Verification of In Situ Thresholds and Integrated Real-Ear Measurements

2010 ◽  
Vol 21 (10) ◽  
pp. 663-670 ◽  
Author(s):  
Jeffrey J. DiGiovanni ◽  
Ryan M. Pratt

Background: Accurate prescriptive gain results in a more accurate fit, lower return rate in hearing aids, and increased patient satisfaction. In situ threshold measurements can be used to determine required gain. The Widex Corporation uses an in situ threshold measurement strategy, called the Sensogram. Real-ear measurements determine if prescriptive gain targets have been achieved. Starkey Laboratories introduced an integrated real-ear measurement system in their hearing aids. Purpose: To determine whether the responses obtained using the Widex Sensogram were equivalent to those obtained using current clinical threshold measurement methods. To determine the accuracy of the Starkey IREMS™ (Integrated Real Ear Measurement System) in measuring RECD (real-ear to coupler difference) values compared to a dedicated real-ear measurement system. Research Design: A verification design was employed by comparing participant data measured from standard, benchmark equipment and procedures against new techniques offered by hearing-aid manufacturers. Study Sample: A total of 20 participants participated in this study. Ten participants with sensorineural hearing loss were recruited from the Ohio University Hearing, Speech, and Language Clinic participated in the first experiment. Ten participants with normal hearing were recruited from the student population at Ohio University participated in both experiments. The normal-hearing group had thresholds of 15 dB HL or better at the octave frequencies of 250–8000 Hz. The hearing-impaired group had thresholds of varying degrees and configurations with thresholds equal to or poorer than 25 dB HL three-frequency pure-tone average. Data Collection and Analysis: The order of measurement method for both experiments was counterbalanced. In Experiment 1, thresholds obtained via the Widex Sensogram were compared to thresholds obtained for each participant using a clinical audiometer and ER-3A insert ear phones. In Experiment 2, RECD values obtained via the Starkey IREMS were compared to RECD values obtained via the Audioscan Verifit™. A repeated-measures analysis of variance (ANOVA) was used for statistical analysis, and a Fisher's LSD (least significant difference) was used as a post hoc analysis tool. Results: A significant difference between Sensogram thresholds and conventional audiometric thresholds was found with the Sensogram method resulting in better threshold values at 0.5, 1.0, and 2.0 kHz for both groups. In Experiment 2, a significant difference between RECD values obtained by the Starkey IREMS and the Audioscan Verifit system was found with significant differences in RECD values found at 0.25, 0.5, 0.75, 1.5, 2.0, and 6.0 kHz. Conclusions: The Sensogram data differ significantly from traditional audiometry at several frequencies important for speech intelligibility. Real-ear measures are still required for verification of prescribed gain, however, calling into question any claims of shortened fitting time. The Starkey IREMS does perform real-ear measurements that vary significantly from benchmark equipment. These technologies represent a positive direction in prescribing accurate gain during hearing-aid fittings, but a stand-alone system is still the preferred method for real-ear measurements in hearing-aid fittings.

2020 ◽  
Vol 5 (1) ◽  
pp. 36-39
Author(s):  
Mariya Yu. Boboshko ◽  
Irina P. Berdnikova ◽  
Natalya V. Maltzeva

Objectives -to determine the normative data of sentence speech intelligibility in a free sound field and to estimate the applicability of the Russian Matrix Sentence test (RuMatrix) for assessment of the hearing aid fitting benefit. Material and methods. 10 people with normal hearing and 28 users of hearing aids with moderate to severe sensorineural hearing loss were involved in the study. RuMatrix test both in quiet and in noise was performed in a free sound field. All patients filled in the COSI questionnaire. Results. The hearing impaired patients were divided into two subgroups: the 1st with high and the 2nd with low hearing aid benefit, according to the COSI questionnaire. In the 1st subgroup, the threshold for the sentence intelligibility in quiet was 34.9 ± 6.4 dB SPL, and in noise -3.3 ± 1.4 dB SNR, in the 2nd subgroup 41.7 ± 11.5 dB SPL and 0.15 ± 3.45 dB SNR, respectively. The significant difference between the data of both subgroups and the norm was registered (p


2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.


2021 ◽  
Vol 11 (2) ◽  
pp. 200-206
Author(s):  
Gennaro Auletta ◽  
Annamaria Franzè ◽  
Carla Laria ◽  
Carmine Piccolo ◽  
Carmine Papa ◽  
...  

