Effects of Hearing Devices for Adults With Mild-to-Severe Hearing Loss: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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Title: Effects of Hearing Devices for Adults With Mild-to-Severe Hearing Loss: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Authors: Pandey, Preeti1,2 preeti.pandey@cuanschutz.edu, Kruger, Megan2,3, Sharma, Anu2, Swanepoel, De Wet1,2,3, Rodrigo, Hansapani4, Beukes, Eldre5,6, Manchaiah, Vinaya1,2,3,7,8
Source: Journal of Speech, Language & Hearing Research. Jun2026, Vol. 69 Issue 6, p2887-2910. 24p.
Subject Terms: *Treatment of hearing disorders, *Self-evaluation, *Alzheimer's disease, *Neurophysiology, *Cognition, *Adults, Medical information storage & retrieval systems, Research funding, Hearing aids, CINAHL database, Severity of illness index, Treatment effectiveness, Meta-analysis, Systematic reviews, MEDLINE, Online information services, Comorbidity, Disease complications
Abstract: Objectives: The aim of this study was to evaluate the effect of hearing devices for adults with mild-to-severe hearing losses. Specifically, we assessed the magnitude of change across outcome domains, identified measurement tools used, and reported adverse effects associated with device use. Design: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were performed in PubMed, CINAHL, and Embase. Included studies were randomized controlled trials (RCTs) involving adults (≥ 18 years of age) with mild-to-severe hearing loss, comparing any air-conduction hearing device to passive or active controls. Effect sizes were calculated as Hedges's g, and random-effects models estimated pooled effects. Results: Thirty-three RCTs (N = 4,471 participants) met the inclusion criteria, although pooled estimates could be derived from only a subset of trials due to limited reporting. Hearing aids demonstrated moderate-to-large benefits on hearing-related self-report outcomes compared with no-intervention or waitlist controls; however, pooled meta-analytic estimates could not be generated for this comparison because of insufficient data across trials. Compared with placebo, hearing aids yielded a small pooled effect (g ≈ 0.37), driven largely by trials including participants with comorbid Alzheimer's disease. Personal sound amplification products (PSAPs) showed a pooled medium effect compared with no intervention (g ≈ 0.42), with benefits primarily observed for hearing-specific self-report outcomes and selected behavioral measures. In head-to-head comparisons, hearing aids showed a large pooled advantage over other hearing devices, including smartphone hearing aid applications (SHAAs) and extended-wear hearing aids (EWHAs; g ≈ 0.88), based on data from two trials. Across the included studies, most outcomes were self-reported (≈ 81%) and behavioral (≈ 45%), with very limited assessment of cognitive or neurophysiological domains. Nine studies reported adverse events, with only one device-related incident. Heterogeneity was high (I² > 80%), but no publication b ias was detected. Conclusions: Hearing aids provide substantial benefit for hearing-related self-reported outcomes in comparison to PSAPs, SHAAs, EWHAs, and placebo. However, high heterogeneity prevents reliable conclusions based on pooled estimates. There also remains limited evidence on cognitive, neurophysiological, and long-term behavioral outcomes, underscoring the need for more rigorous, domain-diverse RCTs in this field. [ABSTRACT FROM AUTHOR]
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Database: Education Research Complete
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Abstract:Objectives: The aim of this study was to evaluate the effect of hearing devices for adults with mild-to-severe hearing losses. Specifically, we assessed the magnitude of change across outcome domains, identified measurement tools used, and reported adverse effects associated with device use. Design: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were performed in PubMed, CINAHL, and Embase. Included studies were randomized controlled trials (RCTs) involving adults (≥ 18 years of age) with mild-to-severe hearing loss, comparing any air-conduction hearing device to passive or active controls. Effect sizes were calculated as Hedges's g, and random-effects models estimated pooled effects. Results: Thirty-three RCTs (N = 4,471 participants) met the inclusion criteria, although pooled estimates could be derived from only a subset of trials due to limited reporting. Hearing aids demonstrated moderate-to-large benefits on hearing-related self-report outcomes compared with no-intervention or waitlist controls; however, pooled meta-analytic estimates could not be generated for this comparison because of insufficient data across trials. Compared with placebo, hearing aids yielded a small pooled effect (g ≈ 0.37), driven largely by trials including participants with comorbid Alzheimer's disease. Personal sound amplification products (PSAPs) showed a pooled medium effect compared with no intervention (g ≈ 0.42), with benefits primarily observed for hearing-specific self-report outcomes and selected behavioral measures. In head-to-head comparisons, hearing aids showed a large pooled advantage over other hearing devices, including smartphone hearing aid applications (SHAAs) and extended-wear hearing aids (EWHAs; g ≈ 0.88), based on data from two trials. Across the included studies, most outcomes were self-reported (≈ 81%) and behavioral (≈ 45%), with very limited assessment of cognitive or neurophysiological domains. Nine studies reported adverse events, with only one device-related incident. Heterogeneity was high (I² > 80%), but no publication b ias was detected. Conclusions: Hearing aids provide substantial benefit for hearing-related self-reported outcomes in comparison to PSAPs, SHAAs, EWHAs, and placebo. However, high heterogeneity prevents reliable conclusions based on pooled estimates. There also remains limited evidence on cognitive, neurophysiological, and long-term behavioral outcomes, underscoring the need for more rigorous, domain-diverse RCTs in this field. [ABSTRACT FROM AUTHOR]
ISSN:10924388
DOI:10.1044/2026_JSLHR-25-00737