Do we need audiogram-based prescriptions? A systematic review

Abstract

Objective: Hearing aids are typically programmed using the individual’s audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not necessarily programmed using the individual’s audiometric thresholds. This review aimed to identify whether programming hearing aids using the individual’s validated audiogram-based prescription, and verified using real-ear measures, results in better outcomes for adults with hearing loss. Design: The review was registered in PROSPERO and reported in accordance with PRISMA guidelines. Study sample: After screening more than 1370 records, seven experimental studies met the eligibility criteria. Results: Studies were categorised under three methods of fitting: (i) comparative fitting evaluating different settings based on the beliefs of the audiologist; (ii) client choice of preset responses; and (iii) self-fit by adjustment. The findings suggest that using a prescription based on the individual’s audiogram improves outcomes relative to the comparative and client choice fitting approaches. Self-adjustment during daily use may produce equivalent (or better) outcomes than an audiogram-based prescription. The quality of evidence for the outcomes ranged from low to very low. Conclusions: This review has highlighted the dearth of high-quality studies on which to make evidence-based decisions on hearing aid fitting methods.