Background: The aim of this study was to compare, in users of bimodal cochlear implants, the performance obtained using their own hearing aids (adjusted with the standard NAL-NL1 fitting formula) with the performance using the Phonak Naìda Link Ultra Power hearing aid adjusted with both NAL-NL1 and a new bimodal system (Adaptive Phonak Digital Bimodal (APDB)) developed by Advanced Bionics and Phonak Corporations. Methods: Eleven bimodal users (Naìda CI Q70 + contralateral hearing aid) were enrolled in our study. The users’ own hearing aids were replaced with the Phonak Naìda Link Ultra Power and fitted following the new formula. Speech intelligibility was assessed in quiet and noisy conditions, and comparisons were made with the results obtained with the users’ previous hearing aids and with the Naída Link hearing aids fitted with the NAL-NL1 generic prescription formula. Results: Using Phonak Naìda Link Ultra Power hearing aids with the Adaptive Phonak Digital Bimodal fitting formula, performance was significantly better than that with the users’ own rehabilitation systems, especially in challenging hearing situations for all analyzed subjects. Conclusions: Speech intelligibility tests in quiet settings did not reveal a significant difference in performance between the new fitting formula and NAL-NL1 fittings (using the Naída Link hearing aids), whereas the performance difference between the two fittings was very significant in noisy test conditions.


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.


1999 ◽  
Vol 8 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Melisa R. Ellis ◽  
Michael K. Wynne

The loudness growth in 1/2-octave bands (LGOB) procedure has been shown previously to provide valid estimates of loudness growth for adults with normal hearing and those with hearing loss (Allen, Hall, & Jeng, 1990), and it has been widely incorporated into fitting strategies for adult hearing aid users by a hearing aid manufacturer. Here, we applied a simple modification of LGOB to children and adults with normal hearing and then compared the loudness growth functions (as obtained from end-point data) between the two age groups. In addition, reliability data obtained within a single session and between test sessions were compared between the two groups. Large differences were observed in the means between the two groups for the lower boundary values, the upper boundary values, and the range between boundaries both within and across all frequencies. The data obtained from children also had greater variance than the adult data. In addition, there was more variability in the data across test sessions for children. Many test-retest differences for children exceeded 10 dB. Adult test-retest differences were generally less than 10 dB. Although the LGOB with the modifications used in this study may be used to measure loudness growth in children, its poor reliability with this age group may limit its clinical use for children with hearing loss. Additional work is needed to explore whether loudness growth measures can be adapted successfully to children and whether these measures contribute worthwhile information for fitting hearing aids to children.


2012 ◽  
Vol 23 (08) ◽  
pp. 606-615 ◽  
Author(s):  
HaiHong Liu ◽  
Hua Zhang ◽  
Ruth A. Bentler ◽  
Demin Han ◽  
Luo Zhang

Background: Transient noise can be disruptive for people wearing hearing aids. Ideally, the transient noise should be detected and controlled by the signal processor without disrupting speech and other intended input signals. A technology for detecting and controlling transient noises in hearing aids was evaluated in this study. Purpose: The purpose of this study was to evaluate the effectiveness of a transient noise reduction strategy on various transient noises and to determine whether the strategy has a negative impact on sound quality of intended speech inputs. Research Design: This was a quasi-experimental study. The study involved 24 hearing aid users. Each participant was asked to rate the parameters of speech clarity, transient noise loudness, and overall impression for speech stimuli under the algorithm-on and algorithm-off conditions. During the evaluation, three types of stimuli were used: transient noises, speech, and background noises. The transient noises included “knife on a ceramic board,” “mug on a tabletop,” “office door slamming,” “car door slamming,” and “pen tapping on countertop.” The speech sentences used for the test were presented by a male speaker in Mandarin. The background noises included “party noise” and “traffic noise.” All of these sounds were combined into five listening situations: (1) speech only, (2) transient noise only, (3) speech and transient noise, (4) background noise and transient noise, and (5) speech and background noise and transient noise. Results: There was no significant difference on the ratings of speech clarity between the algorithm-on and algorithm-off (t-test, p = 0.103). Further analysis revealed that speech clarity was significant better at 70 dB SLP than 55 dB SPL (p < 0.001). For transient noise loudness: under the algorithm-off condition, the percentages of subjects rating the transient noise to be somewhat soft, appropriate, somewhat loud, and too loud were 0.2, 47.1, 29.6, and 23.1%, respectively. The corresponding percentages under the algorithm-on were 3.0, 72.6, 22.9, and 1.4%, respectively. A significant difference on the ratings of the transient noise loudness was found between the algorithm-on and algorithm-off (t-test, p < 0.001). For overall impression for speech stimuli: under the algorithm-off condition, the percentage of subjects rating the algorithm to be not helpful at all, somewhat helpful, helpful, and very helpful for speech stimuli were 36.5, 20.8, 33.9, and 8.9%, respectively. Under the algorithm-on condition, the corresponding percentages were 35.0, 19.3, 30.7, and 15.0%, respectively. Statistical analysis revealed there was a significant difference on the ratings of overall impression on speech stimuli. The ratings under the algorithm-on condition were significantly more helpful for speech understanding than the ratings under algorithm-off (t-test, p < 0.001). Conclusions: The transient noise reduction strategy appropriately controlled the loudness for most of the transient noises and did not affect the sound quality, which could be beneficial to hearing aid wearers.


