This release by the Journal of the American Medical Association highlights a relatively small study that could snowball into better lives for tens of millions of people who struggle with hearing loss. The finding: Many personal sound amplification products, or PSAPs, which can be purchased over-the-counter, seem to perform nearly as well as much more expensive, medically prescribed hearing aids when it comes to understanding speech. While the release does discuss and compare costs — a frequently overlooked yet crucial issue, as we often bemoan here at HealthNewsReview.org — it whiffed on quantifying the benefits of using cheaper devices and discussing their harms.
Hearing loss affects some 48 million Americans, but Medicare doesn’t cover hearing aids, which can cost thousands of dollars per ear — this despite the fact that people 65 and older are affected by hearing loss. If over-the-counter devices like PSAPs compare to the aid provided by much more expensive prescription hearing aids, then millions more people with hearing loss may be able to reap the benefits.
The cost of the prescription hearing aid used in the study is noted ($1,910), as is the cost range of five different PSAPs tested (ranging from $30 to $350).
This release didn’t dive into the PSAP versus hearing aid benefit numbers and this was a missed opportunity. According to the full study, hearing aids alone improved speech recognition by 12 percent. Meanwhile, the three most expensive PSAPs (all more than $300) improved speech recognition by at least 10 percent. It would also have been helpful to point out that the least expensive PSAP ($30) actually worsened speech recognition by 11 percent.
The news release should have mentioned the potential harms of these devices compared to hearing aids so people have the full picture when considering their potential. One problem is that less expensive PSAPs don’t selectively amplify speech, which could conceivably worsen hearing loss by blasting too loud and broad a range of sound.
Readers are given the number of people who participated (42), along with a cautionary note that this low number is a limitation. That’s to the good. However, it would have been more helpful to characterize why that’s a limitation — i.e. such a small sample size is not likely to represent the tens of millions of people who struggle with hearing loss.
It would also have been good to mention that these tests were done in a simulated, highly controlled setting, and in which a professional was around to help people wear PSAPs. In the real world, people may not correctly set up or wear a PSAP which could lower the cheaper device’s ability to improve speech understanding.
We didn’t see anything alarming or overblown.
The release asks the reader to see the study for “author contributions and affiliations, financial disclosures, funding and support,” which is better than nothing, yet doesn’t make it easy for readers to draw conclusions about any potential bias.
The entire release is about an alternative comparison, which is refreshing. On the other hand, it is hard to compare alternatives in highly controlled settings. Real life is a lot different.
Availability of both hearing aids (“through a licensed professional”) and PSAPs (“over-the-counter”) is clearly established.
The novelty seems so obvious in hindsight, but it is clear: How do PSAPs really stack up against hearing aids? The answer is surprising and worthy of a release, even though the sample size was small and the methodology lacked some real-world challenges (e.g. putting on a PSAP correctly and properly adjusting it).
We didn’t detect any words that hyped the results.
Systematic, Criteria-Driven
The @nytimeswell effort is shown to be unwell once again.
There's pervasive media bias toward hyping treatment benefits while neglecting negative results & harms.
Big part of this is reliance on experts with financial &/or intellectual conflicts of interest.
Att'n journalists: Use this list 100 independent experts to correct imbalance https://twitter.com/garyschwitzer/status/1177189641218330625
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