scholarly journals Evaluation of Hearing Aid Manufacturers’ Software- Derived Fittings to DSL v5.0 Pediatric Targets

2019 ◽  
Author(s):  
Paula Folkeard ◽  
Marlene Bagatto ◽  
Susan Scollie
Keyword(s):  
Hearing Aids ◽  
Speech Intelligibility ◽  
Chart Review ◽  
Hearing Aid ◽  
Mean Square ◽  
Sensation Level ◽  
Acceptable Range ◽  
Data Collection And Analysis ◽  
Speech Intelligibility Index ◽  
Test Level

Background: Hearing aid prescriptive methods are a commonly recommended component of evidencebasedpreferred practice guidelines and are often implemented in the hearing aid programming software.Previous studies evaluating hearing aid manufacturers’ software-derived fittings to prescriptionshave shown significant deviations from targets. However, few such studies examined the accuracy ofsoftware-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription.<br />Purpose: The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSLv5.0 prescription, across a range of hearing aid brands, audiograms, and test levels.<br />Research Design: This study is a prospective chart review with simulated cases.<br />Data Collection and Analysis: A set of software-derived fittings were created for a six-month-old testcase, across audiograms ranging from mild to profound. The aided output from each fitting was verified inthe test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviationsfrom target across frequencies 250–6000 Hz were calculated, together with the root-mean-square error(RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passagesat 55- and 65-dB SPL were compared with published norms.<br />Study Sample: Thirteen behind-the-ear style hearing aids from eight manufacturers were tested.<br />Results: The amount of deviation per frequency was dependent on the test level and degree of hearingloss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ±5 dB of thetarget for most frequencies. RMSE results revealed more than 84 percent of those hearing aid fittings for themild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearinglosses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiogramsfell within the normative range for DSL pediatric fittings, although they fell within the lower portionof the distribution. For more severe losses, SII values for some hearing aids fell below the normative range.<br />Conclusions: In this study, use of the software-derived manufacturers’ fittings based on the DSL v5.0pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target,particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based onverification of hearing aid output would be required to optimize the fit to target, maximize aided SII, andensure appropriate audibility across all degrees of hearing loss.<br />

scholarly journals Evaluation of Hearing Aid Manufacturers' Software-Derived Fittings to DSL v5.0 Pediatric Targets

2020 ◽  
Vol 31 (05) ◽  
pp. 354-362
Author(s):  
Paula Folkeard ◽  
Marlene Bagatto ◽  
Susan Scollie
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Chart Review ◽  
Hearing Aid ◽  
Test Case ◽  
Data Collection And Analysis ◽  
Speech Intelligibility Index ◽  
Programming Software ◽  
Test Level

Abstract Background Hearing aid prescriptive methods are a commonly recommended component of evidence-based preferred practice guidelines and are often implemented in the hearing aid programming software. Previous studies evaluating hearing aid manufacturers' software-derived fittings to prescriptions have shown significant deviations from targets. However, few such studies examined the accuracy of software-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription. Purpose The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSL v5.0 prescription, across a range of hearing aid brands, audiograms, and test levels. Research Design This study is a prospective chart review with simulated cases. Data Collection and Analysis A set of software-derived fittings were created for a six-month-old test case, across audiograms ranging from mild to profound. The aided output from each fitting was verified in the test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviations from target across frequencies 250-6000 Hz were calculated, together with the root-mean-square error (RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passages at 55- and 65-dB SPL were compared with published norms. Study Sample Thirteen behind-the-ear style hearing aids from eight manufacturers were tested. Results The amount of deviation per frequency was dependent on the test level and degree of hearing loss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ± 5 dB of the target for most frequencies. RMSE results revealed more than 84% of those hearing aid fittings for the mild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearing losses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiograms fell within the normative range for DSL pediatric fittings, although they fell within the lower portion of the distribution. For more severe losses, SII values for some hearing aids fell below the normative range. Conclusions In this study, use of the software-derived manufacturers' fittings based on the DSL v5.0 pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target, particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based on verification of hearing aid output would be required to optimize the fit to target, maximize aided SII, and ensure appropriate audibility across all degrees of hearing loss.

