Pairwise Listener Preferences in Hearing Aid Evaluation

1981 ◽  
Vol 24 (3) ◽  
pp. 366-374 ◽  
Author(s):  
Jerry L. Punch ◽  
Cheryl A. Parker
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Pairwise Comparison ◽  
Experimental Conditions ◽  
Repeated Measures Design ◽  
Evaluation Procedures ◽  
Pairwise Preference ◽  
Test Retest Reliability

The relationships among pairwise judgments of the quality of connected discourse, pairwise judgments of the relative intelligibility of discourse, and measured intelligibility on a nonsense-syllable test were evaluated under identical conditions of primary talker and competitive babble. Stimuli were processed by eight hearing aids and presented in a repeated-measures design to 12 listeners with sensorineural hearing loss. Results revealed moderately high test-retest reliability for all three experimental conditions. Overall, a noteworthy positive relationship was evident between relative intelligibility judgments and measured phonemic identification, although this relationship varied considerably among individual listeners. The correspondence between quality judgments and relative intelligibility judgments was substantially lower, while the relationship between judgments of quality and phonemic identification scores was negligible, Findings demonstrate the potential importance of instructional set in producing valid judgments of the relative intelligibility of aided speech. The determination of measurement error inherent in pairwise preference data is discussed from the viewpoint of a probabilistic model encompassing a binomial distribution. It is concluded that experimental optimization of the agreement between relative intelligibility judgments and measured intelligibility performance of individual listeners will be required before the pairwise comparison technique can be considered a viable alternative to traditional hearing aid evaluation procedures.

Evaluation of a Wind Noise Attenuation Algorithm on Subjective Annoyance and Speech-in-Wind Performance

2017 ◽  
Vol 28 (01) ◽  
pp. 046-057 ◽  
Author(s):  
Petri Korhonen ◽  
Francis Kuk ◽  
Eric Seper ◽  
Martin Mørkebjerg ◽  
Majken Roikjer
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Real Life ◽  
Subjective Rating ◽  
Noise Attenuation ◽  
Wind Noise ◽  
Wind Speeds ◽  
Repeated Measures Design ◽  
Phoneme Identification

AbstractWind noise is a common problem reported by hearing aid wearers. The MarkeTrak VIII reported that 42% of hearing aid wearers are not satisfied with the performance of their hearing aids in situations where wind is present.The current study investigated the effect of a new wind noise attenuation (WNA) algorithm on subjective annoyance and speech recognition in the presence of wind.A single-blinded, repeated measures design was used.Fifteen experienced hearing aid wearers with bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study.Subjective rating for wind noise annoyance was measured for wind presented alone from 0° and 290° at wind speeds of 4, 5, 6, 7, and 10 m/sec. Phoneme identification performance was measured using Widex Office of Clinical Amplification Nonsense Syllable Test presented at 60, 65, 70, and 75 dB SPL from 270° in the presence of wind originating from 0° at a speed of 5 m/sec.The subjective annoyance from wind noise was reduced for wind originating from 0° at wind speeds from 4 to 7 m/sec. The largest improvement in phoneme identification with the WNA algorithm was 48.2% when speech was presented from 270° at 65 dB SPL and the wind originated from 0° azimuth at 5 m/sec.The WNA algorithm used in this study reduced subjective annoyance for wind speeds ranging from 4 to 7 m/sec. The algorithm was effective in improving speech identification in the presence of wind originating from 0° at 5 m/sec. These results suggest that the WNA algorithm used in the current study could expand the range of real-life situations where a hearing-impaired person can use the hearing aid optimally.

Chosen Listening Levels for Music With and Without the Use of Hearing Aids

2016 ◽  
Vol 25 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Naomi B. H. Croghan ◽  
Anne M. Swanberg ◽  
Melinda C. Anderson ◽  
Kathryn H. Arehart
Keyword(s):  
Tympanic Membrane ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Rock Music ◽  
Classical Music ◽  
Hearing Aid ◽  
Intersubject Variability ◽  
Repeated Measures Design ◽  
Recorded Music ◽  
Listening Levels

Purpose The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions. Method The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane. Results For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs. Conclusion By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.

