Hearing Aids in the Real World: Typical Automatic Behavior of Expansion, Directionality, and Noise Management

2011 ◽  
Vol 22 (01) ◽  
pp. 034-048 ◽  
Author(s):  
Shilpi Banerjee
Keyword(s):  
Hearing Aids ◽  
Real World ◽  
Hearing Aid ◽  
Published Data ◽  
Data Logging ◽  
High Input ◽  
Real World Data ◽  
The Real ◽  
Input Level ◽  
Noise Management

Background: Automatic DSP (digital signal processing) features, widely available in hearing aids today, are useful because they alleviate the need for the hearing aid wearer to manually adjust the hearing aid as listening conditions change. Although the theoretical basis for the design of these features may be sound, little is known about their behavior in the real world. Data logging offers a glimpse into the life of the individual hearing aid wearer, but there are no published data to date that provide a frame of reference for the interpretation of this information. Further, data logging in hearing aids provides only aggregate summaries for individual features, ignoring complex interactions including the differences between the left and right sides of a bilateral pair. Purpose: The purpose of this study was to determine the typical behavior of three automatic DSP hearing aid features—expansion, directionality, and noise management—in daily life. Data Collection and Analysis: Ten individuals with hearing impairment were fitted bilaterally with BTE (behind the ear) hearing aids. The hearing aids were programmed for the individual's hearing loss with expansion, directionality, and noise management set to activate automatically. A PDA (personal digital assistant) logged the input level and status of expansion, directionality, and noise management from both devices at 5 sec intervals. Data were gathered in this manner over a period of 4–5 wk. Results: A total of 741 hr of hearing aid use were logged, 50% of which were spent in environments no louder than 50 dB SPL. Expansion, directionality, and noise management were active 45, 10, and 21% of the time, respectively; the median amount of gain reduction for noise management was ˜1 dB. Although expansion and noise management were always active at the low and high input levels, respectively, activation of directionality never exceeded 50%. Expansion and noise management were sometimes active simultaneously, as were directionality and noise management. Bilateral agreement in feature activation typically exceeded 80%, except when the input level was at the cusp of a threshold for activation of a specific feature and at high input levels.

scholarly journals Clustering Users Based on Hearing Aid Use: An Exploratory Analysis of Real-World Data

2021 ◽  
Vol 3 ◽  
Author(s):  
Alessandro Pasta ◽  
Tiberiu-Ioan Szatmari ◽  
Jeppe Høy Christensen ◽  
Kasper Juul Jensen ◽  
Niels Henrik Pontoppidan ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Real World ◽  
Hearing Aid ◽  
Objective Data ◽  
Data Logging ◽  
Real World Data ◽  
Hearing Aid Use ◽  
User Clustering ◽  
Usage Patterns ◽  
Typical Day

While the assessment of hearing aid use has traditionally relied on subjective self-reported measures, smartphone-connected hearing aids enable objective data logging from a large number of users. Objective data logging allows to overcome the inaccuracy of self-reported measures. Moreover, data logging enables assessing hearing aid use with a greater temporal resolution and longitudinally, making it possible to investigate hourly patterns of use and to account for the day-to-day variability. This study aims to explore patterns of hearing aid use throughout the day and assess whether clusters of users with similar use patterns can be identified. We did so by analyzing objective hearing aid use data logged from 15,905 real-world users over a 4-month period. Firstly, we investigated the daily amount of hearing aid use and its within-user and between-user variability. We found that users, on average, used the hearing aids for 10.01 h/day, exhibiting a substantial between-user (SD = 2.76 h) and within-user (SD = 3.88 h) variability. Secondly, we examined hearing aid use hourly patterns by clustering 453,612 logged days into typical days of hearing aid use. We identified three typical days of hearing aid use: full day (44% of days), afternoon (27%), and sporadic evening (26%) day of hearing aid use. Thirdly, we explored the usage patterns of the hearing aid users by clustering the users based on the proportion of time spent in each of the typical days of hearing aid use. We found three distinct user groups, each characterized by a predominant (i.e., experienced ~60% of the time) typical day of hearing aid use. Notably, the largest user group (49%) of users predominantly had full days of hearing aid use. Finally, we validated the user clustering by training a supervised classification ensemble to predict the cluster to which each user belonged. The high accuracy achieved by the supervised classifier ensemble (~86%) indicated valid user clustering and showed that such a classifier can be successfully used to group new hearing aid users in the future. This study provides a deeper insight into the adoption of hearing care treatments and paves the way for more personalized solutions.

scholarly journals The everyday acoustic environment and its association with human heart rate: evidence from real-world data logging with hearing aids and wearables

