Objectives. This study evaluated the electroacoustic characteristics of smartphone-based hearing aid applications (apps).Methods. We investigated hearing aid apps based on processing delay measurements, hearing instrument testing, simulated real ear measurements, and a head-and-torso simulator.Results. Many apps exceeded the recommended level for processing delay. Hearing instrument testing showed the highest amplification characteristics and the best sound quality when a hearing aid was used, followed by the high-end apps and then the low-end apps. The simulated real ear measurements results showed that the high-end apps had a better ability to match the amplification targets than the low-end apps, but there was no consistent pattern among apps when controlling the output. Only a few apps could improve the signal-to-noise ratio in the head-and-torso simulator. Conclusion.Most of the apps showed relatively poor electroacoustic performance in comparison with hearing aids. Generalizing access to hearing care through hearing aid apps induces a wide diversity of hearing performance with no fixed standard for reliability. However, we expect their overall quality to improve over the next few years.

Background: The aim of this study was to evaluate the behavioral performance of a selection of currently available hearing aid apps in patients with mild hearing loss. Methods: We investigated 3 user-friendly hearing aid apps (EarMachine, Sound Amplifier, and Petralex) with real-ear measurement, warble-tone audiometry, word recognition testing in unaided and aided conditions, and hearing-in-noise tests in quiet and noise-front conditions in a group of users with mild hearing impairment (n = 7) as a pilot for a future long-term investigation. Results from the apps were compared with those of a conventional hearing aid. Results: Hearing aids showed greater gain at 1 and 3 kHz than hearing aid apps in real-ear insertion gain of real-ear measurements. Hearing aids tended to have greater gain than hearing aid apps at 2 and 3 kHz in the sound field audiometry test. The clinical performance of the listeners tended to be better when using a hearing aid and Petralex (13% and 6% improvement in word recognition score, respectively), while EarMachine and Sound Amplifier conferred limited user benefit. The hearing aid apps did not improve signal-to-noise ratio in comparison with the unaided condition in the hearing-in-noise test. Conclusions: Some hearing aid apps were beneficial for patients with mild hearing loss in terms of amplification, but participants using the apps showed no improvements in hearing-in-noise tests.

BACKGROUND Underuse of hearing aids is caused by several factors, including the stigma associated with hearing disability, affordability, and lack of awareness of rising hearing impairment associated with the growing population. Thus, there is a significant opportunity for the development of direct-to-consumer devices. For the past few years, smartphone-based hearing-aid apps have become more numerous and diverse, but few studies have investigated them. OBJECTIVE This study aimed to elucidate the electroacoustic characteristics and potential user benefits of a selection of currently available hearing-aid apps. METHODS We investigated the apps based on hearing-aid control standards (American National Standards Institute) using measurement procedures from previous studies. We categorized the apps and excluded those we considered inefficient. We investigated a selection of user-friendly, low-end apps, EarMachine and Sound Amplifier, with warble-tone audiometry, word recognition testing in unaided and aided conditions, and hearing-in-noise test in quiet and noise-front conditions in a group of users with mild hearing impairment (n = 7) as a pilot for a future long-term investigation. Results from the apps were compared with those of a conventional hearing aid. RESULTS Five of 14 apps were considered unusable based on low scores in several metrics, while the others varied across the range of electroacoustic measurements. The apps that we considered “high end” that provided lower processing latencies and audiogram-based fitting algorithms were superior overall. The clinical performance of the listeners tended to be better when using hearing aid, while the low end hearing-aid apps had limited benefits on the users. CONCLUSIONS Some apps showed the potential to benefit users with limited cases of minimal or mild hearing loss if the inconvenience of relatively poor electroacoustic performance did not outweigh the benefits of amplification.