Reliability of patient choice between hearing aid systems

Various hearing aid provision strategies have been suggested but it is important to compare patient benefit from these, not only in the laboratory, but in everyday life. The latter can only be assessed by patient report. The false positive report rate of a difference between aids and the reproducibility of patient choice of aids was assessed in two groups of patients. The first received the same system on two occasions and were asked to report if they had any preference. The second group received two different systems on two occasions and the reproducibility of any preference was assessed. Of the 22 patients who were given the same hearing aid system on each visit, eight (36%) reported no differences, 10 (45%) a little and four (18%) a moderate or large difference between them when, in fact, there was none. Of the 34 patients who were asked to compare two acoustically different aids, 32 chose an aid on both occasions but only 22 (65%) chose the same aid, of whom 11 (32%) reported a moderate or large difference on both occasions. If reports of a little difference between aids are discounted and only moderate or large differences are accepted, it is concluded that the false positive report rate of a difference is approximately 20%. In addition, when patients are being asked to compare two NHS hearing aid systems, the rules of chance, order effect and reproducibility of patient choice have all to be controlled for, before decisions regarding patient preference can be made.