Hearing Aid Evaluation

1993 ◽  
Vol 36 (3) ◽  
pp. 621-633 ◽  
Author(s):  
Harvey Dillon

In this study, hearing aid gain for speech was defined as the difference in level between the aided and unaided performance-intensity functions measured at any specific value of percentage of items correct. The articulation index method was used to predict speech gain based on the subject’s unaided sound field thresholds, ambient room noise, hearing aid internal noise, hearing aid insertion gain, and the subject’s unaided performance-intensity function. Predicted speech gain agreed with measured speech gain with rms errors of only 3 dB for 11 subjects with mild or moderate hearing loss tested with monosyllabic words and continuous discourse. The speech gain provided by a hearing aid can thus be predicted from electroacoustic measures, which generally can be obtained in a shorter time. Importance functions believed to be applicable to nonsense syllables, words, and continuous discourse were used to make the predictions, but prediction accuracy was not affected by the importance function chosen. Speech gain measured with the monosyllabic word test was highly correlated with speech gain measured with the continuous discourse test, provided that similar presentation levels were used.

1970 ◽  
Vol 13 (4) ◽  
pp. 789-811 ◽  
Author(s):  
Tom W. Tillman ◽  
Raymond Carhart ◽  
Wayne O. Olsen

Discrimination for monosyllabic words heard against competing sentences was measured at the same sensation level during unaided and aided listening using four types of subject: normal hearers, conductive loss cases, nonpresbycusic sensorineurals, and presbycusics. There were 12 subjects per group. Listening against competing sentences was binaural, monaural direct, and monaural indirect at nominal primary-to-secondary ratios of +18 and +6 dB. Unaided measures, including SRT and monosyllabic discrimination, were obtained by sound field testing conditions; aided measures were obtained with the subject in a separate room wearing the hearing aid receiver and earmold while the hearing aids were mounted on an artificial head placed in the sound field test chamber. The aided measures were obtained at two sound field levels (70 dB and 60 dB SPL) and at two gain settings (50 dB and 40 dB). The main findings were (1) that the hearing-impaired required more of an increase in SPL, re performance in the sound field, to achieve spondee threshold via the hearing aid than can be accounted for by the difference in methodology alone, (2) that intelligibility of monosyllabic words in quiet was somewhat poorer during aided listening than during unaided listening even though sensation level was held constant, (3) that subjects with presbycusis and other sensorineural losses were less resistant to masking by competing sentences during unaided listening than were subjects with normal hearing or with conductive loss, and (4) that all groups exhibited reduced intelligibility for a constant sensation level. This last effect was particularly severe for patients with presbycusic and other sensorineural hearing loss. The practical implications of these findings are discussed.


2020 ◽  
Vol 25 (4) ◽  
pp. 215-223
Author(s):  
James R. Dornhoffer ◽  
Ted A. Meyer ◽  
Judy R. Dubno ◽  
Theodore R. McRackan

Purpose: To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. Methods: Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. Results: Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively). Conclusion: Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.


2020 ◽  
Vol 24 ◽  
pp. 233121652093054
Author(s):  
Carol L. Mackersie ◽  
Arthur Boothroyd ◽  
Harinath Garudadri

While listening to recorded sentences with a sound-field level of 65 dB SPL, 24 adults with hearing-aid experience used the “Goldilocks” explore-and-select procedure to adjust level and spectrum of amplified speech to preference. All participants started adjustment from the same generic response. Amplification was provided by a custom-built Master Hearing Aid with online processing of microphone input. Primary goals were to assess the effects of including a formal speech-perception test between repeated self-adjustments and of adding multitalker babble (signal-to-noise ratio +6 dB) during self-adjustment. The speech test did not affect group-mean self-adjusted output, which was close to the National Acoustics Laboratories’ prescription for Non-Linear hearing aids. Individuals, however, showed a wide range of deviations from this prescription. Extreme deviations at the first self-adjustment fell by a small but significant amount at the second. The multitalker babble had negligible effect on group-mean self-selected output but did have predictable effects on word recognition in sentences and on participants’ opinion regarding the most important subjective criterion guiding self-adjustment. Phoneme recognition in monosyllabic words was better with the generic starting response than without amplification and improved further after self-adjustment. The findings continue to support the efficacy of hearing aid self-fitting, at least for level and spectrum. They do not support the need for inclusion of a formal speech-perception test, but they do support the value of completing more than one self-adjustment. Group-mean data did not indicate a need for threshold-based prescription as a starting point for self-adjustment.