2020 ◽  
Author(s):  
Jeppe H. Christensen ◽  
Gabrielle H. Saunders ◽  
Michael Porsbo ◽  
Niels H. Pontoppidan
Keyword(s):  
Heart Rate ◽  
Hearing Aids ◽  
Real World ◽  
Data Logging ◽  
Environmental Sound ◽  
Real World Data ◽  
Heart Rates ◽  
World Data ◽  
Ambient Sound ◽  
Mean Heart Rate

AbstractWe investigate the longitudinal association between multidimensional characteristics of everyday ambient sound and continuous mean heart rate. We used in-market data from hearing aid users who logged ambient acoustics via smartphone-connected hearing aids and continuous heart rate from their own wearables.We find that ambient acoustic characteristics explain approximately 4% of the fluctuation in mean heart rate throughout the day. Specifically, increases in ambient sound pressure intensity are significantly related to increases in mean heart rates, corroborating prior laboratory and short-term real-world data. In addition, however, and not previously recognized, increases in the ambient sound quality - that is, the difference between sound signal and noise - are associated with decreases in mean heart rates.Our findings document a mixed influence of everyday sounds on cardiovascular stress, and that the relationship is more complex than is seen from examination of sound intensity alone. Thus, our findings highlight the relevance of ambient environmental sound in models of human ecophysiology.

scholarly journals The everyday acoustic environment and its association with human heart rate: evidence from real-world data logging with hearing aids and wearables

2021 ◽  
Vol 8 (2) ◽  
pp. 201345
Author(s):  
Jeppe H. Christensen ◽  
Gabrielle H. Saunders ◽  
Michael Porsbo ◽  
Niels H. Pontoppidan
Keyword(s):  
Heart Rate ◽  
Hearing Aids ◽  
Real World ◽  
Data Logging ◽  
Short Term ◽  
Real World Data ◽  
Acoustic Characteristics ◽  
World Data ◽  
Ambient Sound ◽  
Mean Heart Rate

We investigate the short-term association between multidimensional acoustic characteristics of everyday ambient sound and continuous mean heart rate. We used in-market data from hearing aid users who logged ambient acoustics via smartphone-connected hearing aids and continuous mean heart rate in 5 min intervals from their own wearables. We find that acoustic characteristics explain approximately 4% of the fluctuation in mean heart rate throughout the day. Specifically, increases in ambient sound pressure intensity are significantly related to increases in mean heart rate, corroborating prior laboratory and short-term real-world data. In addition, increases in ambient sound quality—that is, more favourable signal to noise ratios—are associated with decreases in mean heart rate. Our findings document a previously unrecognized mixed influence of everyday sounds on cardiovascular stress, and that the relationship is more complex than is seen from an examination of sound intensity alone. Thus, our findings highlight the relevance of ambient environmental sound in models of human ecophysiology.

Digitizing the Pharma Neurons – A Technological Operation in Progress!

2020 ◽  
Vol 15 (3) ◽  
pp. 178-187
Author(s):  
Payal Bhardwaj ◽  
Raj Kumar Yadav ◽  
Sojan Kurian
Keyword(s):  
Clinical Trials ◽  
Personalized Medicine ◽  
Real World ◽  
Published Data ◽  
Online Information ◽  
Real World Data ◽  
The Real ◽  
Great Consideration ◽  
Increasing Demand ◽  
The Impact

Background: Digitization and automation are the buzzwords in clinical research and pharma companies are investigating heavily here. Right from drug discovery to personalized medicine, digital patients and patient engagement, there is great consideration of technology at each step. Methods: The published data and online information available is reviewed to give an overview of digitization in pharma, across the drug development cycle, industry collaborations and innovations. The regulatory guidelines, innovative collaborations across industry, academics and thought leadership are presented. Also included are some ideas, suggestions, way forwards while digitizing the pharma neurons, the regulatory stand, benefits and challenges. Results: The innovations range from discovering personalized medicine to conducting virtual clinical trials, and maximizing data collection from the real-world experience. To address the increasing demand for the real-world data and the needs of tech-savvy patients, the innovations are shaping up accordingly. Pharma companies are collaborating with academics and they are co-innovating the technology for example Massachusetts Institute of Technology’s program. This focuses on the modernization of clinical trials, strategic use of artificial intelligence and machine learning using real-world evidence, assess the risk-benefit ratio of deploying digital analytics in medicine, and proactively identifying the solutions. Conclusions: With unfolding data on the impact of science and technology amalgamation, we need shared mindset between data scientists and medical professionals to maximize the utility of enormous health and medical data. To tackle this efficiently, there is a need of cross-collaboration and education, and align with ethical and regulatory requirements. A perfect blend of industry, regulatory, and academia will ensure successful digitization of pharma neurons.

