Larson V D, Williams D W, Henderson W G, Luethke L E, Beck L B, Noffsinger D, Wilson R H, Dobie R A, Haskell G B, Bratt G W, Shanks J E, Stelmachowicz P, Studebaker G A, Boysen A E, Donahue A, Canalis R, Fausti S A, Rappaport B Z
Howard Leight Industries, 7828 Waterville Rd, San Diego, CA 92154, USA.
JAMA. 2000 Oct 11;284(14):1806-13. doi: 10.1001/jama.284.14.1806.
Numerous studies have demonstrated that hearing aids provide significant benefit for a wide range of sensorineural hearing loss, but no carefully controlled, multicenter clinical trials comparing hearing aid efficacy have been conducted.
To compare the benefits provided to patients with sensorineural hearing loss by 3 commonly used hearing aid circuits.
Double-blind, 3-period, 3-treatment crossover trial conducted from May 1996 to February 1998.
Eight audiology laboratories at Department of Veterans Affairs medical centers across the United States.
A sample of 360 patients with bilateral sensorineural hearing loss (mean age, 67.2 years; 57% male; 78.6% white).
Patients were randomly assigned to 1 of 6 sequences of linear peak clipper (PC), compression limiter (CL), and wide dynamic range compressor (WDRC) hearing aid circuits. All patients wore each of the 3 hearing aids, which were installed in identical casements, for 3 months.
Results of tests of speech recognition, sound quality, and subjective hearing aid benefit, administered at baseline and after each 3-month intervention with and without a hearing aid. At the end of the experiment, patients ranked the 3 hearing aid circuits.
Each circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech (all 52-dB and 62-dB conditions, P</=.001). All 3 circuits significantly reduced the frequency of problems encountered in verbal communication. Some test results suggested that CL and WDRC circuits provided a significantly better listening experience than PC circuits in word recognition (P =.002), loudness (P =.003), overall liking (P =.001), aversiveness of environmental sounds (P =.02), and distortion (P =.02). In the rank-order ratings, patients preferred the CL hearing aid circuits more frequently (41.6%) than the WDRC (29.8%) and the PC (28.6%) (P =.001 for CL vs both WDRC and PC).
Each circuit provided significant benefit in quiet and noisy listening situations. The CL and WDRC circuits appeared to provide superior benefits compared with the PC, although the differences between them were much less than the differences between the aided vs unaided conditions. JAMA. 2000;284:1806-1813.
大量研究表明，助听器对多种感音神经性听力损失有显著益处，但尚未进行过精心对照的多中心临床试验来比较助听器的疗效。
比较3种常用助听器电路为感音神经性听力损失患者带来的益处。
1996年5月至1998年2月进行的双盲、3阶段、3治疗交叉试验。
美国退伍军人事务部医疗中心的8个听力学实验室。
360例双侧感音神经性听力损失患者的样本（平均年龄67.2岁；57%为男性；78.6%为白人）。
患者被随机分配到线性峰值削波器（PC）、压缩限制器（CL）和宽动态范围压缩器（WDRC）助听器电路的6种序列之一。所有患者佩戴安装在相同外壳中的3种助听器，每种佩戴3个月。
在基线时以及每次3个月干预后（有和没有助听器）进行的言语识别、声音质量和主观助听器益处测试的结果。在实验结束时，患者对3种助听器电路进行排序。
每种电路均显著改善了言语识别，对于轻声和对话音量的言语改善更为明显（所有52分贝和62分贝条件下，P≤.001）。所有3种电路均显著降低了言语交流中遇到问题的频率。一些测试结果表明，在单词识别（P =.002）、响度（P =.003）、总体喜好度（P =.001）、环境声音的厌恶感（P =.02）和失真（P =.02）方面，CL和WDRC电路提供的听力体验明显优于PC电路。在排序评分中，患者更频繁地选择CL助听器电路（41.6%），而非WDRC（29.8%）和PC（28.6%）（CL与WDRC和PC相比，P =.001）。
每种电路在安静和嘈杂的聆听环境中均带来显著益处。与PC相比，CL和WDRC电路似乎提供了更优的益处，尽管它们之间的差异远小于佩戴助听器与未佩戴助听器条件之间的差异。《美国医学会杂志》。2000年；284:1806 - 1813。
