids for mild to moderate hearing loss in adults

Melanie A Ferguson et al. Cochrane Database Syst Rev. .

Abstract

Background: The main clinical intervention for mild to moderate hearing loss is the provision of hearing aids. These are routinely offered and fitted to those who seek help for hearing difficulties. By amplifying and improving access to sounds, and speech sounds in particular, the aim of hearing aid use is to reduce the negative consequences of hearing loss and improve participation in everyday life.

Objectives: To evaluate the effects of hearing aids for mild to moderate hearing loss in adults.

Search methods: The Cochrane ENT Information Specialist searched the ENT Trials Register; the Cochrane Register of Studies Online; MEDLINE; PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 23 March 2017.

Selection criteria: Randomised controlled trials (RCTs) of hearing aids compared to a passive or active control in adults with mild to moderate hearing loss.

Data collection and analysis: We used the standard methodological procedures expected by Cochrane. The primary outcomes in this review were hearing-specific health-related quality of life and the adverse effect pain. Secondary outcomes were health-related quality of life, listening ability and the adverse effect noise-induced hearing loss. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics.

Main results: We included five RCTs involving 825 participants. The studies were carried out in the USA and Europe, and were published between 1987 and 2017. Risk of bias across the studies varied. Most had low risk for selection, reporting and attrition bias, and a high risk for performance and detection bias because blinding was inadequate or absent.All participants had mild to moderate hearing loss. The average age across all five studies was between 69 and 83 years. The duration of the studies ranged between six weeks and six months.There was a large beneficial effect of hearing aids on hearing-specific health-related quality of life associated with participation in daily life as measured using the Hearing Handicap Inventory for the Elderly (HHIE, scale range 1 to 100) compared to the unaided/placebo condition (mean difference (MD) -26.47, 95% confidence interval (CI) -42.16 to -10.77; 722 participants; three studies) (moderate-quality evidence).There was a small beneficial effect of hearing aids on general health-related quality of life (standardised mean difference (SMD) -0.38, 95% CI -0.55 to -0.21; 568 participants; two studies) (moderate-quality evidence). There was a large beneficial effect of hearing aids on listening ability (SMD -1.88, 95% CI -3.24 to -0.52; 534 participants; two studies) (moderate-quality evidence).Adverse effects were measured in only one study (48 participants) and none were reported (very low-quality evidence).

Authors' conclusions: The available evidence concurs that hearing aids are effective at improving hearing-specific health-related quality of life, general health-related quality of life and listening ability in adults with mild to moderate hearing loss. The evidence is compatible with the widespread provision of hearing aids as the first-line clinical management in those who seek help for hearing difficulties. Greater consistency is needed in the choice of outcome measures used to assess benefits from hearing aids. Further placebo-controlled studies would increase our confidence in the estimates of these effects and ascertain whether they vary according to age, gender, degree of hearing loss and type of hearing aid.

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Conflict of interest statement

Melanie Ferguson: none known.

Pádraig T Kitterick: PK's employing organisation has received financial support from Cochlear Europe Ltd. and support in kind from Phonak UK Ltd. to conduct a multicentre clinical trial of cochlear implantation in single‐sided deafness co‐ordinated by PK. PK has accepted the hospitality of Cochlear Europe Ltd. to attend and speak at national and international scientific meetings.

Lee Yee Chong: none known.

Mark Edmondson‐Jones: none known.

Fiona Barker: none known

Derek Hoare: none known.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
3
3
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Forest plot of comparison: 1 Hearing aids versus no/placebo hearing aids, outcome: 1.1 Hearing‐specific health‐related quality of life. Assessed using Hearing Handicap Inventory for the Elderly (HHIE) in all studies.
5
5
Forest plot of comparison: 1 Hearing aids versus no/placebo hearing aids, outcome: 1.2 Health‐related quality of life.
6
6
Forest plot of comparison: 1 Hearing aids versus no/placebo hearing aids, outcome: 1.3 Listening ability.
1.1
1.1. Analysis
Comparison 1 Hearing aids versus no/placebo hearing aids, Outcome 1 Hearing‐specific health‐related quality of life.
1.2
1.2. Analysis
Comparison 1 Hearing aids versus no/placebo hearing aids, Outcome 2 Health‐related quality of life.
1.3
1.3. Analysis
Comparison 1 Hearing aids versus no/placebo hearing aids, Outcome 3 Listening ability.
See this image and copyright information in PMC

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  • doi: 10.1002/14651858.CD012023

