***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study compared hearing aid benefit obtained 6 weeks and a minimum of 1 year after fitting to determine if changes occurred over time . Fifteen individuals with mild-to-moderate sensorineural hearing losses , who were successful users of linear amplification , were fitted binaurally with the Resound BT2 Personal Hearing System . These hearing aids are programmable in two frequency b and s that provide wide dynamic range compression ( WDRC ) amplification . The manufacturer 's recommended loudness growth in octave b and s ( LGOB ) and audiogram programming algorithm and fitting procedures were used . Following an initial 6-week period and again following a minimum of 1 year of use , the Profile of Hearing Aid Benefit ( PHAB ) was administered . Similarly , speech recognition performance was tested using the Connected Speech Test ( CST ) in a six-talker speech babble at 50 dBA , + 10 signal-to-noise ( S/N ) ; 60 dBA , + 5 SNR ; and 70 dBA , + 2 SNR ; and in quiet with a reverberation time of 0.78 seconds . Significant aided benefit was shown . These short-term benefit scores for the PHAB and CST were compared with those obtained after 1 year of full-time use . Results revealed no significant change in hearing aid benefit with long-term use , suggesting that a 6-week acclimatization period is sufficiently long for clinical trials of this type of WDRC amplification BACKGROUND Little is known about quality of life after the use of specific types of hearing aids , so it is difficult to determine whether technologies such as programmable circuits and directional microphones are worth the added expense . OBJECTIVE To compare the effectiveness of an assistive listening device , a nonprogrammable nondirectional microphone hearing aid , with that of a programmable directional microphone hearing aid against the absence of amplification . DESIGN R and omized controlled trial . SETTING Audiology clinic at the VA Puget Sound Health Care System , Seattle , Wash. PATIENTS Sixty veterans with bilateral moderate to severe sensorineural hearing loss completed the trial . Half the veterans ( n = 30 ) had hearing loss that the Veterans Affairs clinic determined was rated as " service connected , " which meant that they were eligible for Veterans Affairs-issued hearing aids . INTERVENTION Veterans with non-service-connected hearing loss , who were ineligible for Veterans Affairs-issued hearing aids , were r and omly assigned to no amplification ( control arm ) or to receive an assistive listening device .  Veterans with service-connected loss were r and omly assigned to receive either the nonprogrammable hearing aid that is routinely issued ( " conventional " ) or a programmable aid with a directional microphone ( " programmable " ) . MAIN OUTCOME MEASURES Hearing-related quality of life , self-rated communication ability , adherence to use , and willingness to pay for the amplification devices ( measured 3 months after fitting ) . RESULTS Clear distinctions were observed between all 4 arms . The mean improvement in hearing-related quality of life ( Hearing H and icap Inventory for the Elderly ) scores was small for control patients ( 2.2 points ) and patients who received an assistive listening device ( 4.4 points ) , excellent for patients who received a conventional device ( 17.4 points ) , and substantial for patients who received a programmable device ( 31.1 points ) ( P<.001 by the analysis of variance test ) . Qualitative analyses of free-text diary entries , self-reported communication ability ( Abbreviated Profile of Hearing Aid Benefit ) scores , adherence to hearing aid use , and willingness to pay for replacement devices showed similar trends . CONCLUSIONS A programmable hearing aid with a directional microphone had the highest level of effectiveness in the veteran population . A nonprogrammable hearing aid with an omnidirectional microphone was also effective compared with an assistive listening device or no amplification Twelve experienced hearing aid users with mild to moderate hearing loss used two new , commercially available behind-the-ear amplitude compression hearing aids for 1 month each . One aid was a single-channel device ; the other was a two-channel aid . All subjects had used other compression aids for at least 1 year . Performance in real-life situations with the personal aid and the two trial aids was evaluated by the Hearing Performance Inventory ( HPI ) . Another question naire probed subjective preference for the three aids and willingness to purchase each of the trial aids . The major HPI finding was an equal performance superiority for the two trial aids over the personal aid for half the subjects . The preference/purchase question naire results indicated that the two-channel aid had some sound quality advantages , but was unacceptable physically . The single-channel trial was clearly preferred over the personal and two-channel device In this clinical study , 110 patients seen at three different clinical facilities were fit binaurally with linear , in-the-canal ( ITC ) hearing aids .  