Potential of Augmented Reality Platforms to Improve Hearing Aids and Support More Ecologically Valid Research: A Systematic Review

Abstract

Augmented reality (AR) technologies are increasingly being explored as tools for advancing hearing assistance, offering the potential to supplement or extend the capabilities of traditional hearing aids. From a human factors perspective, this systematic review evaluates the current state of AR-integrated audio systems and their impact on communication, accessibility, spatial awareness, cognitive workload, and user adaptability in everyday environments. Using PRISMA guidelines, a search of PubMed and Engineering Village (Compendex and Inspec) identified 477 articles published between 2000 and 2025, of which fourteen met inclusion criteria. Findings across these studies were characterized into four areas: personalization and accessibility, ecological validity, multimodal sensing, and spatial/3D audio modeling. Results indicate that AR-assisted devices show promise in supporting user-driven auditory adjustments, enhancing spatial awareness, and enabling more realistic testing environments through AR/VR soundscapes. However, many solutions remain early prototypes, with limited evaluation in naturalistic settings and sparse reporting on long-term user experience. Overall, AR audio systems demonstrate significant potential to reshape hearing-aid design, but further longitudinal and real-world research is required to validate their impact on listening performance and everyday communication.