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References

References to studies included in this review

Adrait 2017 {published and unpublished data}
    1. Adrait A, Perrot X, Nguyen MF, Gueugon M, Petitot C, Collet L, et al. Do hearing aids influence behavioral and psychological symptoms in hearing impaired Alzheimer's Disease patients and their caregivers?. Journal of Alzheimer's Disease 2017;58(1):109‐21. [DOI: 10.3233/JAD-160792] - DOI - PubMed
Humes 2017 {published and unpublished data}
    1. Humes LE, Rogers S, Quigley TM, Main AK, Kinney DL, Herring C. The effects of service‐delivery model and purchase price on hearing aid outcomes in older adults: a randomized double‐blind placebo‐controlled clinical trial. American Journal of Audiology 2017;26(1):53‐79. - PMC - PubMed
McArdle 2005 {published and unpublished data}
    1. McArdle R, Chisolm TH, Abrams HB, Wilson RH, Doyle PJ. The WHO‐DAS II: measuring outcomes of hearing aid intervention for adults. Trends in Amplification 2005;9(3):127‐43. - PMC - PubMed
Melin 1987 {published and unpublished data}
    1. Melin L, Scott B, Lindberg P, Lyttkens L. Hearing aids and tinnitus ‐ an experimental group study. British Journal of Audiology 1987;21(2):91‐7. - PubMed
Mulrow 1990 {published data only (unpublished sought but not used)}
    1. Mulrow CD, Aguilar C, Endicott JE, Tuley MR, Velez R, Charlip WS, et al. Quality‐of‐life changes and hearing impairment: a randomized trial. Annals of Internal Medicine 1990;113(3):188‐94. - PubMed

References to studies excluded from this review

Abrams 2002 {published data only}
    1. Abrams HB, Hnath‐Chisolm T, Guerreiro SM, Ritterman S. The effects of intervention strategy on self‐perception of hearing handicap. Amplification and Aural Rehabilitation 1992;5:371‐7. - PubMed
Jerger 1992 {published data only}
    1. Jerger J, Chmiel R, Florin E, Pirozzolo F, Wilson N. Comparison of conventional amplification and an assistive listening device in elderly persons. Ear and Hearing 1996;17(6):490‐504. - PubMed
Lavie 2015 {published data only}
    1. Lavie L, Banai K, Kami A, Attias J. Hearing aid‐induced plasticity in the auditory system of older adults: evidence from speech perception. Journal of Speech Language Hearing Research 2015;58:1601‐10. - PubMed
Tolson 2002 {published data only}
    1. Tolson D, Swan I, Knussen C. Hearing disability: a source of distress for older people and carers. British Journal of Nursing 2002;11(15):1021‐5. - PubMed
Yueh 2001 {published data only}
    1. Yueh B, Souza PE, McDowell JA, Collins MP, Loovis CF, Hedrick SC, et al. Randomized trial of amplification strategies. Archives of Otolaryngology‐‐Head & Neck Surgery 2001;127:1197‐204. - PubMed

References to ongoing studies

NCT03002142 {published data only}
    1. NCT03002142. Auditory rehabilitation with hearing aids and cognition in Alzheimer patients. https://clinicaltrials.gov/ct2/show/NCT03002142 (first received 16 March 2016).