All patients were new hearing aid users . Each of the hearing aids was equipped with an adjustable control that could be set by one of the audiologists ( Audiologist A ) at each site to convert it from a linear instrument to an experimental nonlinear one with automatic reduction of low-frquency gain at high input levels ( or base increase at low levels , BILL ) . Both the patient and the audiologist performing the outcome testing at each site ( Audiologist B ) were blind as to the present setting of the hearing aid . Each participant was enrolled in the study for a total of 12 weeks , with the hearing aid set to either the linear or BILL-processing mode of operation for the first 8 weeks and the opposite setting for a subsequent 4-week period . In summary , this was a prospect i ve , doubleblind , crossover study of 110 new hearing aid users . Outcome measures focused on hearing-aid benefit and included both objective and subjective measures . Objective measures were derived from scores on the Northwestern University Auditory Test NO . 6 ( NU-6 ) and the Connected Speech Test ( CST ) obtained for all possible combinations of two speech presentation levels ( 60 and 75 dB SPL ) two types of background noise ( cafeteria noise and multitalker babble ) , and two signal-to-noise ratios ( + 5 and + 10 dB ) . Subjective outcome measures included magnitude estimation of listening effort ( MELE ) , the abbreviated form of the Hearing Aid Performance Inventory ( HAPI ) , and estimations of hearing-aid usage based on daily-use logs kept by the participants . All of these measures were used to evaluate the benefit provided by linear amplification and the benefit result ing from the experimental BILL processing . Participant preferences for the experimental BILL-processing scheme or linear processing were also examined by using a paired-comparison task at the end of the study . Results were analyzed separately for three subgroups of patients ( mild , moderate , severe ) formed on the basis of their average hearing loss at 500 , 1000 , 2000 , and 4000 Hz . In all three subgroups , significant improvement in performance was observed for linear amplification and for BILL processing when compared to unaided performance . There were no significant differences in aided performance , however , between linear processing and the experimental BILL processing OBJECTIVE To assess whether hearing aids improve the quality of life of elderly persons with hearing loss . SETTING Primary care clinics at a Bureau of Veterans Affairs hospital . PATIENTS One hundred and ninety-four elderly veterans who were identified as being hearing impaired from a screening survey involving 771 consecutive clinic patients . Of the original 194 , 188 ( 97 % ) completed the trial . INTERVENTION Subjects were r and omly assigned to either receive a hearing aid ( n = 95 ) or join a waiting list ( n = 99 ) . MAIN ENDPOINTS : A comprehensive battery of disease-specific and generic quality -of-life measures were administered at baseline , 6 weeks , and 4 months . MEASUREMENTS AND MAIN RESULTS Persons assigned to the two groups were similar in age , ethnicity , education , marital status , occupation , and comorbid diseases . At baseline , 82 % of subjects reported adverse effects on quality of life due to hearing impairment , and 24 % were depressed . At follow-up , a significant change in score improvements for social and emotional function ( 34.0 ; 95 % CI , 27.3 to 40.8 ; P less than 0.0001 ) , communication function ( 24.2 ; CI , 17.2 to 31.2 ; P less than 0.0001 ) , cognitive function ( 0.28 ; CI , 0.08 to 0.48 ; P = 0.008 ) , and depression ( 0.80 ; CI , 0.09 to 1.51 ; P = 0.03 ) was seen in subjects who received hearing aids compared with those assigned to the waiting list . Six drop-outs ( three per group ) , no crossovers , and no significant changes in co interventions were seen . Average , self-reported , daily aid use in the hearing aid group was 8 hours . CONCLUSION Hearing loss is associated with important adverse effects on the quality of life of elderly persons , effects which are reversible with hearing aids It seems reasonable to postulate that if a patient has a hearing impairment at particular frequencies , selective amplification at those frequencies would be an advantage . Attempts have been made in the laboratory to show that when this is done scores on various audiometric tasks will improve . Whether such laboratory benefit will be preferred by patients in their daily life is another matter . Despite a lack of knowledge on this subject , modifications are frequently made to a hearing aid system in the expectation that this will improve auditory performance and hence be preferred by the patient . The most common modifications made to an ear level aid in the British National Health Service are adjusting the tone control and venting the ear mould with the aim of emphasizing the higher frequencies . A r and omized crossover study was carried out in 83 first time hearing aid users with a