In situ Hearing Tests for the Purpose of a Self-Fit Hearing Aid

2017 ◽  
Vol 22 (1) ◽  
pp. 15-23
Author(s):  
Monique Boymans ◽  
Wouter A. Dreschler
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
Added Value ◽  
Good Correspondence ◽  
Loudness Scaling ◽  
Tone Generator ◽  
Test Retest Reliability ◽  
Selection Of

This study investigated the potential and limitations of a self-fit hearing aid. This can be used in the “developing” world or in countries with large distances between the hearing-impaired subjects and the professional. It contains an on-board tone generator for in situ user-controlled, automated audiometry, and other tests for hearing aid fitting. Twenty subjects with mild hearing losses were involved. In situ audiometry showed a test-retest reliability (SD <3.7 dB) that compared well with the precision of diagnostic audiometry using headphones. There was good correspondence (SD <5.2 dB) with traditional pure-tone audiometry. In situ loudness scaling yielded important information about suprathreshold perception, which will have an added value for the selection of compression and the selection of maximum power output to be allowed in hearing aids.

Feasibility of smartphone-based hearing-aid apps for patients with mild hearing loss: an exploratory pilot study (Preprint)

2020 ◽  
Author(s):  
Willy Nguyen ◽  
Miseung Koo ◽  
Seung Ha Oh ◽  
Jun Ho Lee ◽  
Moo Kyun Park
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Clinical Performance ◽  
Hearing Aid ◽  
National Standards ◽  
Hearing In Noise ◽  
Mild Hearing Loss ◽  
Consumer Devices ◽  
Selection Of

BACKGROUND Underuse of hearing aids is caused by several factors, including the stigma associated with hearing disability, affordability, and lack of awareness of rising hearing impairment associated with the growing population. Thus, there is a significant opportunity for the development of direct-to-consumer devices. For the past few years, smartphone-based hearing-aid apps have become more numerous and diverse, but few studies have investigated them. OBJECTIVE This study aimed to elucidate the electroacoustic characteristics and potential user benefits of a selection of currently available hearing-aid apps. METHODS We investigated the apps based on hearing-aid control standards (American National Standards Institute) using measurement procedures from previous studies. We categorized the apps and excluded those we considered inefficient. We investigated a selection of user-friendly, low-end apps, EarMachine and Sound Amplifier, with warble-tone audiometry, word recognition testing in unaided and aided conditions, and hearing-in-noise test in quiet and noise-front conditions in a group of users with mild hearing impairment (n = 7) as a pilot for a future long-term investigation. Results from the apps were compared with those of a conventional hearing aid. RESULTS Five of 14 apps were considered unusable based on low scores in several metrics, while the others varied across the range of electroacoustic measurements. The apps that we considered “high end” that provided lower processing latencies and audiogram-based fitting algorithms were superior overall. The clinical performance of the listeners tended to be better when using hearing aid, while the low end hearing-aid apps had limited benefits on the users. CONCLUSIONS Some apps showed the potential to benefit users with limited cases of minimal or mild hearing loss if the inconvenience of relatively poor electroacoustic performance did not outweigh the benefits of amplification.

Counseling during Real Ear Measurements: The Clients' Perspective

2021 ◽  
Author(s):  
Angela Ryall ◽  
Lorienne M. Jenstad ◽  
John Pumford ◽  
Tami Howe ◽  
Garnet Grosjean
Keyword(s):  
Focus Groups ◽  
Hearing Aids ◽  
Visual Information ◽  
Best Practice ◽  
Qualitative Content Analysis ◽  
Hearing Aid ◽  
Added Value ◽  
Centered Care ◽  
Prior Literature ◽  
First Time