Additional references

Aazh 2015
    1. Aazh H, Prasher D, Nanchahal K, Moore BCJ. Hearing‐aid use and its determinants in the UK National Health Service: a cross‐sectional study at the Royal Surrey County Hospital. International Journal of Audiology 2015;54:152‐61. - PubMed
Akeroyd 2014
    1. Akeroyd MA, Foreman K, Holman JA. Estimates of the number of adults in England, Wales, and Scotland with a hearing loss. International Journal of Audiology 2014;53(1):60‐1. - PMC - PubMed
AoHL 2015
    1. Action on Hearing Loss. Hearing Matters. http://www.actiononhearingloss.org.uk/supporting‐you/policy‐research‐and... (accessed 2 August 2017). London, 1‐114.
Barker 2016
    1. Barker F, Mackenzie E, Elliott L, Jones S, Lusignan S. Interventions to improve hearing aid use in adult auditory rehabilitation. Cochrane Database of Systematic Reviews 2016, Issue 8. [DOI: 10.1002/14651858.CD010342.pub3] - DOI - PMC - PubMed
Barton 2004
    1. Barton GR, Bankart J, Davis AC, Summerfield QA. Comparing utility scores before and after hearing‐aid provision. Applied Health Economics and Health Policy 2004;3(2):103‐5. - PubMed
Bertoli 2009
    1. Bertoli S, Staehelin K, Zemp E, Schindler C, Bodner D, Probst R. Survey on hearing aid use and satisfaction in Switzerland and their determinants. International Journal of Audiology 2009;48:183‐95. - PubMed
Boothroyd 2007
    1. Boothroyd A. Adult aural rehabilitation: what is it and does it work?. Trends in Amplification 2007;11(2):63‐71. - PMC - PubMed
Browning 2017
    1. Browning GG, Howell P, Whitmer WM, Ftouh S, Chong LY, Naylor G. Unilateral versus bilateral hearing aids for bilateral hearing impairment in adults. Cochrane Database of Systematic Reviews 2017, Issue 5. [DOI: 10.1002/14651858.CD012665] - DOI - PMC - PubMed
Chisolm 2005
    1. Chisolm TH, Abrams HB, McArdle R, Wilson RH, Boyle PJ. The WHO‐DAS II: Psychometric properties in the measurement of functional health status in adults with acquired hearing loss. Trends in Amplification 2005;9(3):111‐26. - PMC - PubMed
Chisolm 2007
    1. Chisolm T, Johnson CE, Danhauer JL, Portz Laural JP, Abrams HB, Lesner S, et al. A systematic review of health‐related quality of life and hearing aids: final report of the American Academy of Audiology Task Force on the Health‐Related Quality of Life Benefits of Amplification in Adults. Journal of the American Academy of Audiology 2007;18(2):151‐83. - PubMed
CONSORT 2010
    1. CONSORT (Consolidated Standards of Reporting Trials). CONSORT 2010. http://www.consort‐statement.org/consort‐2010. - PubMed
Coulson 2016
    1. Coulson N, Ferguson M, Henshaw H, Heffernan E. Applying theories of health behaviour and change to hearing health research: time for a new approach. International Journal of Audiology 2016;55(Suppl 3):S99‐104. - PubMed
Covidence 2017 [Computer program]
    1. Veritas Health Innovation. Covidence systematic review software. Melbourne, Australia: Veritas Health Innovation, (accessed 7 February 2017).
Cox 1990
    1. Cox RM, Gilmore C. Development of the Profile of Hearing Aid Performance (PHAP). Journal of Speech Language and Hearing Research 1990;33(2):343‐57. - PubMed
Cox 1995
    1. Cox RM, Alexander GC. The abbreviated profile of hearing aid benefit. Ear and Hearing 1995;16:176‐86. - PubMed
Cruickshanks 1998
    1. Cruickshanks KJ, Wiley TL, Tweed TS, Klein BEK, Klein R, Mares‐Perlman JA, et al. Prevalence of hearing loss in older adults in Beaver Dam, Wisconsin. The epidemiology of hearing loss study. American Journal of Epidemiology 1998;148(9):879‐86. - PubMed
Danermark 2013
    1. Danermark B, Granberg S, Kramer SE, Selb M, Möller C. The creation of a comprehensive and a brief core set for hearing loss using the international classification of functioning, disability and health. American Journal of Audiology 2013;22(2):323‐8. - PubMed
Davis 2007
    1. Davis A, Smith P, Ferguson M, Stephens D, Gianopoulos I. Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models. Health Technology Assessment 2007;11(42):1‐294. - PubMed
Dillon 2012
    1. Dillon H. Hearing Aids. 2nd Edition. New York: Thieme, 2012.
Duval 2000
    1. Duval S, Tweedie R. Trim and fill: a simple funnel‐plot‐based method of testing and adjusting for publication bias in meta‐analysis. Biometrics 2000;56(2):455‐63. - PubMed
Ferguson 2016
    1. Ferguson MA, Brandreth M, Brassington W, Leighton P, Wharrad H. A randomized controlled trial to evaluate the benefits of a multimedia educational programme for first‐time hearing aid users. Ear and Hearing 2016;27(2):123‐36. - PMC - PubMed
Furlong 2001