Comparing NAL-NL1 and DSL v5 in Hearing Aids Fit to Children with Severe or Profound Hearing Loss: Goodness of Fit-to-Targets, Impacts on Predicted Loudness and Speech Intelligibility

2015 ◽  
Vol 26 (03) ◽  
pp. 260-274 ◽  
Author(s):  
Teresa Y.C. Ching ◽  
Tian Kar Quar ◽  
Earl E. Johnson ◽  
Philip Newall ◽  
Mridula Sharma
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Goodness Of Fit ◽  
Hearing Aid ◽  
High Input ◽  
Profound Hearing Loss ◽  
Significant Difference ◽  
The Impact ◽  
Input Level

Background: An important goal of providing amplification to children with hearing loss is to ensure that hearing aids are adjusted to match targets of prescriptive procedures as closely as possible. The Desired Sensation Level (DSL) v5 and the National Acoustic Laboratories’ prescription for nonlinear hearing aids, version 1 (NAL-NL1) procedures are widely used in fitting hearing aids to children. Little is known about hearing aid fitting outcomes for children with severe or profound hearing loss. Purpose: The purpose of this study was to investigate the prescribed and measured gain of hearing aids fit according to the NAL-NL1 and the DSL v5 procedure for children with moderately severe to profound hearing loss; and to examine the impact of choice of prescription on predicted speech intelligibility and loudness. Research Design: Participants were fit with Phonak Naida V SP hearing aids according to the NAL-NL1 and DSL v5 procedures. The Speech Intelligibility Index (SII) and estimated loudness were calculated using published models. Study Sample: The sample consisted of 16 children (30 ears) aged between 7 and 17 yr old. Data Collection and Analysis: The measured hearing aid gains were compared with the prescribed gains at 50 (low), 65 (medium), and 80 dB SPL (high) input levels. The goodness of fit-to-targets was quantified by calculating the average root-mean-square (RMS) error of the measured gain compared with prescriptive gain targets for 0.5, 1, 2, and 4 kHz. The significance of difference between prescriptions for hearing aid gains, SII, and loudness was examined by performing analyses of variance. Correlation analyses were used to examine the relationship between measures. Results: The DSL v5 prescribed significantly higher overall gain than the NAL-NL1 procedure for the same audiograms. For low and medium input levels, the hearing aids of all children fit with NAL-NL1 were within 5 dB RMS of prescribed targets, but 33% (10 ears) deviated from the DSL v5 targets by more than 5 dB RMS on average. For high input level, the hearing aid fittings of 60% and 43% of ears deviated by more than 5 dB RMS from targets of NAL-NL1 and DSL v5, respectively. Greater deviations from targets were associated with more severe hearing loss. On average, the SII was higher for DSL v5 than for NAL-NL1 at low input level. No significant difference in SII was found between prescriptions at medium or high input level, despite greater loudness for DSL v5 than for NAL-NL1. Conclusions: Although targets between 0.25 and 2 kHz were well matched for both prescriptions in commercial hearing aids, gain targets at 4 kHz were matched for NAL-NL1 only. Although the two prescriptions differ markedly in estimated loudness, they resulted in comparable predicted speech intelligibility for medium and high input levels.

Hearing Aids in the Real World: Use of Multimemory and Volume Controls

2011 ◽  
Vol 22 (06) ◽  
pp. 359-374 ◽  
Author(s):  
Shilpi Banerjee
Keyword(s):  
Hearing Aids ◽  
Real World ◽  
Hearing Aid ◽  
Personal Digital Assistant ◽  
Bilateral Symmetry ◽  
Time Data ◽  
Environmental Characteristics ◽  
Factors Affecting ◽  
The Real ◽  
Left And Right

Background: Despite advances in technology, hearing aid users continue to express a desire for some control over their devices. Access to a suitable control can significantly affect overall satisfaction with amplification, yet little is known about the circumstances that drive hearing aid users to manipulate controls. Such information would be useful in guiding clinical decisions about the selection of controls and synchronization of their operation in a bilateral pair of hearing aids. Purpose: The purpose of this study was to examine the real-world use of multimemory (MM) and volume (VC) controls and environmental characteristics that may influence their use. Research Design: Real-time data about MM and VC usage were gathered in the real world. Subjective reports of the environmental characteristics were obtained. This design allowed examination of the nature of hearing aid adjustments as well as exploration of factors affecting them. Study Sample: Ten adults with bilaterally symmetric, mild-to-moderate sensorineural hearing loss participated in the study. All had previous experience with hearing aids. Intervention: Participants were fitted bilaterally with BTE (behind-the-ear) hearing aids equipped with an MM button and/or VC wheel. The devices were connected to a PDA (personal digital assistant) that logged data from the hearing aids and stored surveys completed by participants in various listening situations. Data Collection and Analysis: The following data were obtained from the PDA: (1) MM and VC settings in the left and right devices, (2) broadband input level at the microphone of the left and right devices, and (3) participant reports of the presence, distance, and location of signal and background noise. Prevalence of nondefault settings and bilateral symmetry of hearing aid adjustments were summarized descriptively, while the influence of environmental characteristics on hearing aid adjustments was analyzed using nonparametric methods. Results: Over 4–5 wk, 912 hr of data were logged and 184 surveys completed. Results showed that (1) the default (i.e., the programmed or “use”) setting was preferred most often, (2) the preferred hearing aid settings were mostly bilaterally symmetrical, and (3) nondefault settings were often used in difficult listening situations. Conclusions: The findings of this study generally support the use of synchronized MMs and/or VCs, although there may be exceptions to their utility.

