- Design
- Post hoc subgroup analysis of a randomised trial with wait-list control
- Population
- 151 adults aged 60 or older with untreated hearing loss
- Primary outcome
- Change in HHIE-S score at 3 months
- Effect
- −14.1 (tech-connected) vs −12.5 (not connected); difference −1.6 (−7.8 to 4.1)
This secondary analysis of the HEARS trial looked at 151 older adults with untreated hearing loss in low-income housing and senior centres. Community health workers provided a low-cost over-the-counter hearing device, orientation and ongoing navigation support, against a wait-list control.
At three months, hearing handicap scores fell by 14.1 points among those who used smartphones, computers or the internet and by 12.5 points among those who did not, compared with controls. The difference between the two groups, 1.6 points, was not significant.
Over-the-counter hearing aids are often set up through an app, which can shut out older adults who do not use technology. With hands-on support, that barrier did not reduce benefit. The analysis was post hoc, so the finding is reassuring rather than conclusive.
- Ask older adults about hearing difficulty at routine visits, not only when they complain
- Do not assume low technology use rules out an app-based hearing device
- Pair any hearing device with practical setup and follow-up support
- Use simple questionnaires such as the HHIE-S to track benefit
Why it matters
Technology barriers need not exclude older adults from affordable hearing care if someone helps them start.
Don't overread it
A post hoc subgroup analysis of a single trial — exploratory.
The statistics, in plain English
A 12 to 14 point fall on the 40-point HHIE-S is a large, meaningful improvement. The difference between groups has a wide interval (−7.8 to 4.1), so a modest difference cannot be ruled out.
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