Abstract Background When dispensing hearing aids, audiologists must follow validated fitting and verification procedures to ensure that the hearing aids are properly fitted to the client's hearing. Real ear measurements (REMs) are best practice for verifying hearing aids. Prior literature regarding REMs has mainly focused on the clinicians' perspective. Purpose This study investigated informational counseling throughout REMs by gathering perspectives of first-time hearing aid users regarding the content and format of counseling. Research Design The study used an interpretive description approach with focus groups. Study Sample There were 16 adult participants (4 males, 12 females) who were first-time hearing aid users and who all had memory of REMs occurring during their own hearing aid verification. Intervention We investigated the addition of informational counseling during REM verification. Data Collection and Analysis Four focus groups were conducted to elicit feedback on a demonstration of informational counseling during REM hearing aid verification. The data from the focus groups were transcribed verbatim and analyzed using qualitative content analysis. Results Analysis revealed positive aspects, negative aspects, and suggested changes in relation to the verbal and visual information presented during the REM verification demonstration. These data fell into two broad categories: the interaction and transaction of informational counseling. Conclusion Most clients were interested in learning more about REMs if the information was accessible. Results provide recommendations for clinical audiologists and REM system manufacturers to make the information presented during informational counseling more client-friendly and individualized for client-centered care. To continue exploring this new inquiry, further experimental research is required to determine if there is any added value of incorporating informational counseling during REMs.

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.

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
Keyword(s):  
Measurement System ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Analysis Tool ◽  
Ohio University ◽  
Positive Direction ◽  
Significant Difference ◽  
Threshold Measurement

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.

Review of Recent Research on the Selection of Frequency-Gain Characteristics for Hearing Aids

1980 ◽  
Vol 89 (5_suppl) ◽  
pp. 79-83
Author(s):  
Richard Lippmann
Keyword(s):  
Hearing Aids ◽  
Speech Intelligibility ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Linear Amplification ◽  
Percentage Points ◽  
Gain Characteristic ◽  
The Relationship ◽  
Fitting Hearing Aids ◽  
Selection Of

Following the Harvard master hearing aid study in 1947 there was little research on linear amplification. Recently, however, there have been a number of studies designed to determine the relationship between the frequency-gain characteristic of a hearing aid and speech intelligibility for persons with sensorineural hearing loss. These studies have demonstrated that a frequency-gain characteristic that rises at a rate of 6 dB/octave, as suggested by the Harvard study, is not optimal. They have also demonstrated that high-frequency emphasis of 10–40 dB above 500–1000 Hz is beneficial. Most importantly, they have demonstrated that hearing aids as they are presently being fit do not provide maximum speech intelligibility. Percent word correct scores obtained with the best frequency-gain characteristics tested in various studies have been found to be 9 to 19 percentage points higher than scores obtained with commercial aids owned by subjects. This increase in scores is equivalent to an increase in signal-to-noise ratio of 10 to 20 dB. This is a significant increase which could allow impaired listeners to communicate in many situations where they presently cannot. These results demonstrate the need for further research on linear amplification aimed at developing practical suggestions for fitting hearing aids.

Evaluation of the International Outcome Inventory for Hearing Aids in a Veteran Sample

2009 ◽  
Vol 20 (06) ◽  
pp. 374-380 ◽  
Author(s):  
Sherri L. Smith ◽  
Colleen M. Noe ◽  
Genevieve C. Alexander
Keyword(s):  
Psychometric Properties ◽  
Hearing Aids ◽  
Normative Data ◽  
Hearing Aid ◽  
Digital Signal ◽  
Critical Difference ◽  
Male Veterans ◽  
Data Collection And Analysis ◽  
Hearing Difficulty ◽  
Test Retest Reliability