    1. Furlong WJ, Feeny DH, Torrance GW, Barr RD. The Health Utilities Index (HUI) system for assessing health‐related quality of life in clinical studies. Annals of Medicine 2001;33(5):375‐84. - PubMed
Furukawa 2014
    1. Furukawa TA, Noma H, Caldwell DM, Honyashiki M, Shinohara K, Imai H, et al. Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta‐analysis. Acta Psychiatrica Scandinavica 2014;130(3):181‐92. [DOI: 10.1111/acps.12275] - DOI - PubMed
Gatehouse 1999
    1. Gatehouse S. A self‐report outcome measure for the evaluation of hearing aid fittings and services. Health Bulletin 1999;57:424‐36. - PubMed
Gatehouse 2004
    1. Gatehouse S, Noble W. The Speech, Spatial and Qualities of Hearing Scale (SSQ). International Journal of Audiology 2004;43:85‐99. - PMC - PubMed
Granberg 2014
    1. Granberg S, Dahlström J, Möller C, Kähäri K, Danermark B. The ICF core sets for hearing loss‐researcher perspective. Part I: Systematic review of outcome measures identified in audiological research. International Journal of Audiology 2014;53(2):65‐76. - PubMed
Handbook 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Harbour 2001
    1. Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ 2001;323(7308):334. - PMC - PubMed
Hopkins 2011
    1. Hopkins K, Moore BCJ. The effects of age and cochlear hearing loss on temporal fine structure sensitivity, frequency selectivity, and speech reception in noise. Journal of the Acoustical Society of America 2011;130(1):334‐49. - PubMed
Hougaard 2011
    1. Hougaard S, Ruf S. Eurotrak I: A consumer survey about hearing aids in Germany, France and the UK. Hearing Review 2011;18(2):12‐28.
Johnson 2016
    1. Johnson CE, Danhauer JL, Ellis BB, Jilla AM. Hearing aid benefit in patients with mild sensorineural hearing loss: a systematic review. Journal of the American Academy of Audiology 2016;27:293‐310. - PubMed
Joore 2002
    1. Joore MA, Potjewijd J, Timmerman AA, Anteunis LJC. Response shift in the measurement of quality of life in hearing impaired adults after hearing aid fitting. Quality of Life Research 2002;11(4):299‐307. - PubMed
Joore 2003
    1. Joore MA, Stel H, Peters HJM, Boas GM, Anteunis LJC. The cost‐effectiveness of hearing‐aid fitting in the Netherlands. Archives of Otolaryngology‐–Head & Neck Surgery 2003;129(3):297‐304. - PubMed
Kiessling 2003
    1. Kiessling J, Pichora‐Fuller MK, Gatehouse S, Stephens D, Arlinger S, Chisolm T, et al. Candidature for and delivery of audiological services: special needs of older people. International Journal of Audiology 2003;42(Suppl 2):S92‐101. - PubMed
Kirkwood 2013
    1. Kirkwood D. Research firm analyzes market share, retail activity, and prospects of major hearing aid manufacturers. http://hearinghealthmatters.org/hearingnewswatch/2013/research‐firm‐anal... (accessed 14 December 2015) 2013.
Kochkin 2009
    1. Kochkin S. MarkeTrak VIII: 25‐year trends in the hearing health market. Hearing Review 2009;16(11):12‐31.
Kochkin 2010
    1. Kochkin S, Beck DL, Christensen LA, Compton‐Conley C, Fligor BJ, Kricos PB, et al. MarkeTrak VIII: The impact of the hearing healthcare professional on hearing aid user success. Hearing Review 2010;17(4):12‐34.
Lin 2011
    1. Lin FR, Metter EJ, O'Brien RJ, Resnick SM, Zonderman AB, Ferrucci L. Hearing loss and incident dementia. Archives of Neurology 2011;68(2):214‐20. - PMC - PubMed
Linn 1984
    1. Linn MW, Linn BS. Self‐evaluation of life function (SELF) scale: a short, comprehensive self‐report of health for elderly adults. Journal of Gerontology 1984;39:603‐12. - PubMed
Loughrey 2015
    1. Loughrey D, Kelly M, Kelley G, Lawlor B, Brennan S. The association of age‐related hearing loss with cognition function, cognitive impairment and dementia: a systematic review with meta‐analysis. http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015026052 2015. - PMC - PubMed
Lupsakko 2005
    1. Lupsakko T, Kautiainen HJ, Sulkava R. The non‐use of hearing aids in people aged 75 years and over in the city of Kuopio in Finland. European Archives of Otorhinolaryngology 2005;262:165‐9. - PubMed
Mathers 2000
    1. Mathers C, Smith A, Concha M. Global burden of hearing loss in the year 2000. Global Burden of Disease 2000;18:1‐30.
McArdle 2006
    1. McArdle R, Chisolm TH, Abrams HA, Wilson RH, Boyle PJ. Erratum. The WHO‐DAS II: Measuring outcomes of hearing aid intervention for adults. Trends in Amplification 2006;10(2):105. - PMC - PubMed
McCormack 2013
    1. McCormack A, Fortnum H. Why do people fitted with hearing aids not wear them?. International Journal of Audiology 2013;52(5):360‐8. - PMC - PubMed
