Bilateral hearing aids gave more benefit than one, by a modest margin

Design

Single-blinded parallel-group randomised trial, two US centres

Population

275 adults ≥50 years with age-related hearing loss, new to hearing aids

Primary outcome

APHAB benefit score at 3 months

Effect

19.7 vs 14.4 points; difference 5.3 (95% CI 1.8–8.8) favouring bilateral

Bilateral fitting is the default in many services, but direct randomised evidence has been thin. This single-blinded trial at audiology clinics at Duke and Vanderbilt universities randomised 275 adults aged 50 or over (mean 71) with age-related hearing loss and less than three months' previous aid use to one or two commercially available receiver-in-the-canal aids.

At three months, both groups improved on the Abbreviated Profile of Hearing Aid Benefit: by 14.4 points with one aid and 19.7 points with two. The difference of about 5.3 points (95% CI 1.8 to 8.8) favoured bilateral fitting. The authors note that this difference is statistically clear but may fall short of what patients would notice as meaningful, and that one aid alone gave a substantial benefit.

This supports offering bilateral aids as the starting point for symmetrical age-related loss, but it also supports one aid as a real option where cost, dexterity or preference argue for it. That matters in India, where most people pay for hearing aids themselves and an untreated loss is the more common problem. Follow-up was only three months, and outcomes were self-reported.

• Offer bilateral hearing aids as the default for symmetrical age-related hearing loss.
• Offer a single aid as a reasonable alternative when cost, dexterity or preference make two impractical.
• Explain that one aid gives most of the benefit of two in the short term.
• Review benefit at about three months with a validated questionnaire.
• Avoid delaying any amplification while deciding between one and two aids.

Why it matters

It lets clinicians offer one aid without feeling they are giving second-best care.

Don't overread it

Benefit was self-reported over three months; the difference may not be clinically meaningful.

The statistics, in plain English

The 5.3-point difference has an interval of 1.8 to 8.8, so it is unlikely to be chance. But a statistically clear difference is not automatically one patients notice; the trial was not designed to show that, and both groups gained much more than the gap between them.

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