Accuracy and Reliability of a Real-Ear-to-Coupler Difference Measurement Procedure Implemented within a Behind-the-Ear Hearing Aid

2011 ◽  
Vol 22 (09) ◽  
pp. 612-622 ◽  
Author(s):  
Susan Scollie ◽  
Marlene Bagatto ◽  
Sheila Moodie ◽  
Jeff Crukley
Keyword(s):  
Repeated Measures ◽  
Predictive Accuracy ◽  
Hearing Aid ◽  
Measurement Procedure ◽  
Convenience Sample ◽  
Retest Reliability ◽  
The Real ◽  
Repeated Measures Design ◽  
The Individual ◽  
Test Retest Reliability

Background: Measurement of the real ear response of a fitted hearing aid allows matching of the frequency response to prescriptive targets, as well as comparison of the response to both threshold and loudness discomfort level (LDL). These processes are recommended procedures for hearing aid fittings. The real ear aided response (REAR) is often predicted based on the coupler response of the device, the real-ear-to-coupler difference (RECD), and the microphone location effect (MLE). Individualized measurement of the RECD tends to increase the accuracy of this prediction. A commercial hearing aid has been developed that measures the individual RECD and incorporates the data into the software-assisted fitting process. Purpose: This study evaluated the test-retest reliability and predictive validity of this particular method for measuring the RECD. Research Design: A repeated measures design was used to evaluate differences between subsequent measures of the RECD in the same ear, and prediction differences associated with using the RECD (and other information) to predict the REAR. Study Sample: Fifteen ears, on a convenience sample of ten adults (45–86 yr) and five children (6–15 yr) were tested. All participants were hearing aid users. Data Collection and Analysis: Predicted and measured REARs were collected using normal clinical procedures, on an Audioscan Verifit VF-1 for two test signals/levels. Reliability, mean differences between predicted and measured REARs, and 95% confidence intervals of the prediction accuracy are reported. Results: The RECD procedure had test-retest reliability within 2.5 dB for 14 out of 15 ears between 500 and 4000 Hz, and had predictive accuracy within 5 dB between 500 and 4000 Hz for 14 out of 15 ears. However, errors associated with earhook misalignment were discovered. Also, the RECD values measured using this hearing-aid-specific procedure differ somewhat from the normative data available from insert earphone RECDs. Conclusions: This procedure, when measured according to recommendations, provides a reasonably accurate prediction of the REAR. Functionally, this procedure does not replace the range of measures offered by modern real ear measurement systems. However, given the inaccuracy of software-assisted fittings without a measure of individual ear canal acoustics, use of this procedure may have the potential to improve the accuracy of fittings versus fittings completed without real ear measurement.

Using the Repeat-Recall Test to Examine Factors Affecting Context Use

2021 ◽  
Author(s):  
Francis Kuk ◽  
Christopher Slugocki ◽  
Petri Korhonen
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Speech Processing ◽  
Repeated Measures ◽  
Recall Test ◽  
Outcome Measure ◽  
Hearing Aid ◽  
Listening Effort ◽  
Double Blind ◽  
Repeated Measures Design

Abstract Background The effect of context on speech processing has been studied using different speech materials and response criteria. The Repeat-Recall Test (RRT) evaluates listener performance using high context (HC) and low context (LC) sentences; this may offer another platform for studying context use (CU). Objective This article aims to evaluate if the RRT may be used to study how different signal-to-noise ratios (SNRs), hearing aid technologies (directional microphone and noise reduction), and listener working memory capacities (WMCs) interact to affect CU on the different measures of the RRT. Design Double-blind, within-subject repeated measures design. Study Sample Nineteen listeners with a mild-to-moderately severe hearing loss. Data Collection The RRT was administered with participants wearing the study hearing aids under two microphone (omnidirectional vs. directional) by two noise reduction (on vs. off) conditions. Speech was presented from 0 degree at 75 dB sound pressure level and a continuous speech-shaped noise from 180 degrees at SNRs of 0, 5, 10, and 15 dB. The order of SNR and hearing aid conditions was counterbalanced across listeners. Each test condition was completed twice in two 2-hour sessions separated by 1 month. Results CU was calculated as the difference between HC and LC sentence scores for each outcome measure (i.e., repeat, recall, listening effort, and tolerable time). For all outcome measures, repeated measures analyses of variance revealed that CU was significantly affected by the SNR of the test conditions. For repeat, recall, and listening effort measures, these effects were qualified by significant two-way interactions between SNR and microphone mode. In addition, the WMC group significantly affected CU during recall and rating of listening effort, the latter of which was qualified by an interaction between the WMC group and SNR. Listener WMC affected CU on estimates of tolerable time as qualified by significant two-way interactions between SNR and microphone mode. Conclusion The study supports use of the RRT as a tool for measuring how listeners use sentence context to aid in speech processing. The degree to which context influenced scores on each outcome measure of the RRT was found to depend on complex interactions between the SNR of the listening environment, hearing aid features, and the WMC of the listeners.

scholarly journals Difference between the Default Telecoil (T-Coil) and Programmed Microphone Frequency Response in Behind-the-Ear (BTE) Hearing Aids

