Product reviews are meant to help shoppers determine whether or not a product is right for them, but author Vinaya Manchaiah and colleagues believe that these reviews are also important—albeit underutilized—research tools. Manchaiah, Amyn M. Amlani, Christina M. Bricker, Clayton T. Whitfield, and Pierre Ratinaud studied reviews of direct-to-consumer hearing devices (DCHDs), such as personal sound amplification systems, on Amazon.com.

Manchaiah pointed out that although these devices may look and function like traditional hearing aids, they are a different category of devices—a category typically focused on people with “normal hearing sensitivity” who wish to improve listening for a specific activity. Despite this, reviews suggest that people with hearing loss may be purchasing and using these items, as well as over-the-counter hearing aids, in place of prescribed hearing aids. The authors looked at reviews for 62 different DCHDs ranging from $10 to more than $600, ultimately looking at more than 11,000 unique reviews in their study.

Manchaiah said that in the past, researchers have found contradictory reports that these devices are suitable for people with hearing loss, although these studies have been small. In order to find large-scale data, the authors identified devices on Amazon. “While this is an unconventional approach to research, we believe that using the existing secondary data will give us some insight that we don’t have from clinical studies,” Manchaiah said.

In the study, the authors used automated analysis to identify the main themes within the user feedback; this yielded seven unique themes. The authors also performed a qualitative analysis, enabling them to identify eight main themes and 40 subthemes. The subtheme topics ranged from sound quality to why the item was purchased (as a gift, a backup hearing aid, or an introductory hearing aid). They also compared the price levels of the devices to ratings of satisfaction.

Although the study highlights both the benefits and the shortcomings of DCHDs, Manchaiah thought it was important to dispel some of the stigma surrounding these devices. “There is a lot of negative feeling within audiology that these devices don’t work, and we shouldn’t prescribe them,” he said, adding that the high ratings received by some of the more expensive models suggested that some of those models may be of better quality.

The authors hope that their study can help clinicians learn about DCHDs and advise consumers on these products. “Solely based on this study, we cannot make any recommendations on  . . .  devices,” Manchaiah pointed out. Manchaiah stated that adding more options for a patient would help promote shared decision making. “It is important for us to have a number of good choices rather than having one best choice” when referring to the management of hearing loss.