scholarly journals Parameter Optimization for Real-World ENSO Forecast in an Intermediate Coupled Model

2019 ◽  
Vol 147 (5) ◽  
pp. 1429-1445 ◽  
Author(s):  
Yuchu Zhao ◽  
Zhengyu Liu ◽  
Fei Zheng ◽  
Yishuai Jin
Keyword(s):  
Data Assimilation ◽  
Parameter Optimization ◽  
Real World ◽  
Climate Models ◽  
Coupled Model ◽  
Prediction Skill ◽  
Model Parameters ◽  
Real World Data ◽  
The Real ◽  
Advection Term

Abstract We performed parameter estimation in the Zebiak–Cane model for the real-world scenario using the approach of ensemble Kalman filter (EnKF) data assimilation and the observational data of sea surface temperature and wind stress analyses. With real-world data assimilation in the coupled model, our study shows that model parameters converge toward stable values. Furthermore, the new parameters improve the real-world ENSO prediction skill, with the skill improved most by the parameter of the highest climate sensitivity (gam2), which controls the strength of anomalous upwelling advection term in the SST equation. The improved prediction skill is found to be contributed mainly by the improvement in the model dynamics, and second by the improvement in the initial field. Finally, geographic-dependent parameter optimization further improves the prediction skill across all the regions. Our study suggests that parameter optimization using ensemble data assimilation may provide an effective strategy to improve climate models and their real-world climate predictions in the future.

scholarly journals Trastuzumab-based palliative chemotherapy for HER2-positive gastric cancer: a single-center real-world data

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tae-Hwan Kim ◽  
Hun Do Cho ◽  
Yong Won Choi ◽  
Hyun Woo Lee ◽  
Seok Yun Kang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Real World ◽  
Group Performance ◽  
Eastern Cooperative Oncology Group ◽  
Conversion Surgery ◽  
Single Center ◽  
Her2 Positive ◽  
Real World Data ◽  
World Data ◽  
The Real

Abstract Background Since the results of the ToGA trial were published, trastuzumab-based chemotherapy has been used as the standard first-line treatment for HER2-positive recurrent or primary metastatic gastric cancer (RPMGC). However, the real-world data has been rarely reported. Therefore, we investigated the outcomes of trastuzumab-based chemotherapy in a single center. Methods This study analyzed the real-world data of 47 patients with HER2-positive RPMGC treated with trastuzumab-based chemotherapy in a single institution. Results With the median follow-up duration of 18.8 months in survivors, the median overall survival (OS) and progression-free survival were 12.8 and 6.9 months, respectively, and the overall response rate was 64%. Eastern Cooperative Oncology Group performance status 2 and massive amount of ascites were independent poor prognostic factors for OS, while surgical resection before or after chemotherapy was associated with favorable OS, in multivariate analysis. In addition, 5 patients who underwent conversion surgery after chemotherapy demonstrated an encouraging median OS of 30.8 months, all with R0 resection. Conclusions Trastuzumab-based chemotherapy in patients with HER2-positive RPMGC in the real world demonstrated outcomes almost comparable to those of the ToGA trial. Moreover, conversion surgery can be actively considered in fit patients with a favorable response after trastuzumab-based chemotherapy.

Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers

2017 ◽  
Vol 28 (10) ◽  
pp. 883-892 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Todd A. Ricketts ◽  
Anne Marie Tharpe
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Parent Report ◽  
School Age Children ◽  
School Age ◽  
Data Logging ◽  
Hearing Aid Use ◽  
System Use ◽  
Children With Hearing Loss

Background: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children’s hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. Purpose: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. Study Sample: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. Data Collection and Analysis: Parents and teachers of children completed written surveys about each child’s hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer’s software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. Results: Average daily hearing aid use time was ˜6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ˜1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child’s ability to manage their hearing devices independently. Conclusions: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children’s hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.

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