Background: Hearing loss is one of the most common chronic health conditions of older people. Hearing aids are the customary treatment and they improve quality of life in older adults. Even so, relatively few older adults with uncomplicated, mild to moderate, adult-onset, sensorineural hearing loss use hearing aids. One reason for this is a belief that hearing aids do not provide sufficient value to justify their expense. Although modern hearing aids are available at several price points, there is minimal evidence about the relative benefits of premium-level versus basic-level hearing aid technologies.

Objective: This research was designed to demonstrate the relative effectiveness of premium hearing aids compared with basic hearing aids in improving speech understanding and quality of life.

Methods: 25 participants, including both new and experienced hearing aid users, completed blinded month-long field trials with each of four pairs of hearing aids: two basic and two premium level. Outcomes were laboratory speech understanding tests, standardized questionnaires and open-ended diary items.

Results: Participants reacted very positively to all the hearing aids. Both everyday speech understanding and quality of life were substantially improved with hearing aids. RESULTS for both new and experienced users were consistent with a conclusion that there were no statistically significant or clinically important differences in improvement between the premium- and basic-level hearing aids.

Conclusions: It should not be assumed that more costly hearing aids always produce better outcomes. With contemporary hearing aids from two major manufacturers, the subjects obtained as much improvement in speech understanding and quality of life from lower-cost basic-level instruments as from higher-cost premium-level instruments. Regardless of technology level, comprehensive best-practice fitting protocols should be followed to optimize results for every patient.