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Knoetze M, Manchaiah V, De Sousa K, Moore DR, Swanepoel DW. Comparing Self-Fitting Strategies for Over-the-Counter Hearing Aids: A Crossover Clinical Trial. JAMA Otolaryngol Head Neck Surg 2024:2821570. [PMID: 39052241 PMCID: PMC11273283 DOI: 10.1001/jamaoto.2024.2007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/23/2024] [Indexed: 07/27/2024]
Abstract
Importance Fewer than 20% of US adults with hearing loss use hearing aids due to barriers like high cost. Over-the-counter (OTC) hearing aids offer a potential solution, incorporating self-fitting strategies via smartphone apps. Self-fitting strategies have been validated for Food and Drug Administration (FDA)-approved OTC hearing aids compared with prescription-based approaches. However, no direct comparative analysis exists between in situ audiometry and self-adjustment strategies using self-fitting OTC (OTC-SF) hearing aids. Objective To compare self-adjustment and in situ audiometry self-fitting strategies in OTC-SF hearing aids for adults with mild to moderate hearing difficulties. Design Settings and Participants A crossover, within-participant pseudorandomized clinical trial was conducted between July and November 2023. Twenty-eight participants were pseudo-randomly assigned to 1 of the 2 self-fitting strategies, and they experienced both interventions for 4 consecutive weeks. Interventions The self-adjustment group manually adjusted settings, including overall gain and spectral tilt, using Lexie B2 hearing aids, while the in situ audiometry group used Lexie B2 Plus hearing aids (Lexie Hearing by hearX Group), with an automated fitting based on in situ tests conducted through the app. Main Outcomes and Measures The primary outcome was Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary outcomes were International Outcome Inventory for Hearing Aids (IOI-HA), speech-in-noise tests (DIN and QuickSIN), and real-ear measurements (REMs). Measures were completed at baseline and after the 4-week field trial using each strategy. Results Twenty-eight participants (mean [SD] age, 60.2 [12.0] years) were included; 14 men and 14 women. Self-adjustment and in situ audiometry strategies produced no clinically meaningful differences across various outcome measures, including overall APHAB benefit (Cohen d = 0.2; 95% CI, -0.2 to 0.6) and overall IOI-HA satisfaction (Rosenthal r = 0.0; 95% CI, -0.3 to 0.2). Self-adjustment users reported higher satisfaction (Rosenthal r = -0.4; 95% CI, -0.6 to -0.1) and longer daily use (Rosenthal r = -0.3; 95% CI, -0.5 to 0.0) compared with those using in situ audiometry. No clinically meaningful differences were observed in speech-in-noise benefit and real-ear measurements. Conclusion and Relevance In this clinical trial of OTC-SF hearing aids, self-adjustment and in situ audiometry strategies resulted in similar outcomes. However, self-adjustment may produce higher satisfaction and longer daily use, highlighting the potential advantages of active user involvement in the fitting process. Further investigation is needed for long-term outcomes. Trial registration ClinicalTrials.gov Identifier: NCT05782153.
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Affiliation(s)
- Megan Knoetze
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, a Collaborative initiative between the University of Colorado School of Medicine, Aurora, Colorado, and the University of Pretoria, Pretoria, South Africa
| | - Vinaya Manchaiah
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, a Collaborative initiative between the University of Colorado School of Medicine, Aurora, Colorado, and the University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Karina De Sousa
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, a Collaborative initiative between the University of Colorado School of Medicine, Aurora, Colorado, and the University of Pretoria, Pretoria, South Africa
| | - David R. Moore
- Communication Sciences Research Center, Patient Services Research, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | - De Wet Swanepoel
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, a Collaborative initiative between the University of Colorado School of Medicine, Aurora, Colorado, and the University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado
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Chang HY, Lo TS. Validation of a Bluetooth Self-Fitting Device for People With Mild-to-Moderate Hearing Loss in Quiet or Noisy Environments. Am J Audiol 2024:1-13. [PMID: 39024518 DOI: 10.1044/2024_aja-23-00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the benefits of a Bluetooth self-fitting device using an in situ hearing screening test and self-fitting processes. METHOD Thirty Mandarin-speaking individuals (16 men and 14 women) with mild-to-moderate hearing loss participated in this study. The hearing screening test was conducted using neckband earphones of a Bluetooth self-fitting device controlled by a smartphone app. The hearing screening tests were compared with the pure-tone audiometry in an audiometric booth. The amplification benefits of the self-fitting program-aided condition were evaluated and compared with those of unaided and preset program-aided conditions using the Mandarin Hearing in Noise Test (MHINT) and questionnaires. RESULTS The pure-tone audiometry and hearing screening test results exhibited strong positive correlations at all test frequencies. In the environment with 90° noise, the sentence reception thresholds (SRTs) obtained for the self-fitting program-aided condition were significantly lower (p = .032) than those obtained for the unaided condition, whereas no significant difference was observed between the preset program-aided and the unaided conditions. Moreover, the participants' satisfaction ratings for the devices were consistent with their MHINT results, with a strong positive correlation observed between satisfaction with self-fitting and user satisfaction in smartphone app's control, functionality, and learning. Younger participants were significantly more satisfied in learning to use the app. CONCLUSIONS Bluetooth self-fitting devices can be used for simplified in situ hearing screenings with a sensitivity of 90.4%. The satisfaction ratings and improvements in SRTs indicate significant clinical benefits of the self-fitting program compared with the preset program, particularly in the 90°-noise environments.
