{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:01:30Z","timestamp":1789988490905,"version":"4.0.1"},"reference-count":41,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiol. Res.","Audiology Research"],"abstract":"<jats:p>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 [\u22120.44, 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 [\u22120.25, 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.<\/jats:p>","DOI":"10.3390\/audiolres16050139","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:01:38Z","timestamp":1789981298000},"page":"139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self-Fitting Versus Professional-Fitting Hearing Aids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1244-7769","authenticated-orcid":false,"given":"Ebraheem","family":"Albazee","sequence":"first","affiliation":[{"name":"Otorhinolaryngology-Head and Neck Surgery, Kuwait Institute for Medical Specializations (KIMS), Kuwait City 13018, Kuwait"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Al-Jahra Hospital, Al-Jahra 03200, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4604-8665","authenticated-orcid":false,"given":"Hajar","family":"Alismail","sequence":"additional","affiliation":[{"name":"Kuwait Institute for Medical Specializations (KIMS), Kuwait City 13018, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4113-9258","authenticated-orcid":false,"given":"Noof","family":"Albannai","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqoub Yousef","family":"Alenezi","sequence":"additional","affiliation":[{"name":"College of Medicine and Medical Sciences, Arabian Gulf University, Manama 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2337-6588","authenticated-orcid":false,"given":"Abdullah M.","family":"Alharran","sequence":"additional","affiliation":[{"name":"College of Medicine and Medical Sciences, Arabian Gulf University, Manama 26671, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0684-9001","authenticated-orcid":false,"given":"Maya Yassir H.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7348-9794","authenticated-orcid":false,"given":"Durar Ahmed","family":"Aljishi","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abu-Zaid","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1177\/0194599820910377","article-title":"Hearing Loss, Loneliness, and Social Isolation: A Systematic Review","volume":"162","author":"Shukla","year":"2020","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Podury, A., Jiam, N.T., Kim, M., Donnenfield, J.I., and Dhand, A. 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