title: Impact of digital labeling on outcome measures.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the label attached to the hearing aid being presented would bias outcome measures towards newer technological designs.
  
  
  METHODS
  Two groups of subjects participated in this investigation. The groups were matched for age, gender, previous hearing aid experience, degree and configuration of hearing loss. Group A wore each of two digital hearing aids for 1 mo; Group B wore the same digital hearing aid for 2 mo, but the subjects were given the impression they were changing hearing aids after 1 mo. In each group the subjects were told that one of the months they were wearing a "digital" hearing aid and one of the months they were wearing a "conventional" hearing aid. Outcome measures consisted of a number of behavioral speech perception tasks and self-report measures, each completed at the onset and after 1 mo use with the hearing aids.
  
  
  RESULTS
  Labeling effects were observed for many of the outcome measures. Using a mixed-model factorial analysis of variance to control for irrelevant variables and to explore interaction terms, prejudice (digital versus conventional labeling) was treated as a within-subject factor while the subject group (A or B) and clinician were treated as between-subject factors. Although only the APHAB RV and BN scales showed significant labeling effects on their own, the group of tests used in this study showed a significant labeling effect as a whole (p < 0.01). The total influence of labeling and related interaction terms indicated labeling-related effects accounted for 2 to 32% of the variance in individual outcome measures.
  
  
  CONCLUSIONS
  The results of this investigation indicate a need for double-blinding in hearing aid research aimed at assessing the effectiveness of newer technologies, as well as a need for clinicians to critically evaluate the research describing the potential advantages of certain circuit options.
authors.affiliation: Department of Speech Pathology & Audiology, The University of Iowa, Iowa City, Iowa 52242, USA. ruth-bentler@uiowa.edu
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Bentler
authors.forename: Diane P
authors.initials: DP
authors.lastname: Niebuhr
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Johnson
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Flamme
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001309:Auditory Threshold; D016022:Case-Control Studies; D004867:Equipment Design; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011356:Product Labeling; D013067:Speech Perception; D011795:Surveys and Questionnaires; D016896:Treatment Outcome