Author(s):  
Peter J. Blamey

This chapter aimed to estimate speech perception benefits in quiet for clients with different degrees of hearing loss. The difference between aided and unaided scores on a monosyllabic word test presented binaurally was used as the measure of benefit. Retrospective data for 492 hearing aid users with four-frequency pure-tone average hearing losses (PTA) ranging from 5 dB HL to 76 dB HL in the better ear were analyzed using nonlinear regression. The mean benefit for the perception of monosyllabic words in this group of clients was 22.3% and the maximum expected benefit was 33.6% for a PTA of 52 dB HL. The expected benefit can be expressed as a reduction of the error rate by about half for isolated words and about one quarter for sentences across the full range of PTA.


1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.


1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.


Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  

Abstract Background Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. Purpose To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. Research Design An observational study. Study Sample Thirty-nine older adults with hearing loss. Data Collection and Analysis The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. Results For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029–0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28–0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. Conclusion The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.


2008 ◽  
Vol 19 (06) ◽  
pp. 496-506 ◽  
Author(s):  
Richard H. Wilson ◽  
Rachel McArdle ◽  
Heidi Roberts

Background: So that portions of the classic Miller, Heise, and Lichten (1951) study could be replicated, new recorded versions of the words and digits were made because none of the three common monosyllabic word lists (PAL PB-50, CID W-22, and NU–6) contained the 9 monosyllabic digits (1–10, excluding 7) that were used by Miller et al. It is well established that different psychometric characteristics have been observed for different lists and even for the same materials spoken by different speakers. The decision was made to record four lists of each of the three monosyllabic word sets, the monosyllabic digits not included in the three sets of word lists, and the CID W-1 spondaic words. A professional female speaker with a General American dialect recorded the materials during four recording sessions within a 2-week interval. The recording order of the 582 words was random. Purpose: To determine—on listeners with normal hearing—the psychometric properties of the five speech materials presented in speech-spectrum noise. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M = 23 years) with normal pure-tone thresholds (≤20-dB HL at 250 to 8000 Hz) participated. The participants were university students who were unfamiliar with the test materials. Data Collection and Analysis: The 582 words were presented at four signal-to-noise ratios (SNRs; −7-, −2-, 3-, and 8-dB) in speech-spectrum noise fixed at 72-dB SPL. Although the main metric of interest was the 50% point on the function for each word established with the Spearman-Kärber equation (Finney, 1952), the percentage correct on each word at each SNR was evaluated. The psychometric characteristics of the PB-50, CID W-22, and NU–6 monosyllabic word lists were compared with one another, with the CID W-1 spondaic words, and with the 9 monosyllabic digits. Results: Recognition performance on the four lists within each of the three monosyllabic word materials were equivalent, ±0.4 dB. Likewise, word-recognition performance on the PB-50, W-22, and NU–6 word lists were equivalent, ±0.2 dB. The mean recognition performance at the 50% point with the 36 W-1 spondaic words was ˜6.2 dB lower than the 50% point with the monosyllabic words. Recognition performance on the monosyllabic digits was 1–2 dB better than mean performance on the monosyllabic words. Conclusions: Word-recognition performances on the three sets of materials (PB-50, CID W-22, and NU–6) were equivalent, as were the performances on the four lists that make up each of the three materials. Phonetic/phonemic balance does not appear to be an important consideration in the compilation of word-recognition lists used to evaluate the ability of listeners to understand speech.A companion paper examines the acoustic, phonetic/phonological, and lexical variables that may predict the relative ease or difficulty for which these monosyllable words were recognized in noise (McArdle and Wilson, this issue).