1980 ◽  
Vol 45 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Jeffrey L. Danhauer ◽  
Gordon W. Blood ◽  
Ingrid M. Blood ◽  
Nancy Gomez

This study determined whether professional and lay observers had similar impressions of preschoolers wearing hearing aids and if the size of the aid affected ratings. Stimuli consisted of three photographic slides of nine normally-hearing and speaking male preschoolers wearing (1) a body-type hearing aid, (2) a post-auricular type aid, and (3) no aid. Slides were accompanied by taped speech samples. Stimuli were presented to 75 professional and 75 lay observers who rated the children on a semantic differential scale containing 15 adjectives. Ratings were submitted to a factor analysis revealing Factor I as achievement and Factor II as appearance. Results of MANOVAs revealed that neither professional nor lay observers discriminated against the children on appearance regardless of the presence of a hearing aid, but that both groups rated them significantly poorer on achievement when an aid was present. Lay observers' ratings showed a bias against the size of the aid, while professionals exhibited negative impressions whenever an aid was present, regardless of its size. These findings indicate that the "hearing aid effect" was present on variables of achievement even for normal-hearing preschoolers.


2009 ◽  
Vol 20 (07) ◽  
pp. 422-432 ◽  
Author(s):  
Victoria A. Williams ◽  
Carole E. Johnson ◽  
Jeffrey L. Danhauer

Purpose: To use the International Outcome Inventory for Hearing Aids (IOI-HA) with patients having advanced hearing aid technology to assess their satisfaction and benefit focusing on gender and experience effects, compare to norms, and use the IOI-HA and a practice-specific questionnaire to monitor the quality of the services provided by a dispensing practice. Research Design: A study of 160 potential participants who had worn their newly purchased multichannel digital hearing aids having directional microphones for at least three months, completed a trial period, and should have had time to acclimatize to them. English-speaking, private or insurance paying, competent, adult patients from a private practice were mailed a 12-item practice-specific questionnaire and the seven-item IOI-HA. Results: Of the160 questionnaires mailed, 73 were returned for a 46% return rate. Of those, 64 were useable. Participants included male (34) and female (30), new (30) and previous (34) hearing aid users, who self-selected their participation by returning the questionnaires. The practice-specific questionnaire assessed patients' demographics and the quality of services received. The IOI-HA was analyzed according to an overall score and on two different factor scores. A power analysis revealed that 19 respondents per group were needed for the IOI-HA results to have a statistical power of .80 and probability of a Type II error of .20 for detecting a significant difference at the p < 0.05 level. Similar to earlier studies, no significant differences were observed either for any of the main effects or interactions for gender or user experience for the two IOI-HA factors and overall scores. A significant, but weak, positive correlation (r = .34; df = 63; p < .05) was observed between patients' overall satisfaction as indicated from the IOI-HA and the practice-specific quality assurance satisfaction question. T-tests on IOI-HA items 4 (satisfaction) and 7 (quality of life) revealed that the present participants' responses were significantly higher than for those in the normative study. Conclusions: Gender and hearing aid experience did not influence these patients' responses on the IOI-HA, and all respondents were satisfied with their hearing aids and the practice that dispensed them. No major differences were found between these patients' IOI-HA results and normative data suggesting that both sets of respondents were satisfied with their hearing aids. However, limited statistical comparisons for the satisfaction and quality of life items revealed significant differences in favor of these participants' scores over those in the normative study. This suggested that the advanced hearing aid technology used here had a positive effect on patients' ratings and that the IOI-HA norms should be updated periodically to reflect changes in technology.


