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Schinkel-Bielefeld N, Burke L, Holube I, Iankilevitch M, Jenstad LM, Lelic D, Naylor G, Singh G, Smeds K, von Gablenz P, Wolters F, Wu YH. Implementing Ecological Momentary Assessment in Audiological Research: Opportunities and Challenges. Am J Audiol 2024:1-26. [PMID: 38950171 DOI: 10.1044/2024_aja-23-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
Ecological momentary assessment (EMA) is a way to evaluate experiences in everyday life. It is a powerful research tool but can be complex and challenging for beginners. Application of EMA in audiological research brings with it opportunities and challenges that differ from other research disciplines. This tutorial discusses important considerations when conducting EMA studies in hearing care. While more research is needed to develop specific guidelines for the various potential applications of EMA in hearing research, we hope this article can alert hearing researchers new to EMA to pitfalls when using EMA and help strengthen their study design. The current article elaborates study design details, such as choice of participants, representativeness of the study period for participants' lives, and balancing participant burden with data requirements. Mobile devices and sensors to collect objective data on the acoustic situation are reviewed alongside different possibilities for EMA setups ranging from online questionnaires paired with a timer to proprietary apps that also have access to parameters of a hearing device. In addition to considerations for survey design, a list of questionnaire items from previous studies is provided. For each item, an example and a list of references are given. EMA typically provides data sets that are rich but also challenging in that they are noisy, and there is often unequal amount of data between participants. After recommendations on how to check the data for compliance, reactivity, and careless responses, methods for statistical analysis on the individual level and on the group level are discussed including special methods for direct comparison of hearing device programs.
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Affiliation(s)
| | - Louise Burke
- School of Medicine, University of Nottingham, United Kingdom
| | - Inga Holube
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
- Cluster of Excellence Hearing4All, Oldenburg, Germany
| | - Maria Iankilevitch
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Lorienne M Jenstad
- School of Audiology and Speech Sciences, The University of British Columbia, Vancouver, Canada
| | | | - Graham Naylor
- School of Medicine, University of Nottingham, United Kingdom
- National Institute for Health and Care Research, Nottingham Biomedical Research Centre, United Kingdom
| | - Gurjit Singh
- Sonova Canada, Kitchener, Ontario, Canada
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Psychology, Toronto Metropolitan University, Ontario, Canada
| | | | - Petra von Gablenz
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
- Cluster of Excellence Hearing4All, Oldenburg, Germany
| | | | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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Jorgensen E, Wu YH. Effects of entropy in real-world noise on speech perception in listeners with normal hearing and hearing lossa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:3627-3643. [PMID: 38051522 PMCID: PMC10699887 DOI: 10.1121/10.0022577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/07/2023]
Abstract
Hearing aids show more benefit in traditional laboratory speech-in-noise tests than in real-world noisy environments. Real-world noise comprises a large range of acoustic properties that vary randomly and rapidly between and within environments, making quantifying real-world noise and using it in experiments and clinical tests challenging. One approach is to use acoustic features and statistics to quantify acoustic properties of real-world noise and control for them or measure their relationship to listening performance. In this study, the complexity of real-world noise from different environments was quantified using entropy in both the time- and frequency-domains. A distribution of noise segments from low to high entropy were extracted. Using a trial-by-trial design, listeners with normal hearing and hearing loss (in aided and unaided conditions) repeated back sentences embedded in these noise segments. Entropy significantly affected speech perception, with a larger effect of entropy in the time-domain than the frequency-domain, a larger effect for listeners with normal hearing than for listeners with hearing loss, and a larger effect for listeners with hearing loss in the aided than unaided condition. Speech perception also differed between most environment types. Combining entropy with the environment type improved predictions of speech perception above the environment type alone.