2021 ◽  
Vol 32 (07) ◽  
pp. 395-404
Author(s):  
Adam Voss ◽  
Alison Brockmeyer ◽  
Michael Valente ◽  
John Pumford ◽  
Cameron C. Wick ◽  
...  

Abstract Background Best practice guidelines for verifying fittings of bone-anchored hearing devices (BAHD) recommend using aided sound-field thresholds (ASFT), but express caution regarding the variables impacting obtaining valid and reliable ASFTs.1 Recently, a skull simulator was introduced to facilitate programming BAHD devices in force level (FL) to desired sensation level-bone conduction devices (skull simulator/DSL-BCD)2 3 targets in a hearing aid analyzer. Currently, no evidence is available reporting if differences in measured FL using the manufacturer first-fit (FF) and word recognition in quiet, sentence reception threshold in noise, and subjective outcomes are present for a BAHD programmed using ASFT versus programmed using skull simulator/DSL-BCD targets. Purpose The aim of this study was to examine if significant differences were present in FL using the FF and word recognition in quiet at 50 and 65 decibel of sound pressure level (dB SPL), sentence reception threshold in noise and subjective outcomes using the abbreviated profile of hearing aid benefit (APHAB), and speech, spatial, and qualities of hearing (SSQ) between a BAHD fit using ASFT or skull simulator/DSL-BCD targets. Research Design A double-blind randomized crossover design with 15 adults having unilateral sensorineural hearing loss. All participants were successful users of the Cochlear America Baha 5. Data Collection and Analysis Baha Power 5 devices were fit using FF, ASFT, and skull simulator/DSL-BCD targets. Order of the three fitting strategies was randomly assigned and counter-balanced. Results No significant differences were found for a BAHD device programmed using ASFT versus skull simulator/DSL-BCD targets for consonant-nucleus-consonant words in quiet at 50 or 65 dB SPL, sentence reception threshold in noise, the APHAB or SSQ. There were, however, significant differences, at primarily 500 to 2,000 Hz in measured FLs between the FF, ASFT, and skull simulator/DSL-BCD targets at 50 and 65 dB SPL. Conclusions There were no significant differences in subject performance with two speech measures and subjective responses to two questionnaires for BAHD fittings using ASFT versus using skull simulator/DSL-BCD targets. Differences in FL between the three fitting strategies were present primarily at 500 to 2,000 Hz. Limitations of the study are highlighted along with situations where the skull simulator can play a significantly beneficial role when fitting BAHD devices.


1971 ◽  
Vol 36 (2) ◽  
pp. 208-212 ◽  
Author(s):  
Herbert J. Arkebauer ◽  
George T. Mencher ◽  
Carol McCall

Ten patients with bilateral asymmetrical hearing losses were tested for differences in speech discrimination scores under the following listening conditions: poorer ear under earphone; better ear under earphone; sound field, ears unoccluded; and sound field, poorer ear occluded. A patient manifesting a bilateral asymmetrical hearing loss may not be able to either separate or integrate two speech signals; however, occlusion of the poorer ear may be an advantageous means of obtaining maximum speech discrimination. Examination of the speech discrimination scores indicates the existence of detrimental interaction between ears exhibiting bilateral asymmetrical hearing loss. These findings also indicate that when the difference between ears is greater, speech discrimination is better than when asymmetry approximates symmetry. Apparently, the greater the impairment in the better ear, the greater the results to be gained by occluding the poorer ear. These findings were interpreted as being relevant in determining candidacy for binaural amplification. Such candidacy should be determined on the basis of speech discrimination scores obtained from each ear independently, and the combined effect of both aids.


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