2012 ◽  
Vol 23 (05) ◽  
pp. 366-378 ◽  
Author(s):  
Daniel B. Putterman ◽  
Michael Valente
Keyword(s):  
Frequency Response ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Mixed Model ◽  
Hearing Aid ◽  
Primary Concern ◽  
The Real ◽  
Repeated Measures Design ◽  
Significant Difference ◽  
The Mean

Background: A telecoil (t-coil) is essential for hearing aid users when listening on the telephone because using the hearing aid microphone when communicating on the telephone can cause feedback due to telephone handset proximity to the hearing aid microphone. Clinicians may overlook the role of the t-coil due to a primary concern of matching the microphone frequency response to a valid prescriptive target. Little has been published to support the idea that the t-coil frequency response should match the microphone frequency response to provide “seamless” and perhaps optimal performance on the telephone. If the clinical goal were to match both frequency responses, it would be useful to know the relative differences, if any, that currently exist between these two transducers. Purpose: The primary purpose of this study was to determine if statistically significant differences were present between the mean output (in dB SPL) of the programmed microphone program and the hearing aid manufacturer's default t-coil program as a function of discrete test frequencies. In addition, pilot data are presented on the feasibility of measuring the microphone and t-coil frequency response with real-ear measures using a digital speech-weighted noise. Research Design: A repeated-measures design was utilized for a 2-cc coupler measurement condition. Independent variables were the transducer (microphone, t-coil) and 11 discrete test frequencies (15 discrete frequencies in the real-ear pilot condition). Study Sample: The study sample was comprised of behind-the-ear (BTE) hearing aids from one manufacturer. Fifty-two hearing aids were measured in a coupler condition, 39 of which were measured in the real-ear pilot condition. Hearing aids were previously programmed and verified using real-ear measures to the NAL-NL1 (National Acoustic Laboratories—Non-linear 1) prescriptive target by a licensed audiologist. Data Collection and Analysis: Hearing aid output was measured with a Fonix 7000 hearing aid analyzer (Frye Electronics, Inc.) in a HA-2 2-cc coupler condition using a pure-tone sweep at an input level of 60 dB SPL with the hearing aid in the microphone program and 31.6 mA/M in the t-coil program. A digital speech weighted noise input signal presented at additional input levels was used in the real-ear pilot condition. A mixed-model repeated-measures analysis of variance (ANOVA) and the Tukey Honestly Significant Difference (HSD) post hoc test were utilized to determine if significant differences were present in performance across treatment levels. Results: There was no significant difference between mean overall t-coil and microphone output averaged across 11 discrete frequencies (F(1,102) = 0, p < 0.98). A mixed-model repeated-measures ANOVA revealed a significant transducer by frequency interaction (F(10,102) = 13.0, p < 0.0001). Significant differences were present at 200 and 400 Hz where the mean t-coil output was less than the mean microphone output, and at 4000, 5000, and 6300 Hz where the mean t-coil output was greater than the mean microphone output. Conclusions: The mean t-coil output was significantly lower than the mean microphone output at 400 Hz, a frequency that lies within the typical telephone bandwidth of 300–3300 Hz. This difference may partially help to explain why some patients often complain the t-coil fails to provide sufficient loudness for telephone communication.

A Proposed Electroacoustic Test Protocol for Personal FM Receivers Coupled to Cochlear Implant Sound Processors

2013 ◽  
Vol 24 (10) ◽  
pp. 941-954 ◽  
Author(s):  
Erin C. Schafer ◽  
Elizabeth Musgrave ◽  
Sadaf Momin ◽  
Carl Sandrock ◽  
Denise Romine
Keyword(s):  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Behavioral Testing ◽  
Test Protocol ◽  
Repeated Measures Design ◽  
Specialized Equipment ◽  
Acoustic Output ◽  
Speech Recognition In Noise ◽  
Sound Processor

