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Using screening questionnaires we were able to detect individuals aged 50-65 years with hearing disability in a general practice population. Those who had better ear hearing levels of 30 dB or worse were invited to take place in a cross-over study comparing the acceptability of a monaural or binaural hearing-aid fitting. Fifty-five per cent ultimately opted for a binaural fitting and had greater hearing disability and worse mean hearing levels than those who opted for a monaural fitting. They made their choice for acoustical reasons, particularly on the basis of improved localization ability.