mild to moderate hearing impairment to assess whether a hearing aid at the ' H ' tone setting and with a 2 mm vented mould would be preferred by those with a more marked high frequency impairment . BE series aids were used so that any findings could be directly translated to NHS practice . No consistent preference for the modified system was identified when patients were subgrouped according to the overall slope ( 0.5 to 4 kHz ) of their audiogram . However , when the slope between 0.25 and 1 kHz , which corresponds to the real ear effect of these modifications , was analyzed patients with a slope at these frequencies preferred the high-tone emphasis system ( p less than 0.005 ) . ( ABSTRACT TRUNCATED AT 250 WORDS The objective of this study was to evaluate  hearing aid fitting  from a societal viewpoint , rather than the more traditional patient perspective . The effects of hearing aid fitting on generic quality of life ( EuroQol ) , social functioning ( SF36 ) , auditory disability , productivity at paid and unpaid labour , and medical consumption , were assessed in a prospect i ve study among 80 moderately hearingimpaired first-time hearing aid applicants . The study showed that hearing aid fitting solved problems with paid employment , but did not seem to affect unpaid work . Use of medical services remained relatively stable after first-time hearing aid fitting . The Amsterdam Inventory proved to be a useful question naire to assess the effects on hearing disability . No effects of hearing aid fitting on generic quality of life could be determined with the EuroQol , while hearing aid fitting did lead to an improvement in one aspect of generic quality of life ; namely social functioning . El objetivo de este estudio fue evaluar la adaptación de auxiliares auditivos desde un punto de vista social , más que desde la perspective tradicional del paciente . Los efectos de la adaptación de auxiliares auditivos en la calidad genérica de vida ( EuroQWol ) , funcionamiento social ( SF36 ) , discapacidad auditiva , productividad en el trabajo remunerado o no remunerado , además de gastos médicos , fueron evaluados en un estudio prospect ivo con 80 pacientes con impedimentos auditivos moderados a quienes se les adaptó por primera vez un auxiliar auditivo . El estudio mostró que la adaptación de auxiliares auditivos resuelve problemas en los empleos remunerados pero no parece afectar el trabajo sin remuneración . El uso de servicios médicos permaneció relativamente estable después de la primera adaptación . El cuestionario Amsterdam probó ser un instrumento útil para evaluar los efectos en la discapacidad auditiva . No se pudieron determinar los efectos de la adaptación de auxiliares auditivos en la calidad genérica de vida por medio del EuroQol , mientras que la adaptación de auxiliares auditivos condicionó la mejoría en un aspecto de la calidad genérica de vida , que es concretamente , el funcionamiento social Background : Hearing impairment ( HI ) is a very common condition in elderly people and the epidemiology together with hearing-related problems is still poorly investigated . Moreover , the cognitive status may be impaired in relation to hearing function . Objective : The goal of the study was to evaluate : ( a ) the prevalence of HI in a r and om sample of elderly people aged 65 and over ( n = 1,750 ) living in Campania , a region of southern Italy ; ( b ) the cross-sectional relationship between hearing function and cognitive status and also depressive symptomatology and disability , and ( c ) to assess the role of hearing aids on depressive symptomatology . Methods : Cross-sectional study on a r and om sample of elderly population . Results : The overall participation rate in the study was 74.8 % ( n = 1,332 , mean age was 74.2 ± 6.4 years ) . The prevalence rate of HI ( evaluated by question naire ) was 27.2 % , cognitive impairment prevalence ( evaluated by the Mini-Mental State Examination ( MMSE ) ) was 27.9 % , mean depressive symptomatology score ( evaluated by Geriatric Depression Scale ( GDS ) ) was 11.4 ± 6.6 , while disability assessed by Activity of Daily Living ( ADL ) was present in 7.0 % of the whole population . A strong relationship was found between both decreasing hearing function and MMSE decline 
    Output:
    
A r and om-effects meta- analysis showed differential results for generic versus disease-specific HRQoL measures for within- and between-subject design s. Although generic measures used for within-subject design s did not demonstrate HRQoL benefits from hearing aids , mean effect sizes and confidence intervals for within-subject design s and disease-specific instruments suggested that hearing aids have a small-to-medium impact on HRQoL. Further , the between-subject studies supported at least a small effect for generic measures , and when measured by disease-specific instruments , hearing aids had medium-to-large effects on adults ' HRQoL. This review concludes that hearing aids improve  adults ' HRQoL by reducing psychological , social , and emotional effects of SNHL .