Two hearing aids gave somewhat more benefit than one in age-related hearing loss

Design

Two-centre, single-blinded parallel-group randomised trial

Population

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

Primary outcome

Change in APHAB global score at 3 months

Effect

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

This single-blinded randomised trial at two US university audiology clinics assigned 275 adults aged 50 or over with age-related hearing loss, new to hearing aids, to a unilateral or bilateral fitting with receiver-in-the-canal aids. The primary outcome was benefit at three months on the Abbreviated Profile of Hearing Aid Benefit (APHAB), a self-report scale.

Both groups improved meaningfully. Benefit was larger with two aids (mean 19.7 vs 14.4 points), a difference of about 5.3 points (95% CI 1.8 to 8.8). The authors note that this is statistically clear but may sit near or below the threshold most clinicians would call clinically important.

For most patients with symmetrical loss, bilateral fitting remains the sensible default where affordable. Where cost decides whether someone gets any aid at all, one well-fitted aid still gave substantial benefit, and is far better than none.

• Offer bilateral fitting as the default for symmetrical age-related hearing loss where affordable.
• If cost is the barrier, recommend a single aid rather than no aid; it still gave clear benefit.
• Fit the better-candidate ear first when only one aid is possible, guided by audiometry and patient preference.
• Review at about three months to check use, fit and benefit.
• Revisit a second aid later if the first is used and valued.

Why it matters

It gives trial evidence for a routine choice that has largely rested on convention and cost.

Don't overread it

The extra benefit of the second aid was statistically clear but may not be clinically meaningful for everyone.

The statistics, in plain English

A 5-point difference on the APHAB, with an interval from about 2 to 9 points, is reliably greater than zero. Whether 5 points matters to an individual is less certain; both groups improved by more than 14 points, which is the larger effect.

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