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Affiliation(s)
- Erik Jorgensen
- Department of Communication Sciences and Disorders University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa 52242, USA
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Jorgensen E, Xu J, Chipara O, Oleson J, Galster J, Wu YH. Auditory Environments and Hearing Aid Feature Activation Among Younger and Older Listeners in an Urban and Rural Area. Ear Hear 2023; 44:603-618. [PMID: 36534639 PMCID: PMC10101872 DOI: 10.1097/aud.0000000000001308] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate differences in auditory environments and hearing aid feature activation between younger listeners with normal hearing and older listeners with hearing loss in an urban and rural location. We hypothesized that (1) urban dwellers and younger listeners would encounter more diverse and demanding auditory environments than rural dwellers and older listeners, respectively; (2) the advanced hearing aid features (noise reduction and directional microphone) of urban dwellers and younger listeners would be activated more frequently than rural dwellers and older listeners, respectively. DESIGN The design of this study was cross-sectional with repeated measures. A total of 12 older adults with hearing loss (OHL-U) and 11 younger adults with normal hearing (YNH-U) were recruited from an urban area (Berkeley, California) and 13 older adults with hearing loss (OHL-R) and 10 YNH-U were recruited from a rural area (Iowa City, Iowa). Participants wore hearing aids that recorded data about their listening environments and completed ecological momentary assessments for 1 week. RESULTS The YNH-U group experienced higher sound pressure levels and hearing aid features were activated more frequently than in the OHL groups. The OHL-R group experienced significantly less diverse sound pressure levels than the YNH-U group. The YNH-R group had sound levels between the YNH-U group and the OHL groups but without significant differences from any other group. The YNH groups showed a greater likelihood of hearing aid feature activation than the OHL-R group. CONCLUSIONS Demographics affect auditory environments and the activation of hearing aid features. Younger urban dwellers have the most diverse or demanding auditory environments and hearing aid feature activation, and older, rural dwellers with hearing loss have the least diverse or demanding auditory environments and hearing aid feature activation. Future studies of real-world auditory environments and audiology intervention effectiveness should consider location in recruitment and interpretation of results.
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Affiliation(s)
- Erik Jorgensen
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Octav Chipara
- Department of Computer Science, University of Iowa, Iowa City, Iowa, USA
| | - Jacob Oleson
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
| | | | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
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Jorgensen E, Xu J, Chipara O, Wu YH. Auditory environment diversity quantified using entropy from real-world hearing aid data. Front Digit Health 2023; 5:1141917. [PMID: 37090064 PMCID: PMC10114586 DOI: 10.3389/fdgth.2023.1141917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Using data collected from hearing aid users' own hearing aids could improve the customization of hearing aid processing for different users based on the auditory environments they encounter in daily life. Prior studies characterizing hearing aid users' auditory environments have focused on mean sound pressure levels and proportions of environments based on classifications. In this study, we extend these approaches by introducing entropy to quantify the diversity of auditory environments hearing aid users encounter. Materials and Methods Participants from 4 groups (younger listeners with normal hearing and older listeners with hearing loss from an urban or rural area) wore research hearing aids and completed ecological momentary assessments on a smartphone for 1 week. The smartphone was programmed to sample the processing state (input sound pressure level and environment classification) of the hearing aids every 10 min and deliver an ecological momentary assessment every 40 min. Entropy values for sound pressure levels, environment classifications, and ecological momentary assessment responses were calculated for each participant to quantify the diversity of auditory environments encountered over the course of the week. Entropy values between groups were compared. Group differences in entropy were compared to prior work reporting differences in mean sound pressure levels and proportions of environment classifications. Group differences in entropy measured objectively from the hearing aid data were also compared to differences in entropy measured from the self-report ecological momentary assessment data. Results Auditory environment diversity, quantified using entropy from the hearing aid data, was significantly higher for younger listeners than older listeners. Entropy measured using ecological momentary assessment was also significantly higher for younger listeners than older listeners. Discussion Using entropy, we show that younger listeners experience a greater diversity of auditory environments than older listeners. Alignment of group entropy differences with differences in sound pressure levels and hearing aid feature activation previously reported, along with alignment with ecological momentary response entropy, suggests that entropy is a valid and useful metric. We conclude that entropy is a simple and intuitive way to measure auditory environment diversity using hearing aid data.
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Affiliation(s)
- Erik Jorgensen
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Octav Chipara
- Department of Computer Science, University of Iowa, Iowa City, IA, United States
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, United States
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