A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss

Figures & data

Figure 1. Selection of studies for the systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.

Figure 2. Summary of the random effects meta-analyses for speech intelligibility: (A) PSAPs vs. unaided; (B) Hearing aids + FM system vs. Unaided; (C) Hearing aids + FM system vs. Hearing aids alone; (D) Hearing aids + FM system vs. FM only; (E) Hearing aids + FM system vs. Hearing aids +2.4 GHz system; (F) Hearing aids + Bluetooth system vs. Hearing aids alone. Black squares = summery effect size of each study for speech intelligibility. Error bars =95% confidence intervals (CI) for the summery effects. Diamond = overall effect size, lateral points indicate 95% CI for overall effect estimate.

Table 1. Review authors’ judgements using Downs and Black (1998) checklist to assess study quality for each included study, whereby higher scores indicate superior study quality (total maximum score of 28).

		Risk of bias
Study	Study quality	A	B	C	D	E	F	G
Sacco et al. (2016)	21 (good)	High	High	High	High	Low	High	Unclear
Lewis et al. (2004)	20 (good)	High	High	High	High	Low	High	Unclear
Lewis et al. (2005)	20 (good)	High	High	High	Low	Low	High	Unclear
Chisolm et al. (2007)	19 (fair)	High	High	High	Low	Low	High	Unclear
Lewis et al. (2010)	18 (fair)	High	High	High	High	Low	High	Unclear
Rodemerk and Galster (2015)	16 (fair)	High	High	High	High	Low	High	Unclear
Thibodeau (2014)	16 (fair)	High	High	Low	Low	Low	High	Unclear
Reed et al. (2017)	15 (fair)	High	High	High	High	Low	Low	Low
Norrix et al. (2016)	14 (poor)	High	High	High	High	Low	High	Low
Kim et al. (2014)	13 (poor)	High	High	High	High	Low	High	Low
Smith and Davis (2014)	13 (poor)	High	High	High	High	Low	High	Unclear

Risk of bias was assessed using the Cochrane risk of bias tool: A: sequence generation; B: allocation concealment; C: blinding of participants and personnel; D: blinding of outcome assessors; E: incomplete outcome data; F: selective outcome reporting; G: other sources of bias.

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Lewis, M. S., C. C. Crandell, M. Valente, and J. E. Horn. 2004. “Speech Perception in Noise: Directional Microphones versus Frequency Modulation (FM) Systems.” Journal of the American Academy of Audiology 15 (6): 426–439. doi:10.3766/jaaa.15.6.4.

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Lewis, M. S., M. Valente, J. Enrietto Horn, and C. C. Crandell. 2005. “The Effect of Hearing Aids and Frequency Modulation Technology on Results from the Communication Profile for the Hearing Impaired.” Journal of the American Academy of Audiology 16 (4): 250–261. doi:10.3766/jaaa.16.4.6.

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Chisolm, T. H., C. M. Noe, R. McArdle, and H. Abrams. 2007. “Evidence for the Use of Hearing Assistive Technology by Adults: The Role of the FM system.” Trends in Amplification 11 (2): 73–89. doi:10.1177/1084713807300879.

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Rodemerk, K. S., and J. A. Galster. 2015. “The Benefit of Remote Microphones Using Four Wireless Protocols.” Journal of the American Academy of Audiology 26 (8): 724–731. doi:10.3766/jaaa.15008.

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Thibodeau, L. 2014. “Comparison of Speech Recognition with Adaptive Digital and FM Remote Microphone Hearing Assistance Technology by Listeners Who Use Hearing Aids.” American Journal of Audiology 23 (2): 201–210. doi:10.1044/2014_AJA-13-0065.

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Reed, N. S., J. Betz, N. Kendig, M. Korczak, and F. R. Lin. 2017. “Personal Sound Amplification Products vs a Conventional Hearing Aid for Speech Understanding in Noise.” JAMA 318 (1): 89–90. doi:10.1001/jama.2017.6905.

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Norrix, L. W., K. Camarota, F. P. Harris, and J. Dean. 2016. “The Effects of FM and Hearing Aid Microphone Settings, FM Gain, and Ambient Noise Levels on SNR at the Tympanic Membrane.” Journal of the American Academy of Audiology 27 (2): 117–125. doi:10.3766/jaaa.15012.

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Kim, M.-B., W.-H. Chung, J. Choi, S. H. Hong, Y.-S. Cho, G. Park, and S. Lee. 2014. “Effect of a Bluetooth-Implemented Hearing Aid on Speech Recognition Performance: subjective and Objective Measurement.” Annals of Otology, Rhinology & Laryngology 123 (6): 395–401. doi:10.1177/0003489414526847 doi:.

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Smith, P., and A. Davis. 2014. “The Benefits of Using Bluetooth Accessories with Hearing Aids.” International Journal of Audiology 53 (10): 770–773. doi:10.3109/14992027.2014.941075.

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