Background: The International Outcome Inventory for Hearing Aids (IOI-HA) was developed as a global hearing aid outcome measure targeting seven outcome domains. The published norms were based on a private-pay sample who were fitted with analog hearing aids. Purpose: The purpose of this study was to evaluate the psychometric properties of the IOI-HA and to establish normative data in a veteran sample. Research Design: Survey. Study Sample: The participants were 131 male veterans (mean age of 74.3 years, SD = 7.4) who were issued hearing aids with digital signal processing (DSP). Intervention: Hearing aids with DSP that were fitted bilaterally between 2005 and 2007. Data Collection and Analysis: Veterans were mailed two copies of the IOI-HA. The participants were instructed to complete the first copy of the questionnaire immediately and the second copy in two weeks. The completed questionnaires were mailed to the laboratory. The psychometric properties of the questionnaire were evaluated. As suggested by Cox and colleagues, the participants were divided into two categories based on their unaided subjective hearing difficulty. The two categories were (1) those with less hearing difficulty (none-to-moderate category) and (2) those who report more hearing difficulty (moderately severe+ category). The norms from the current veteran sample then were compared to the original, published sample. For each hearing difficulty category, the critical difference values were calculated for each item and for the total score. Results: A factor analysis showed that the IOI-HA in the veteran sample had the identical subscale structure as reported in the original sample. For the total scale, the internal consistency was good (Chronbach's α = 0.83), and the test–retest reliability was high (λ = 0.94). Group and individual norms were developed for both hearing difficulty categories in the veteran sample. For each IOI-HA item, the critical difference scores were <1.0. This finding suggests that for any item on the IOI-HA, there is a 95 percent chance that an observed change of one response unit between two test sessions reflects a true change in outcome for a given domain. Conclusions: The results of this study confirmed that the psychometric properties of the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.

An Evaluation of Several Rationales for Selecting Hearing Aid Gain

1986 ◽  
Vol 51 (3) ◽  
pp. 272-281 ◽  
Author(s):  
Larry E. Humes
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Second Phase ◽  
Selection Procedures ◽  
Relative Gain ◽  
Typical Range ◽  
Selection Of

The present study evaluates the rationales underlying several hearing aid selection procedures. The first portion of the evaluation confirms that the gain-selection rationales result in the selection of different hearing aids for a given patient. Nine different audiometric configurations representing varying degrees of fiat, sloping, and rising sensorineural hearing loss were considered. The second phase of the evaluation considered how well each procedure achieved the goal of maximizing speech recognition. This analysis made use of the Articulation Index and was applied to each of the nine audiometric configurations. The results of this analysis suggested that, given the ability to adjust the overall gain over a typical range available through most volume controls, any of the procedures could produce optimal aided speech recognition performance. The final portion of the evaluation examined the ability of each procedure to prescribe absolute gain and relative gain (frequency response) that corresponded to that preferred by hearing aid wearers. The data for preferred insertion gain came from a recent investigation by Leijon, Eriksson-Mangold, an d Beck-Karlsen (1984). The results of this evaluation suggested that some procedures prescribe gain values closer to those preferred by listeners than others. More data are needed on preferred gain values for a variety of configurations, however, before any one procedure can be recommended over another.

Style Preference Survey: A Report on the Psychometric Properties and a Cross-Validation Experiment

2013 ◽  
Vol 24 (02) ◽  
pp. 089-104 ◽  
Author(s):  
Sherri L. Smith ◽  
Todd Ricketts ◽  
Rachel A. McArdle ◽  
Theresa H. Chisolm ◽  
Genevieve Alexander ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Internal Consistency ◽  
Hearing Aids ◽  
Cross Validation ◽  
Hearing Aid ◽  
Self Report ◽  
Initial Experiment ◽  
Retest Reliability ◽  
Validation Experiment ◽  
Test Retest Reliability

Background: Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. Purpose: The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. Research Design: An observational design was used in both experiments. Study Sample: Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n = 185) participated in the cross-validation experiment. Data Collection and Analysis: Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n = 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants. Results: The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach's α = .92) and of the subscales (each Cronbach's α > .75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC = .93) and of the subscales (each ICC > .80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. Conclusions: The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference.

