Limitations
complaint
HEARING LOSS, AIDS
In the present study, we focused on a single brand of high-end PSAPs. This choice limits the generalization of our results to only PSAPs similar to the one used in our study. Several brands of PSAPs are on the market, ranging from a few dozen dollars to a few hundred dollars, with different features. The OTC market (OTC hearing aids and PSAPS) rapidly expands, providing many options when purchasing OTC amplifiers. It is urgent to conduct studies comparing other brands of devices, focusing on the features that best maximize the benefits, especially in adverse listening conditions. Noise suppression and directional microphones could be an essential feature, as difficulty listening to speech-in-noise is a frequently reported complaint in aging, even in older adults with normal hearing. We also did not compare the benefits of PSAPs with conventional hearing aids. PSAPs may provide significantly more benefits than the unaided condition but substantially less than traditional hearing aids, which is consistent with the results of a previous study. If this is the case, it would suggest that conventional hearing aids should be preferred over PSAPs for treating hearing loss. It is also possible that PSAPs and conventional hearing aids offer similar benefits, consistent with the meta-analysis mentioned above, indicating that PSAPs may be as effective as conventional hearing aids in treating hearing loss. Although this comparison is critical to understand the extent of the benefits of PSAPs, it is difficult to do given the many different types of hearing aids and PSAPs. Further studies should compare PSAPs and hearing aids with similar characteristics.The lack of objective device output verification is another limitation of the study, as it raises questions about the reliability and accuracy of the data and may be related to the large individual differences in benefit from these devices. The study did not quantify or account for variations in the output of the devices in the ear canal or how well they were coupled to the ear. This factor could be an important predictor of interindividual variability in benefit and was not considered in the current study’s design. Nevertheless, we have effectively overcome this issue by verifying the device’s functionality with self-reported measures, ensuring a minimum level of amplification that participants found noticeable. This study is encouraging because it demonstrates that the participants were able to benefit from self-fitting the devices with very little guidance.Another limitation of this study is the placement of speakers in corners instead of using a single forward-facing speaker, which may not fully reproduce the ecological nature of face-to-face conversations. In addition, the use of babble noise, while providing some background interference, may not fully reflect the complexities of natural listening environments. The use of a multi-speaker background noise, which more closely resembles the acoustic conditions of group conversations, might have been more appropriate for improving the ecological validity of the task.Finally, our sample size is relatively small, which may have reduced the statistical power of our results. We relied on sample sizes from previous studies to determine our sample size because we could not perform a power analysis based on the information provided in those studies. To address this literature problem, we systematically reported the effect sizes of our analyses. This will allow future studies to calculate their sample sizes more accurately based on the effect sizes reported in the current study.