Self-Fitting Versus Professional-Fitting Hearing Aids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
In brief
Self-fitting hearing aids match professional fitting in seven trials, but evidence is weak
Across seven randomized trials involving 1,092 adults, self-fitting hearing aids showed no clear difference from professional fitting in reported hearing benefit, speech-in-noise performance, satisfaction, or adherence. The evidence was very low certainty, with substantial variation among studies and limited safety data, so whether self-fitting is a reliable option beyond selected adults with uncomplicated mild-to-moderate hearing loss remains unknown.
- Journal
- Audiology research (Q2)
- Published
- 19 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Ebraheem Albazee, Hajar Alismail, Noof Albannai, Yaqoub Yousef Alenezi, Abdullah M Alharran, Maya Yassir H Ibrahim, et al.
- PMID
- 42776781
- DOI
- 10.3390/audiolres16050139
Why clinicians should know about it
- Picked for Otorhinolaryngology (top studies of the week, 27 September 2026): Self‑fitting vs professional‑fitting hearing aids systematic review
Abstract
Background: Adult hearing loss is common, yet hearing-aid uptake remains inadequate due to systemic and financial barriers in traditional audiologist-based fitting models. Over-the-counter (OTC) and self-fitting strategies have emerged to improve accessibility, allowing users to select and adjust their devices independently. However, concerns remain that reducing professional involvement may compromise electroacoustic accuracy, speech-in-noise outcomes, and overall patient satisfaction. Methods: A comprehensive literature search across PubMed, Web of Science, CENTRAL, Scopus, and Embase was conducted up to 1 June 2026. Parallel-group and crossover randomized controlled trials (RCTs) comparing self-fitting with professional-fitting were included. The primary outcome was patient-reported hearing benefit. Standardized mean differences (SMDs) and risk ratios (RRs) were pooled using a random-effects model. Results: Seven RCTs involving 1092 participants were included. The analysis revealed no statistically significant difference between self-fitting and professional-fitting strategies regarding patient-reported hearing benefit (SMD: 0.01, 95% CI [-0.44, 0.46], p = 0.97, I2 = 89.2%, very low certainty of evidence). Similarly, no significant differences were observed across secondary outcomes, including speech-in-noise performance (SMD: 0.11, 95% CI [-0.25, 0.47]; p = 0.55), hearing loss (p = 0.12), hearing-aid satisfaction (p = 0.31), device adherence (p = 0.65), or the need for follow-up adjustment (RR: 0.46, 95% CI [0.12, 1.71]; p = 0.25). Safety outcomes were sparse and did not demonstrate a statistically significant difference between the fitting approaches; however, the evidence was imprecise and inconclusive. Conclusions: Self-fitting hearing aids showed no clear differences from professional best-practice fitting across several patient-reported and functional outcomes in adults with uncomplicated mild-to-moderate hearing loss. However, the certainty of evidence was very low because of risk of bias, substantial heterogeneity, imprecision, and the small number of trials. These findings are therefore hypothesis-generating and suggest that well-designed self-fitting pathways may have potential as an accessible alternative for selected users, but larger, rigorous, and longer-term trials are needed before broader clinical implementation can be recommended.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.