Fit-to-Targets for the Desired Sensation Level Version 5.0a Hearing Aid Prescription Method for Children

2017 ◽  
Vol 26 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Sheila T. F. Moodie ◽  
Susan D. Scollie ◽  
Marlene P. Bagatto ◽  
Kelley Keene ◽  
Keyword(s):  
Hearing Loss ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Sensation Level ◽  
Speech Test ◽  
Typical Performance ◽  
Speech Intelligibility Index ◽  
Rms Error ◽  
Test Level ◽  
Significant Factors

Purpose The purpose of this study was to measure the range of fit to Desired Sensation Level version 5.0 (DSL v5.0) targets in pediatric practice environments. Results will be used in the future to develop clinical-aided speech intelligibility index typical performance data. Method Clinical partners collected data from 161 final hearing aid settings for children aged ≤ 10 years. Measured data were obtained by performing 2-cm 3 coupler-simulated real-ear measurements using the DSL v5.0 implementation on the Audioscan VF-1 (Etymonic Design Inc., Dorchester, ON, Canada) for soft, average, and loud speech inputs and maximum hearing aid output levels. Results Fittings were within ± 5-dB root-mean-square (RMS) error of target for 77%, 80%, and 82% of fittings for the soft, medium, and loud speech test levels, respectively. Aided maximum power output measures were within ± 5-dB RMS error in 72% of cases. Degree of hearing loss, test frequency, and frequency by test level were significant factors in deviation from target. The range of aided speech intelligibility index values exhibited a strong correlation with the hearing levels of the children tested. Conclusion This study provides evidence that typical hearing aid fittings for children can be achieved within ± 5-dB RMS error of the DSL v5.0 target. Greater target deviations were observed at extreme frequencies and as the severity of hearing loss increased.

Factors Associated With Hearing Aid Wear Time in a Subset of U.S. Military Veterans: Tinnitus, the Presence of One or More Neurologic Conditions, and Unaided Speech Intelligibility Index

2021 ◽  
pp. 1-6
Author(s):  
Nicholas P. Giuliani
Keyword(s):  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Military Veterans ◽  
Positive Association ◽  
Negative Association ◽  
Medical Problems ◽  
Wear Time ◽  
Male Veterans ◽  
Speech Intelligibility Index

Purpose A retrospective analysis was conducted to explore how tinnitus, one or more neurologic conditions, unaided speech intelligibility index, and other comorbidities impact the average number of hours hearing aids are worn each day by U.S. Military Veterans. Method Medical records and a hearing aid database were queried to obtain information regarding active medical problems and average daily hearing aid wear time. Multiple linear regression was used to explore these relationships for 215 male Veterans whose records were available from 2009 to 2020. To be analyzed, Veterans must have possessed their hearing aid(s) for at least 3 consecutive months. Results An active problem of subjective tinnitus was associated with increased hearing aid wear time (positive association) and one or more active neurologic conditions were associated with decreased hearing aid wear time (negative association). A high unaided speech intelligibility index (greater access to speech sounds without hearing aids) was also associated with decreased hearing aid wear time (negative association). Conclusions There are many complex audiologic and medical concerns that may affect hearing aid wear time in U.S. Military Veterans. Therefore, the information from this study should be expanded on prospectively by further exploring these associations, and their severity, on hearing aid wear time. The information from this and future studies may lead to clinical recommendations with the goal of increasing daily hearing aid use in this and other populations.