Background: Current fitting guidelines from the American Academy of Audiology (Academy) support the use of objective electroacoustic measures and behavioral testing when fitting frequency modulation (FM) systems to hearing aids. However, only behavioral testing is recommended when fitting FM systems to individuals with cochlear implants (CIs) because a protocol for conducting electroacoustic measures has yet to be developed for this population. Purpose: The purpose of this study was to propose and examine the validity of a newly developed, objective, electroacoustic test protocol for fitting electrically and electromagnetically coupled FM systems to CI sound processors. Research Design: Electroacoustic measures were conducted and replicated in the laboratory with three contemporary CI sound processors and several FM system combinations. A repeated measures design was used with four participants to examine the validity of the proposed electroacoustic test protocol. Study Sample: Three contemporary CI sound processors were tested electroacoustically in the laboratory while coupled to combinations of five FM receivers and four FM transmitters. Two adolescents using Cochlear Nucleus 5 sound processors and two adult participants using MED-EL OPUS 2 sound processors completed behavioral and subjective measures. Data Collection and Analysis: Using current hearing aid practice guidelines from the Academy, electroacoustic measurements were conducted in the laboratory with the CIs and FM systems to determine transparency, where equivalent inputs to the CI and FM microphones result in equivalent outputs. Using a hearing aid analyzer, acoustic output from the CI sound processor was measured via monitor earphones and specialized equipment from CI manufacturers with 65 dB SPL speech inputs (1) to the sound processor and (2) to the FM transmitter microphones. The FM gain or volume was adjusted to attempt to achieve transparency for outputs from the two input devices. The four participants completed some or all of the following measures: speech recognition in noise without and with two FM systems in a classroom, loudness ratings without and with two FM systems measures in a quiet condition in a classroom, and questionnaires. Results: Transparency was achieved for most CI and FM combinations, but most systems required adjustments to FM gain or volume relative to the manufacturer default setting. Despite adjustments to the systems, transparency was not attainable for some FM receiver and transmitter combinations. Behavioral testing in four participants provided preliminary support to the proposed electroacoustic test protocol. Conclusions: Valid and reliable electroacoustic test measures may be feasible with CIs coupled to FM systems with specialized equipment from the CI manufacturer. Advances in equipment available for electroacoustic testing with these devices as well as additional research will lend further support to this objective approach to fitting FM systems to CIs.

Effects of Training on the Use of a Manual Microphone Shutoff on a BiCROS Device

2015 ◽  
Vol 26 (05) ◽  
pp. 478-493 ◽  
Author(s):  
Francis Kuk ◽  
Eric Seper ◽  
Chi Lau ◽  
Bryan Crose ◽  
Petri Korhonen
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Real Life ◽  
Final Visit ◽  
Repeated Measures Design ◽  
Negative Effect ◽  
Speech Recognition In Noise ◽  
Study Participants

Background: Bilateral contralateral routing of signals (BiCROS) hearing aids function to restore audibility of sounds originating from the side of the unaidable ear. However, when speech is presented to the side of the aidable ear and noise to the side of the unaidable ear, a BiCROS arrangement may reduce intelligibility of the speech signal. This negative effect may be circumvented if an on/off switch is available on the contralateral routing of signals (CROS) transmitter. Purpose: This study evaluated if the proper use of the on/off switch on a CROS transmitter could enhance speech recognition in noise and sound localization abilities. The participants’ subjective reactions to the use of the BiCROS, including the use of the on/off switch in real-life were also evaluated. Research Design: A between-subjects, repeated-measures design was used to assess differences in speech recognition (in quiet and in noise) and localization abilities under four hearing aid conditions (unaided, unilaterally aided, fixed BiCROS setting, and adjusted BiCROS setting) with speech and noise stimuli presented from different azimuths. Participants were trained on the use of the on/off switch on the BiCROS transmitter before testing in the adjusted BiCROS settings. Subjective ratings were obtained with the Speech, Spatial, and Sound Quality (SSQ) questionnaire and a custom questionnaire. Study Sample: Nine adult BiCROS candidates participated in this study. Data Collection and Analysis: Participants wore the Widex Dream-m-CB hearing aid on the aidable ear for 1 week. They then wore the BiCROS for the remainder of the study. Speech recognition and localization testing were completed in four hearing aid conditions (unaided, unilateral aided, fixed BiCROS, and adjusted BiCROS). Speech recognition was evaluated during the first three visits, whereas localization was evaluated over the course of the study. Participants completed the SSQ questionnaire before each visit. The CROS questionnaire was completed at the final visit. A repeated measures analysis of variance with Bonferroni post hoc analysis was used to evaluate the significance of the results on speech recognition, localization, and the SSQ. Results: The results revealed that the adjusted BiCROS condition improved speech recognition scores by 20 rau (rationalized arcsine unit) when speech was presented to the aidable ear and localization by 37% when sounds are presented from the side of the unaidable ear over the fixed BiCROS condition. Statistically significant benefit on the SSQ was also noted with the adjusted BiCROS condition compared to the unilateral fitting. Conclusions: These findings supported the value of an on/off switch on a CROS transmitter because it allows convenient selective transmission of sounds. It also highlighted the importance of instructions and practice in using the BiCROS hearing aid successfully.

