Abrams 1992.

Methods	Randomised trial (also had a control group with no intervention but control group inclusion was determined by eligibility for VA‐funded HA so not randomised)
Participants	N = 22 in randomised groups Age: 55 and over, PTA 4 frequency average > 30 dB HL in better ear, no previous HA use, women not excluded but none in study Excluded known neurological deficiencies
Interventions	HA + AR group programme versus HA alone AR programme was 90‐minute group session once a week for 3 weeks post‐fitting
Outcomes	Short‐term: baseline and 2 months HANDICAP Hearing Handicap Inventory for the Elderly (HHIE) total score, emotional subscale and social subscale
Notes	—
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "those who received hearing aids were randomly assigned to one of the two treatment groups" Comment: no details given about how sequence was generated Control group not randomised
Allocation concealment (selection bias)	Unclear risk	Comment: no information about how sequence generated or whether it was concealed
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: participants not blinded (due to the nature of the intervention) and experimenters almost certainly not, but it was not explicitly stated in the text
Blinding of outcome assessment (detection bias) All outcomes	High risk	Not blinded
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: no missing data
Selective reporting (reporting bias)	Unclear risk	No study protocol available
Other bias	Low risk	Study appears to be free of other sources of bias