A Comparison of Personal Sound Amplification Products and Hearing Aids in Ecologically Relevant Test Environments

2018 ◽  
Vol 27 (4) ◽  
pp. 581-593 ◽  
Author(s):  
Lisa Brody ◽  
Yu-Hsiang Wu ◽  
Elizabeth Stangl
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Best Practice ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Sound Quality ◽  
Listening Effort ◽  
Speech Intelligibility Index ◽  
Sound Amplification

Purpose The aim of this study was to compare the benefit of self-adjusted personal sound amplification products (PSAPs) to audiologist-fitted hearing aids based on speech recognition, listening effort, and sound quality in ecologically relevant test conditions to estimate real-world effectiveness. Method Twenty-five older adults with bilateral mild-to-moderate hearing loss completed the single-blinded, crossover study. Participants underwent aided testing using 3 PSAPs and a traditional hearing aid, as well as unaided testing. PSAPs were adjusted based on participant preference, whereas the hearing aid was configured using best-practice verification protocols. Audibility provided by the devices was quantified using the Speech Intelligibility Index (American National Standards Institute, 2012). Outcome measures assessing speech recognition, listening effort, and sound quality were administered in ecologically relevant laboratory conditions designed to represent real-world speech listening situations. Results All devices significantly improved Speech Intelligibility Index compared to unaided listening, with the hearing aid providing more audibility than all PSAPs. Results further revealed that, in general, the hearing aid improved speech recognition performance and reduced listening effort significantly more than all PSAPs. Few differences in sound quality were observed between devices. All PSAPs improved speech recognition and listening effort compared to unaided testing. Conclusions Hearing aids fitted using best-practice verification protocols were capable of providing more aided audibility, better speech recognition performance, and lower listening effort compared to the PSAPs tested in the current study. Differences in sound quality between the devices were minimal. However, because all PSAPs tested in the study significantly improved participants' speech recognition performance and reduced listening effort compared to unaided listening, PSAPs could serve as a budget-friendly option for those who cannot afford traditional amplification.

Fit-to-Targets and Aided Speech Intelligibility Index Values for Hearing Aids Fitted to the DSL v5-Adult Prescription

2020 ◽  
Author(s):  
Andre Dao ◽  
Paula Folkeard ◽  
Sandra Baker ◽  
John Pumford ◽  
Susan Scollie
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Mean Squared Error ◽  
Hearing Aid ◽  
Hearing Level ◽  
Average Deviation ◽  
Absolute Deviation ◽  
Low Frequencies ◽  
Speech Intelligibility Index

Abstract Background Matching hearing aid output levels to prescribed targets is a component of preferred practice, yet recent normative data on appropriateness of fittings are lacking. Verification measures that assess closeness of fit-to-target include raw deviations from target, root-mean-squared-error (RMSE) deviations from target, and aided Speech Intelligibility Index (SII) values. Establishing normative ranges for these measures may help hearing professionals determine whether a patient's fit-to-targets and/or aided speech audibility is typical for his or her degree of hearing loss. Purpose This article aims to characterize the range of fit-to-target and the range of aided SII associated with hearing aid fittings using the Desired Sensation Level version 5.0 (DSL v5-adult) prescription with adults, considering also hearing aid style, venting, and audiometric characteristics. Research design A descriptive and correlational study of data collected from a retrospective chart review. Results Hearing aid fittings to 281 ears were compiled. The four-frequency average deviation from target (RMSE) was within ± 5 dB of target in 77% of fittings for mid-level speech. Deviation from targets increased with hearing loss, particularly when the loss is greater than 85 dB hearing level or if the loss was steeply sloping. Venting increased the deviation from targets in the low frequencies. Aided SII values strongly correlated with the participants' hearing thresholds. Clinical ranges for RMSE and aided SII were developed for characterization of fitting outcomes. Conclusion Fitting to DSL v5-adult targets was observed within ± 5 dB absolute deviation, or within 5 dB RMSE, on average for typical adult hearing aid fittings. Confidence intervals for deviation from target and aided SII are proposed.

scholarly journals Audibility-Based Hearing Aid Fitting Criteria for Children With Mild Bilateral Hearing Loss

2020 ◽  
Vol 51 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Derek J. Stiles ◽  
Meredith Spratford ◽  
Jacob J. Oleson ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Language Development ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Language Outcomes ◽  
Hearing Aid Fitting ◽  
Modeling Approach ◽  
Speech Intelligibility Index ◽  
Children With Hearing Loss

