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Is there a difference between premium hearing aids, basic hearing aids and PSAPs?

That is an interesting and worthy question, since hearing aid pricing is all over the lot, and generally on the high side. Recently, I located a lengthy interview on Audiology Online, a well-known industry organ, with Robyn Cox, PhD, Professor Emeritus at the University of Memphis, and Director of the Hearing Aid Research Lab (HARL; Dr. Cox has more than four decades of hearing research and awards, so who better to carry out a nervy bit of research. Nervy? Well, most people would assume that pricier products would have more features and perform better. After all, you would suppose that the top-of-the-line Cadillac, for example, would outperform a cheaper Chevy. When you look at Consumer Reports, the pricier cars generally outperform the cheaper ones. In general, we expect pricier products to be better.

Professor Cox used six devices: two premium hearing aids, two basic hearing aids, and two high-end PSAPs (for Personal Sound Amplification Products).  This last category has been much resisted by Audiologists who insist that hearing aids are medical devices that must be approved by the FDA and other devices regardless of how similar their functionality is to hearing aids may not be marketed or sold as hearing aids.  She then recorded three types of everyday sounds—speech, noise, and music—and played them for 20 people with mild to moderate hearing issues. A double round-robin paired-comparison tournament was performed, using the six recordings of each sound. During the tourney, the six different hearing devices were paired against each other twice. She found that for music or everyday noises, the subjects had no significant preferences among the premium hearing aids, the basic hearing aids, and the PSAPs. Also, with any stimulus, there was no significant preference for premium over basic hearing aids. However, when the stimulus was speech, both the premium and the basic hearing aids were preferred over the PSAPs. See the chart below:


Figure 1. Preference scores for each stimulus. Data are given for two premium hearing aids, two basic hearing aids and two PSAPs. From Audiology Online April 2014

I enclose the chart so you can see that although there were some differences noted between the PSAPs and the hearing aids, the difference was marginal. As she wrote in her conclusion, “It is important to note that there were not substantial differences in preferences among the three types of devices.” 

She also noted, and I think this is very important, that some devices worked better with a specific stimulus. Again Dr. Cox writes: “It appeared that different devices were specialized to process different types of stimuli more effectively.” Different people have different needs. She concluded that “the best device is not necessarily the premium device.” In fact, there are strong reasons to think that for people who haven’t had any experience with such devices, the most appropriate device is the cheapest entry level basic hearing aid or a premium PSAP.