2014 ◽  
Vol 25 (09) ◽  
pp. 893-903 ◽  
Author(s):  
Erik P. Rauterkus ◽  
Catherine V. Palmer

Background: The hearing aid effect is the term used to describe the assignment of negative attributes to individuals using hearing aids. The effect was first empirically identified in 1977 when it was reported that adults rating young children with and without hearing aids assigned negative attributes to the children depicted with hearing aids. Investigations in the 1980s and 1990s reported mixed results related to the extent of the hearing aid effect but continued to identify, on average, some negative attributes assigned to individuals wearing hearing aids. Purpose: The specific aim of this research was to investigate whether the hearing aid effect has diminished in the past several decades by replicating the methods of previous studies for testing the hearing aid effect while using updated devices. Research Design: Five device configurations were rated across eight attributes. Results for each attribute were considered separately. Study Sample: A total of 24 adults judged pictures of young men wearing various ear level technologies across 8 attributes on a 7-point Likert scale. Five young men between ages 15 and 17 yr were photographed wearing each of five device configurations including (1) a standard-sized behind-the-ear (BTE) hearing aid coupled to an earmold with #13 tubing, (2) a mini-BTE hearing aid with a slim tube open-fit configuration, (3) a completely-in-the-canal hearing aid that could not be seen because of its location in the ear canal, (4) an earbud, and (5) a Bluetooth receiver. Data Collection and Analysis: The 24 raters saw pictures of each of the 5 young men with each wearing one of the 5 devices so that devices and young men were never judged twice by the same observer. All judgments of each device, regardless of the young man modeling the device, were combined in the data analysis. The effect of device types on judgments was tested using a one-way between-participant analysis of variance. Results: There was a significant difference on the judgment of age and trustworthiness level among the five devices. However, our post hoc analysis revealed that only two significant effects were present. People wearing a completely-in-the-canal aid (nothing visible in the ear) were rated significantly older than people wearing an earbud, and people wearing the standard-size BTE with earmold were rated significantly more trustworthy than people who wore the Bluetooth device. Conclusions: It was hypothesized that the hearing aid effect would be diminished in 2013 compared with data reported in the past. This proved to be the case, as no hearing aid condition was rated as more negative than any of the non–hearing aid device conditions. In fact, models wearing the standard-size BTE with earmold were rated as more trustworthy than models wearing the Bluetooth device. The standard-sized BTE with earmold condition is the configuration that can be directly compared with previous research because similar devices were used in those studies. These results indicate that the hearing aid effect has diminished, if not completely disappeared, in the 21st century.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258590
Author(s):  
Chihiro Ninomiya ◽  
Harukazu Hiraumi ◽  
Kiyoshi Yonemoto ◽  
Hiroaki Sato

Objective The purpose of this study was to evaluate the effect of hearing aids on body balance function in a strictly controlled auditory environment. Methods We recorded the findings of 10 experienced hearing aid users and 10 normal-hearing participants. All the participants were assessed using posturography under eight conditions in an acoustically shielded non-reverberant room: (1) eyes open with sound stimuli, with and without foam rubber, (2) eyes closed with sound stimuli, with and without foam rubber, (3) eyes open without sound stimuli, with and without foam rubber, and (4) eyes closed without sound stimuli, with and without foam rubber. Results The auditory cue improved the total path area and sway velocity in both the hearing aid users and normal-hearing participants. The analysis of variance showed that the interaction among eye condition, sound condition, and between-group factor was significant in the maximum displacement of the center-of-pressure in the mediolateral axis (F [1, 18] = 6.19, p = 0.02). The maximum displacement of the center-of-pressure in the mediolateral axis improved with the auditory cues in the normal-hearing participants in the eyes closed condition (5.4 cm and 4.7 cm, p < 0.01). In the hearing aid users, this difference was not significant (5.9 cm and 5.7 cm, p = 0.45). The maximum displacement of the center-of-pressure in the anteroposterior axis improved in both the hearing aid users and the normal-hearing participants.


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