Misjudgments of Hearing Loss and Its Implications for Over-The-Counter Hearing Aids

Introduction: An affordable and accessible option for hearing aids was made available to the public when over-the-counter (OTC) hearing aids became available for people with a perceived mild to moderate hearing loss without needing a formal evaluation. This retrospective review investigated whether patients’ perception of their hearing loss accurately reflects their measured hearing thresholds on their audiogram, specifically relating to a mild to moderate hearing loss, the determining candidacy for OTC hearing aids.

Methods: This retrospective chart review included 116 patients over the age of 18 seen for audiograms at our audiology clinic between 2022 and 2023. Prior to undergoing their audiograms, patients were asked what their estimated degree of hearing loss was. Data points were then taken from their completed audiograms using the average thresholds from 500-2000 Hz, 2000 Hz, and the average thresholds from 2000-4000 Hz, as these frequencies are most widely associated with the comprehension of speech sounds and gives a broad understanding of the level of hearing loss. These data points were correlated with their perceived hearing loss to determine how accurate their estimations were.

Results: Our data revealed that 57% of patients with greater than a moderate hearing loss underestimated the amount of hearing loss they had and thus incorrectly identified themselves as candidates for OTC hearing aids. Most (51%) patients with a mild to moderate hearing loss overestimated the amount of hearing loss they had and would not have properly identified themselves as candidates for OTC hearing aids.

Conclusions: This study suggested that individuals considering OTC hearing aids are not able to assess their own degree of hearing loss with sufficient accuracy to choose the most appropriate care. To ensure that consumers are making informed decisions about the use of OTC hearing aids, the FDA should consider offering additional guidance that directs patients to first seek out a more standardized measure of hearing provided by a hearing health professional. This additional direction can enhance the quality of care of OTC hearing aid consumers.