Best Hearing Aids by Sound Performance in 2024

Our goal is to evaluate hearing aids in realistic environments and with the most common settings. We have built a custom laboratory to create these environments, and use an industry-standard acoustic manikin to make recordings. The recordings are passed through validated models from the hearing science literature. The outputs of those models are presented as the scores on this site. To learn more visit our How We Measure page which includes a brief video and a thorough outline of our scientific approach in our whitepaper.

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Our methods leverage the best our scientific community has to offer; however, we understand that no testing method is perfect. We can not account for every hearing loss or the numerous ways hearing devices can be programmed. We remain humble and are continuously working to improve our current v1.0 methods.

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We program hearing aids to a common age-related mild sloping to moderate hearing loss. If you have more or less hearing loss, or a different pattern, our audio samples will not reflect the performance you may experience with hearing aids programmed for your needs. You should also exercise caution when interpreting our data as hearing aid performance varies with programming. We are attempting to simplify the comparison process but nothing beats a trial with hearing aids programmed for you.

Here are steps to improve the realism of audio comparisons with our hearing aid sound files: 

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1. Minimize any environmental noises or move to a quieter location. 
2. Remove any hearing aids and wear your best headphones.
3. Adjust your volume so the “Open Ear” audio sample sounds as loud as you would expect it to be in the real world. Do not adjust your speaker volume between audio samples.

To hear your best with a common age-related hearing loss, it is important that hearing aids provide adequate high-frequency (high tone) amplification. Emphasizing the high frequencies can alter the sound quality substantially, leading to a less natural sound on first impression. But ultimately, replacing those missing high frequency sounds (that haven't been heard clearly for some time) is the key to understanding speech better.

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So while you're listening to our sound samples, remember that what sounds best from a sound quality perspective may not align with what provides the greatest benefit to speech clarity. If you're an experienced hearing aid user, you will know well that hearing aids can seem unnatural and overly bright initially, but over time you acclimatize and retrain your brain to hear in a more natural way.

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We also encourage you to go beyond the sound samples and click through our ratings for speech performance in quiet and noisy settings, own voice quality, feedback handling, and audio streaming quality. 

You may be tempted to believe that over-the-counter (OTC) hearing aids, like the Jabra Enhance Plus, are just as good as prescription (Rx) hearing aids. In some cases, OTC hearing aids can offer the same performance as prescription devices but there are some important caveats to consider:

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1. OTC hearing aids are specifically geared for users with no greater than a mild-to-moderate hearing loss. When optimized for users with this loss, some OTC devices are capable of performing at or close to the level of Rx devices. However, had HearAdvisor tested devices programmed for a more severe hearing loss, or a less standard shape, some of the OTC devices would have been much less effective. The Rx devices tested are capable of providing much more amplification in order to meet the needs of users with severe or even profound hearing loss.
2. Prescription hearing aids often use proprietary fitting software for their “first fit” which may prioritize sound comfort over speech clarity. This can result in low Initial Fit scores which are weighted higher when calculating our final SoundGrade. For more information about how our SoundGrade (previously called SoundScore) is calculated, and the reasoning behind it, please read our whitepaper. 
3. We optimized the amplification of OTC and Rx devices in a lab using sophisticated tools to assist with applying appropriate sound levels for the target hearing loss. Most hearing aid users are unlikely to achieve such perfectly-beneficial settings on their own with OTC devices. On the other hand, if you seek an audiologist who performs real-ear measurements, it's likely that you can achieve HearAdvisor's Tuned Fit settings with both types of devices.

We test hearing aids using a state-of-the art anthropomorphic manikin and custom built test chamber. We also rely on industry standard hearing aid measurements and leverage the latest science with metrics that model the injured hearing system. Our data represents the real hearing aid performance based on our test setup and protocol. 

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If we suspect our test results are inaccurate, we perform retests to double-check our measurements and we commonly reach out to the manufacturer for clarification on the performance we observe. 

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We are also in regular discussions with manufacturers and field experts regarding potential improvements to our current v1.0 metrics.

Several OTC companies rebrand prescription technologies for the direct-to-consumer market. While the technology may be the same, manufacturers can alter the programming, default settings, and software recommendations (e.g., ear tips). These changes can impact the overall performance and our SoundGrade.

Not necessarily as there are many reasons a device may score below an A, such as lower amplification in the default settings. Performance for these devices may improve with tuning however, this is less common in the real world. For this reason, our SoundGrade is weighted towards the performance we observe in the Initial Fit. 

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Another consideration is the relation between price and performance. A $200 device with a B SoundGrade represents a great overall value.

We report data on the sound performance of hearing devices, but this is only one dimension that should be considered when purchasing a hearing aid. Other elements such as comfort, durability, wireless performance, and style are not covered on HearAdvisor.  For more information on usability factors, check out the thorough product reviews that reference our data on HearingTracker.com.

“Open-fit” hearing aids are hearing aids that leave your ear canal open. All of the prescription devices tested to date by HearAdvisor are considered open-fit hearing aids. “Closed-fit” hearing aids are those that seal off your ear canal with either a tight custom mold or rubber / silicone ear tip that lets little to no air in or out. Devices such as the Sony CRE-C10, Jabra Enhance Plus, and Apple AirPods Pro 2 are considered closed-fit devices.

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The open-fit configuration has several implications for sound quality, benefit with hearing aids, sound localization, and hearing in noise:

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1. Sound Quality: In the real world, open-fit hearing aids generally provide a more natural sound quality because they do not block the ear canal. By combining natural and amplified sound, open-fit hearing aids create a more balanced listening experience.
2. The Occlusion Effect: Open-fit hearing aids prevent the occlusion effect, which is the sensation of hearing your own voice as if speaking into a barrel.
3. Benefit with Hearing Aids: Open-fit hearing aids are particularly beneficial for individuals with mild to moderate high-frequency hearing loss. This is because they can amplify high-frequency sounds while still allowing low-frequency sounds to enter the ear naturally. This configuration helps users maintain a sense of spatial awareness and natural sound quality, making the transition to using hearing aids easier.
4. Sound Localization: Sound localization is the ability to determine the source and direction of a sound. Open-fit hearing aids allow for a better sense of sound localization compared to traditional behind-the-ear (BTE) hearing aids because they do not block the ear canal. By allowing natural sound to enter the ear, users can better utilize their residual hearing and spatial cues to localize sounds.
5. Hearing in Noise: Open-fit hearing aids can struggle in noisy environments because they allow background noise to enter the ear along with the amplified signal. To address this issue, many open-fit hearing aids incorporate advanced features like directional microphones and AI noise removal to improve speech understanding in noisy situations. While these technologies can help, users with more severe hearing loss or those who struggle in very noisy environments may find traditional BTE or in-the-ear (ITE) hearing aids with a closed fit more beneficial.
6. Wireless streaming: Open-fit hearing aids allow sound to escape from the ear canal due to their open design. This can result in a decrease in overall sound quality, particularly at higher volumes or with bass-heavy audio content. Closed-fit hearing aids provide better sound isolation, which can lead to richer and fuller sound quality during streaming. However, keep in mind that situational awareness will suffer with closed-fit hearing aids as they will more effectively block outside sounds.

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While open-fit hearing aids offer several advantages over closed-fit hearing aids, they may not be the best choice for everyone, especially those with severe hearing loss or who need better performance in noisy environments. We recommend working closely with an audiologist to determine the most appropriate hearing aid style and features for your individual needs.

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