Use of Hearing Aids and Assistive Listening Devices in an Older Australian Population

2010 ◽  
Vol 21 (10) ◽  
pp. 642-653 ◽  
Author(s):  
David Hartley ◽  
Elena Rochtchina ◽  
Philip Newall ◽  
Maryanne Golding ◽  
Paul Mitchell
Keyword(s):  
Hearing Loss ◽  
Older People ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Significant Proportion ◽  
Pure Tone Audiometry ◽  
Population Based ◽  
Self Report ◽  
Australian Population ◽  
Factors Associated

Background: Hearing loss is a common sensory impairment experienced by older persons. Evidence shows that the use of hearing aids and/or assistive listening devices (ALDs) can benefit those with a hearing loss but that historically the uptake and use of these technologies has remained relatively low compared with the number of people who report a hearing loss. Purpose: The aim of this study was to determine the prevalence, usage, and factors associated with the use of hearing aids and ALDs in an older representative Australian population. Research Design: A population-based survey. Study Sample: A total of 2956 persons out of 3914 eligible people between the ages of 49 and 99 yr (mean age 67.4 yr), living in the Blue Mountains, west of Sydney, completed a hearing study conducted from 1997 to 2003. Data Collection and Analysis: Hearing levels were assessed using pure tone audiometry, and subjects were administered a comprehensive hearing survey by audiologists, which included questions about hearing aid and ALD usage. Logistic regression analysis was used to identify factors associated with hearing aid and ALD usage. Results: Of the surveyed population, 33% had a hearing loss as measured in the better ear. 4.4% had used an ALD in the past 12 mo, and 11% owned a hearing aid. Of current hearing aid owners, 24% never used their aids. ALD and hearing aid usage were found to be associated with increasing age, hearing loss, and self-perceived hearing disability. Conclusions: These results indicate that hearing aid ownership and ALD usage remains low in the older population. Given the significant proportion of older people who self-report and have a measured hearing loss, it is possible that more could be helped through the increased use of hearing aid and/or ALD technology. Greater efforts are needed to promote the benefits of these technologies and to support their use among older people with hearing loss.

scholarly journals Assessment of Objective Audiometry to Predict Subjective Satisfaction in Patients With Hearing Aids

2020 ◽  
Vol 13 (2) ◽  
pp. 141-147
Author(s):  
Min Young Kwak ◽  
Woo Ri Choi ◽  
Jun Woo Park ◽  
Eun Jeong Hwang ◽  
Yeo Ra Ha ◽  
...  
Keyword(s):  
Hearing Aids ◽  
User Satisfaction ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
Significant Group ◽  
Hearing Aid Fitting ◽  
Significant Difference ◽  
Objective Audiometry ◽  
Group A ◽  
Group B

Objectives. To investigate the correlation of objective audiometry with user satisfaction as measured with the questionnaire scores.Methods. Twenty patients with hearing loss, who agreed to wear a hearing aid and were referred for hearing aid fitting, were included in this prospective clinical study. All patients used the in-the-canal type of Wide7 hearing aid provided by BSL Co., Ltd. We performed the Korean version of the Hearing Handicap Inventory for the Elderly (K-HHIE) and the International Outcome Inventory for Hearing Aids (K-IOI-HA) before and 1, 3, and 6 months after wearing the hearing aid. We also performed pure tone audiometry (PTA), speech audiometry (SA), functional gain (FG), hearing in noise test (HINT), and central auditory processing disorder tests, such as frequency pattern test (CA-f), duration pattern test (CA-d), and dichotic test (CA-Di). Patients were divided into two groups (group A-HHIE, improved; group B-HHIE, same or worse) by comparing the score of K-HHIE before and 6 months after wearing the hearing aid. In the 6-month K-IOI-HA questionnaire, 21 points were considered as the average score. Based on this, we further divided patients into two groups (group A-IOI, >21 points; group B-IOI, ≤21 points).Results. Group A-HHIE included six patients and group B-HHIE included 14 patients. In PTA, SA, HINT, CA-d, and CA-Di, group A-HHIE showed higher improvements than group B-HHIE, which were not statistically significant. Group A-IOI included 12 patients and group B-IOI included eight patients. No statistically significant difference was noted in the improvement of audiometric results over a period of 6 months after wearing the hearing aid between groups A-IOI and B-IOI.Conclusion. There were no significant and consistent audiometric results to reflect patient’s satisfaction with the hearing aid. Therefore, when analyzing the hearing aid-fitting outcome, both the objective audiometric tests and subjective questionnaire should be performed together for validating hearing aid performance.

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