Chen Chih-Hao, Huang Chii-Yuan, Cheng Hsiu-Lien, Lin Heng-Yu Haley, Chu Yuan-Chia, Chang Chun-Yu, Lai Ying-Hui, Wang Mao-Che, Cheng Yen-Fu
Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan.
Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
EClinicalMedicine. 2022 Apr 7;46:101378. doi: 10.1016/j.eclinm.2022.101378. eCollection 2022 Apr.
Hearing loss is a common morbidity that requires a hearing device to improve quality of life and prevent sequelae, such as dementia, depression falls, and cardiovascular disease. However, conventional hearing aids have some limitations, including poor accessibility and unaffordability. Consequently, personal sound amplification products (PSAPs) are considered a potential first-line alternative remedy for patients with hearing loss. The main objective of this study was to compare the efficacy of PSAPs and conventional hearing aids regarding hearing benefits in patients with hearing loss.
This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases and reference lists were searched from inception to January 12, 2022. Studies including randomised, controlled trials; nonrandomised, controlled trials; or observational studies comparing PSAPs and hearing aids with regard to hearing gain performance (e.g., speech intelligence) were considered eligible. The review was registered prospectively on PROSPERO (CRD42021267187).
Of 599 records identified in the preliminary search, five studies were included in the review and meta-analysis. A total of 124 patients were divided into the PSAP group and the conventional hearing aid group. Five studies including seven groups compared differences for speech intelligence in the signal-noise ratio (SNR) on the hearing in noise test (HINT) between PSAPs and conventional hearing aids. The pooled results showed nonsignificant differences in speech intelligence (SMD, 0.14; 95% CI, -0.19 to 0.47; = .41; =65%), sound quality (SMD, -0.37; 95% CI, -0.87 to 0.13; = .15; =77%) and listening effort (SMD 0.02; 95% CI, -0.24 to 0.29; = .86; =32%). Nonsignificant results were also observed in subsequent analyses after excluding patients with moderately severe hearing loss. Complete sensitivity analyses with all of the possible combinations suggested nonsignificant results in most of the comparisons between PSAPs and conventional hearing aids.
PSAPs are potentially beneficial as conventional hearing aids are in patients with hearing loss. The different features among PSAPs should be considered for patients indicated for hearing devices.
This work was supported by grants from Ministry of Science and Technology (MOST-10-2622-8-075-001) and Veterans General Hospitals and University System of Taiwan Joint Research Program (VGHUST111-G6-11-2 and VGHUST111c-140).
听力损失是一种常见疾病，需要使用听力设备来提高生活质量并预防后遗症，如痴呆、抑郁、跌倒和心血管疾病。然而，传统助听器存在一些局限性，包括可及性差和费用高昂。因此，个人声音放大产品（PSAP）被认为是听力损失患者潜在的一线替代疗法。本研究的主要目的是比较PSAP和传统助听器对听力损失患者听力益处的疗效。
本系统评价和荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。从数据库建立至2022年1月12日，检索了五个数据库及参考文献列表。纳入的研究包括随机对照试验、非随机对照试验或观察性研究，这些研究比较了PSAP和助听器在听力增益表现（如言语清晰度）方面的差异。该评价在PROSPERO（CRD42021267187）上进行了前瞻性注册。
在初步检索中识别出的599条记录中，五项研究被纳入本评价和荟萃分析。总共124名患者被分为PSAP组和传统助听器组。五项研究（包括七组）比较了PSAP和传统助听器在噪声环境下听力测试（HINT）中言语清晰度在信噪比（SNR）方面的差异。汇总结果显示，在言语清晰度（标准化均数差[SMD]，0.14；95%置信区间[CI]，-0.19至0.47；P = 0.41；I² = 65%）、声音质量（SMD，-0.37；95% CI，-0.87至0.13；P = 0.15；I² = 77%）和聆听努力程度（SMD 0.02；95% CI，-0.24至0.29；P = 0.86；I² = 32%）方面无显著差异。在排除中度重度听力损失患者后的后续分析中也观察到无显著结果。对所有可能组合进行的完全敏感性分析表明，在PSAP和传统助听器的大多数比较中结果无显著差异。
对于听力损失患者，PSAP可能与传统助听器一样有益。对于适合使用听力设备的患者，应考虑PSAP的不同特性。
本研究得到了科技部（MOST - 10 - 2622 - 8 - 075 - 001）以及台湾地区荣民总医院与大学系统联合研究计划（VGHUST111 - G6 - 11 - 2和VGHUST111c - 140）的资助。
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