Reed Nicholas S, Betz Joshua, Lin Frank R, Mamo Sara K
*Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine†Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health‡Center on Aging and Health, Johns Hopkins Medical Institutions§Johns Hopkins Biostatistics Center, Baltimore, Maryland.
Otol Neurotol. 2017 Jul;38(6):804-808. doi: 10.1097/MAO.0000000000001414.
Recent national initiatives from the White House and Institute of Medicine have focused on strategies to increase the accessibility and affordability of hearing loss treatment given the average cost of $4700 for bilateral hearing aids. More affordable direct-to-consumer hearing technologies are increasingly gaining recognition, but the performance of these devices has been poorly studied. We investigated the technical and electroacoustic capabilities of several direct-to-consumer hearing devices to inform otolaryngologists who may be asked by patients to comment on these devices.
PATIENTS/INTERVENTION: Nine direct-to-consumer hearing devices ranging in retail cost from $144.99 to $395.00 and one direct-to-consumer hearing device with a retail cost of $30.00.
Electroacoustic results and simulated real-ear measurements. Main electroacoustic measures are frequency response, equivalent input noise, total harmonic distortion, and maximum output sound pressure level at 90 dB.
Five devices met all four electroacoustic tolerances presented in this study, two devices met three tolerances, one device met two tolerances, one device met one tolerance, and one device did not meet any tolerances. Nine devices were able to approximate five of nine National Acoustics Laboratories (NAL) targets within 10 dB while only three devices were able to approximate five of nine NAL targets within a more stringent 5 dB.
While there is substantial heterogeneity among the selection of devices, certain direct-to-consumer hearing devices may be able to provide appropriate amplification to persons with mild-to-moderate hearing loss and serve as alternatives for hearing aids in specific cases.
鉴于双侧助听器的平均成本为4700美元,白宫和医学研究所近期发起的全国性倡议聚焦于提高听力损失治疗的可及性和可承受性的策略。越来越实惠的直接面向消费者的听力技术日益获得认可,但对这些设备的性能研究不足。我们调查了几种直接面向消费者的听力设备的技术和电声能力,以便为可能被患者要求对这些设备发表意见的耳鼻喉科医生提供信息。
患者/干预措施:九种零售成本在144.99美元至395.00美元之间的直接面向消费者的听力设备,以及一种零售成本为30.00美元的直接面向消费者的听力设备。
电声结果和模拟真耳测量。主要电声指标为频率响应、等效输入噪声、总谐波失真以及90分贝时的最大输出声压级。
五种设备符合本研究提出的所有四项电声公差,两种设备符合三项公差,一种设备符合两项公差,一种设备符合一项公差,一种设备不符合任何公差。九种设备能够在10分贝范围内接近九个国家声学实验室(NAL)目标中的五个,而只有三种设备能够在更严格的5分贝范围内接近九个NAL目标中的五个。
虽然所选设备之间存在很大异质性,但某些直接面向消费者的听力设备可能能够为轻度至中度听力损失患者提供适当放大,并在特定情况下作为助听器的替代品。