The Benefit of Remote Microphones Using Four Wireless Protocols

2015 ◽  
Vol 26 (08) ◽  
pp. 724-731 ◽  
Author(s):  
Krishna S. Rodemerk ◽  
Jason A. Galster
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Wireless Transmission ◽  
Transmission Protocol ◽  
Repeated Measures Design ◽  
Audio Transmission ◽  
Speech Recognition In Noise

Background: Many studies have reported the speech recognition benefits of a personal remote microphone system when used by adult listeners with hearing loss. The advance of wireless technology has allowed for many wireless audio transmission protocols. Some of these protocols interface with commercially available hearing aids. As a result, commercial remote microphone systems use a variety of different protocols for wireless audio transmission. It is not known how these systems compare, with regard to adult speech recognition in noise. Purpose: The primary goal of this investigation was to determine the speech recognition benefits of four different commercially available remote microphone systems, each with a different wireless audio transmission protocol. Research Design: A repeated-measures design was used in this study. Study Sample: Sixteen adults, ages 52 to 81 yr, with mild to severe sensorineural hearing loss participated in this study. Intervention: Participants were fit with three different sets of bilateral hearing aids and four commercially available remote microphone systems (FM, 900 MHz, 2.4 GHz, and Bluetooth® paired with near-field magnetic induction). Data Collection and Analysis: Speech recognition scores were measured by an adaptive version of the Hearing in Noise Test (HINT). The participants were seated both 6 and 12′ away from the talker loudspeaker. Participants repeated HINT sentences with and without hearing aids and with four commercially available remote microphone systems in both seated positions with and without contributions from the hearing aid or environmental microphone (24 total conditions). The HINT SNR-50, or the signal-to-noise ratio required for correct repetition of 50% of the sentences, was recorded for all conditions. A one-way repeated measures analysis of variance was used to determine statistical significance of microphone condition. Results: The results of this study revealed that use of the remote microphone systems statistically improved speech recognition in noise relative to unaided and hearing aid-only conditions across all four wireless transmission protocols at 6 and 12′ away from the talker. Conclusions: Participants showed a significant improvement in speech recognition in noise when comparing four remote microphone systems with different wireless transmission methods to hearing aids alone.

scholarly journals Test–retest reliability of laser evoked pain perception and fMRI BOLD responses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanzhi Bi ◽  
Xin Hou ◽  
Jiahui Zhong ◽  
Li Hu
Keyword(s):  
Resting State ◽  
Repeated Measures ◽  
Subjective Experience ◽  
Pain Perception ◽  
Primary Motor Cortex ◽  
Intraclass Correlation ◽  
Retest Reliability ◽  
Repeated Measures Design ◽  
Brain Responses ◽  
Test Retest Reliability

AbstractPain perception is a subjective experience and highly variable across time. Brain responses evoked by nociceptive stimuli are highly associated with pain perception and also showed considerable variability. To date, the test–retest reliability of laser-evoked pain perception and its associated brain responses across sessions remain unclear. Here, an experiment with a within-subject repeated-measures design was performed in 22 healthy volunteers. Radiant-heat laser stimuli were delivered on subjects’ left-hand dorsum in two sessions separated by 1–5 days. We observed that laser-evoked pain perception was significantly declined across sessions, coupled with decreased brain responses in the bilateral primary somatosensory cortex (S1), right primary motor cortex, supplementary motor area, and middle cingulate cortex. Intraclass correlation coefficients between the two sessions showed “fair” to “moderate” test–retest reliability for pain perception and brain responses. Additionally, we observed lower resting-state brain activity in the right S1 and lower resting-state functional connectivity between right S1 and dorsolateral prefrontal cortex in the second session than the first session. Altogether, being possibly influenced by changes of baseline mental state, laser-evoked pain perception and brain responses showed considerable across-session variability. This phenomenon should be considered when designing experiments for laboratory studies and evaluating pain abnormalities in clinical practice.

The Effects of Receiver Placement on Probe Microphone, Performance, and Subjective Measures with Open Canal Hearing Instruments

2010 ◽  
Vol 21 (04) ◽  
pp. 249-266 ◽  
Author(s):  
Lynzee N. Alworth ◽  
Patrick N. Plyler ◽  
Monika Bertges Reber ◽  
Patti M. Johnstone
Keyword(s):  
Repeated Measures ◽  
Hearing Aid ◽  
Clinical Importance ◽  
Ease Of Use ◽  
Subjective Measures ◽  
Repeated Measures Design ◽  
Hearing Instruments ◽  
Data Collection And Analysis ◽  
Significant Difference ◽  
Occlusion Effect

Background: Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome. Purpose: To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr). Data Collection and Analysis: Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period. Results: Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments. Conclusions: Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.

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