Purpose Because of uncertainty about the level of hearing where hearing aids should be provided to children, the goal of the current study was to develop audibility-based hearing aid candidacy criteria based on the relationship between unaided hearing and language outcomes in a group of children with hearing loss who did not wear hearing aids. Method Unaided hearing and language outcomes were examined for 52 children with mild-to-severe hearing losses. A group of 52 children with typical hearing matched for age, nonverbal intelligence, and socioeconomic status was included as a comparison group representing the range of optimal language outcomes. Two audibility-based criteria were considered: (a) the level of unaided hearing where unaided children with hearing loss fell below the median for children with typical hearing and (b) the level of unaided hearing where the slope of language outcomes changed significantly based on an iterative, piecewise regression modeling approach. Results The level of unaided audibility for children with hearing loss that was associated with differences in language development from children with typical hearing or based on the modeling approach varied across outcomes and criteria but converged at an unaided speech intelligibility index of 80. Conclusions Children with hearing loss who have unaided speech intelligibility index values less than 80 may be at risk for delays in language development without hearing aids. The unaided speech intelligibility index potentially could be used as a clinical criterion for hearing aid fitting candidacy for children with hearing loss.

Comparison of In-the-Ear and Over-the-Ear Hearing Aid Fittings

1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
The Difference ◽  
Functional Gain ◽  
The Relationship

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.

Performance Improvement of Digital Hearing Aid Systems

2015 ◽  
Vol 1 ◽  
pp. 27
Author(s):  
Isiaka Ajewale Alimi
Keyword(s):  
Noise Reduction ◽  
Hearing Aids ◽  
Digital Signal Processor ◽  
Speech Intelligibility ◽  
Communication Systems ◽  
Hearing Aid ◽  
Spectral Subtraction ◽  
Residual Spectrum ◽  
Digital Hearing Aids ◽  
Digital Hearing Aid

Digital hearing aids addresses the issues of noise and speech intelligibility that is associated with the analogue types. One of the main functions of the digital signal processor (DSP) of digital hearing aid systems is noise reduction which can be achieved by speech enhancement algorithms which in turn improve system performance and flexibility. However, studies have shown that the quality of experience (QoE) with some of the current hearing aids is not up to expectation in a noisy environment due to interfering sound, background noise and reverberation. It is also suggested that noise reduction features of the DSP can be further improved accordingly. Recently, we proposed an adaptive spectral subtraction algorithm to enhance the performance of communication systems and address the issue of associated musical noise generated by the conventional spectral subtraction algorithm. The effectiveness of the algorithm has been confirmed by different objective and subjective evaluations. In this study, an adaptive spectral subtraction algorithm is implemented using the noise-estimation algorithm for highly non-stationary noisy environments instead of the voice activity detection (VAD) employed in our previous work due to its effectiveness. Also, signal to residual spectrum ratio (SR) is implemented in order to control the amplification distortion for speech intelligibility improvement. The results show that the proposed scheme gives comparatively better performance and can be easily employed in digital hearing aid system for improving speech quality and intelligibility.

scholarly journals Integrated Bimodal Fitting for Unilateral CI Users with Residual Contralateral Hearing

2021 ◽  
Vol 11 (2) ◽  
pp. 200-206
Author(s):  
Gennaro Auletta ◽  
Annamaria Franzè ◽  
Carla Laria ◽  
Carmine Piccolo ◽  
Carmine Papa ◽  
...  
Keyword(s):  
Cochlear Implants ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Performance Difference ◽  
Test Conditions ◽  
Significant Difference ◽  
Noisy Conditions ◽  
New Formula ◽  
Better Than

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.

scholarly journals Comparison of In-Situ and Retrospective Self-Reports on Assessing Hearing Aid Outcomes

2020 ◽  
Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Outcome Data ◽  
Self Report ◽  
Data Collection And Analysis ◽  
Self Reports ◽  
Outcome Difference ◽  
The Difference ◽  
Ecological Momentary

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.

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