# Clinical Performance of a Smartphone-Based Sound Amplification Device Versus a Personal Sound Amplification Product in Elders with Mild-to-Moderate Hearing Loss: A Prospective Cohort Study

## TL;DR

A smartphone-based sound amplification device works as well as traditional hearing aids for older adults with mild-to-moderate hearing loss.

## Contribution

The study demonstrates that smartphone-based devices can be a viable alternative to traditional hearing aids for older adults.

## Key findings

- Both devices improved hearing thresholds significantly compared to unaided listening.
- User satisfaction and sound quality ratings were similar between the smartphone-based device and traditional PSAP.
- Smartphone-based solutions are a viable and accessible option for hearing aid alternatives.

## Abstract

Background and Objectives: To evaluate the clinical performance of a smartphone-based sound amplification device (SBSAD) compared to a conventional personal sound amplification product (PSAP) in older adults with mild-to-moderate sensorineural hearing loss (SNHL), ad-dressing the need for accessible alternatives given the low adoption of traditional hearing aids. Materials and Methods: Forty-nine participants (mean age 68 years) with mild-to-moderate SNHL underwent audiometric testing and subjective evaluation under three conditions: unaided, aided with a commercial PSAP, and aided with an SBSAD (iPhone with wireless earbuds). Primary outcomes included functional gain in sound field thresholds and user ratings of sound quality and acceptability via a custom questionnaire. Results: Both devices yielded significant threshold improvements compared to the unaided condition (p < 0.001). Mean functional gain was 16.0 dB for the PSAP and 15.3 dB for the SBSAD, with no statistically significant difference (p > 0.5). Subjective ratings for sound quality, comfort, cosmetic acceptability, and future willingness to use were comparable between devices (all p > 0.05). Conclusions: The SBSAD performed equivalently to a traditional PSAP in improving audibility and user satisfaction. Smartphone-based technologies offer a viable, accessible mobile health solution to bridge the gap for older adults who lack conventional hearing aids.