Mueller 2005
    1. Mueller GH. Fitting hearing aids to adults using prescriptive methods: an evidence‐based review of effectiveness. Journal of the American Academy of Audiology 2005;16(7):448‐60. - PubMed
Newman 1990
    1. Newman CW, Weinstein BE, Jacobson GP, Hug GA. The Hearing Handicap Inventory for Adults: psychometric adequacy and audiometric correlates. Ear and Hearing 1990;11:430‐3. - PubMed
Nguyen 2017
    1. Nguyen M‐F, Bonnefoy M, Adrait A, Gueugnon M, Petitot C, Collet L, et al. Efficacy of hearing aids on cognitive status of patients with Alzheimer's disease and hearing loss: a multicenter controlled randomized trial. Journal of Alzheimer's Disease 2017;58(1):123‐37. [DOI: 10.3233/JAD-160793] - DOI - PubMed
Pichora‐Fuller 2016
    1. Pichora‐Fuller MK, Kramer SE, Eckert MA, Edwards B, Hornsby BWY, Humes LE, et al. Hearing impairment and cognitive energy: the Framework for Understanding Effortful Listening (FUEL). Ear and Hearing 2016;37:S5‐S27. - PubMed
Picou 2013
    1. Picou EM, Ricketts TA, Hornsby BWY. How hearing aids, background noise, and visual cues influence objective listening effort. Ear and Hearing 2013;34(5):e52‐64. - PubMed
Rabin 2001
    1. Rabin R, Charro F. EQ‐SD: a measure of health status from the EuroQol Group. Annals of Medicine 2001;33:337‐43. - PubMed
Rabins 1999
    1. Rabins PV, Kasper JD, Kleinman L, Black BS, Patrick DL. Concepts and methods in the development of the ADRQL: an instrument for assessing health‐related quality of life in persons with Alzheimer's disease. Journal of Mental Health 1999;5:33‐48.
Reese 2005
    1. Reese JL, Hnath‐Chisolm T. Recognition of hearing aid orientation content by first‐time users. American Journal of Audiology 2005;14(1):94‐104. - PubMed
Resnik 2009
    1. Resnik L, Plow MA. Measuring participation as defined by the international classification of functioning, disability and health: an evaluation of existing measures. Archives of Physical Medicine and Rehabilitation 2009;90(5):856‐66. - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Robinson 1996
    1. Robinson K, Gatehouse S, Browning GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Annals of Otology, Rhinology and Laryngology 1996;105:415‐22. - PubMed
Solheim 2017
    1. Solheim J, Hickson L. Hearing aid use in the elderly as measured by datalogging and self‐report. International Journal of Audiology 2017;56:466‐73. - PubMed
Stark 2004
    1. Stark P, Hickson L. Outcomes of hearing aid fitting for older people with hearing impairment and their significant others. International Journal of Audiology 2004;43(7):390‐8. - PubMed
Timmer 2015
    1. Timmer BHB, Hickson L, Launer S. Adults with mild hearing impairment: are we meeting the challenge?. International Journal of Audiology 2015;54(11):786‐95. - PubMed
Tuley 1990
    1. Tuley MR, Mulrow CD, Aguilar C, Velez R. A critical reevaluation of the Quantified Denver Scale of Communication Function. Ear and Hearing 1990;11:56‐61. - PubMed
Ventry 1982
    1. Ventry IM, Weinstein BE. The Hearing Handicap Inventory for the Elderly: a new tool. Ear and Hearing 1982;3:128‐34. - PubMed
Ware 1992
    1. Ware JE, Sherbourne CD. The MOS 36‐item short‐form health survey (SF‐36): I. Conceptual framework and item selection. Medical Care 1992;30(6):473‐83. - PubMed
Weinstein 1997
    1. Weinstein B. Outcome measures in the hearing aid fitting/selection process. Trends in Amplification 1997;2(4):117‐37. - PMC - PubMed
WHO 2001
    1. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization, 2001.
WHO 2002
    1. World Health Organization. Towards a common language for functioning, disability and health: The International Classification of Functioning, Disability and Health. http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf 2002.
WHO 2008
    1. World Health Organization. The Global Burden of Disease: 2004 Update. Geneva: World Health Organization, 2008:1‐146.
WHO 2012a
    1. World Health Organization. WHO global estimates on prevalence of hearing loss. http://www.who.int/pbd/deafness/WHO_GE_HL.pdf 2012.
WHO 2012b
    1. World Health Organization. WHO Disability Assessment Schedule 2.0. http://www.who.int/classifications/icf/whodasii/en/ 2012.

References to other published versions of this review

Ferguson 2015
    1. Ferguson MA, Kitterick PT, Edmondson‐Jones M, Hoare DJ. Hearing aids for mild to moderate hearing loss in adults. Cochrane Database of Systematic Reviews 2015, Issue 12. [DOI: 10.1002/14651858.CD012023] - DOI - PMC - PubMed

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