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Affiliation(s)
- Hung-Yue Chang
- Department of Mechanical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Tun-Shin Lo
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
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De Sousa KC, Manchaiah V, Moore DR, Graham MA, Swanepoel DW. Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids. JAMA Otolaryngol Head Neck Surg 2024:2821103. [PMID: 38990557 PMCID: PMC11240231 DOI: 10.1001/jamaoto.2024.1825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/09/2024] [Indexed: 07/12/2024]
Abstract
Importance With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy. Objective To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists. Design, Setting, and Participants Building on a previous randomized clinical trial, this follow-up comparative effectiveness research study reassessed a number of the original participants that were not lost to follow-up. Participants were initially divided into those with self-fit OTC hearing aids and those with audiologist-fit devices. Approximately 8 months after fitting, participants completed self-reported questionnaires. Missing data were addressed through multiple imputation. The original noninferiority trial was conducted at the University of Pretoria in South Africa from April 2022 to August 2022. The current analysis took place between July 7, 2023, to November 20, 2023. Interventions In the original trial, participants in the self-fit device group received a pair of OTC hearing aids and independently fit them with remote support as needed. The audiologist-fit device group received the same hearing aids fit by a certified audiologist using best practices. Main Outcomes and Measures The main outcomes were self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the International Outcome Inventory for Hearing Aids (IOI-HA). Results Of 64 participants in the trial, 44 participants were included in the extension study (21 [47.7%] in the audiologist-fit group; 23 [52.3%] in the self-fit group). The mean (SD) age of these participants was 63.0 (13.2) years, and 21 (47.7%) were male. At the long-term follow-up, self-fit and audiologist-fit groups showed no significant differences in the APHAB global score (mean difference, 0.02 [95% CI, -7.1 to 7.1]; Cohen d, 0.01 [95% CI, -0.5 to 0.5]) or the IOI-HA total score (mean difference, 1.5 [95% CI, -1.4 to 4.4]; Cohen d, 0.3 [95% CI, -0.2 to 0.8]). From 6 weeks to 8 months, no clinically meaningful group-time interaction was found between groups for the APHAB global score (Cohen d, 0.1 [95% CI, -0.2 to 0.3]), but a significant interaction for the IOI-HA total score was found (Cohen d, -0.6 [95% CI, -0.8 to -0.3]), with the self-fit group generally performing better. Conclusion This comparative effectiveness research study demonstrated that self-fit OTC hearing aids can offer comparable long-term benefits to audiologist-fit hearing aids for individuals with mild to moderate hearing loss.
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Affiliation(s)
- Karina C. De Sousa
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between the University of Colorado and the University of Pretoria, Aurora, Colorado
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between the University of Colorado and the University of Pretoria, Aurora, Colorado
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - David R. Moore
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between the University of Colorado and the University of Pretoria, Aurora, Colorado
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora
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Malmberg M, Hagberg J. Synchronous remote fine-tuning and follow-up within aural rehabilitation: a randomised controlled trial. Int J Audiol 2024; 63:458-466. [PMID: 36971711 DOI: 10.1080/14992027.2023.2188437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE The objective of the study was to evaluate the effect of including synchronous remote fine-tuning and follow-up as a part of the aural rehabilitation process. DESIGN A randomised controlled trial (RCT). STUDY SAMPLE Experienced hearing aid users who were due for renewed aural rehabilitation were randomised to either an intervention group (n = 46) or a control group (n = 49). Both groups underwent all stages of the conventional renewed aural rehabilitation process within our clinics, but the intervention group was also offered remote follow-up visits, including an opportunity for synchronous remote fine-tuning of hearing aids. The Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the International Outcome Intervention for Hearing Aid Users (IOI-HA) were used as outcome measures. RESULTS Both groups improved in self-rated hearing difficulties and hearing aid benefits measured with HHIE/A and APHAB. No significant differences were found between the intervention and the control group. CONCLUSION Including synchronous remote follow-up and fine-tuning as a part of an aural rehabilitation process may effectively complement clinical visits. Additionally, the synchronous remote follow-up has the potential to further develop person-centred care by enabling hearing aid users to identify individual needs directly in an everyday environment.
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Affiliation(s)
- Milijana Malmberg
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jennie Hagberg
- Region Västra Götaland, Habilitation & Health, Hearing Organization, Gothenburg, Sweden
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Van Eeckhoutte M, Jasper BS, Kjærbøl EF, Jordell DH, Dau T. In-situ Audiometry Compared to Conventional Audiometry for Hearing Aid Fitting. Trends Hear 2024; 28:23312165241259704. [PMID: 38835268 PMCID: PMC11155351 DOI: 10.1177/23312165241259704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 06/06/2024] Open
Abstract
The use of in-situ audiometry for hearing aid fitting is appealing due to its reduced resource and equipment requirements compared to standard approaches employing conventional audiometry alongside real-ear measures. However, its validity has been a subject of debate, as previous studies noted differences between hearing thresholds measured using conventional and in-situ audiometry. The differences were particularly notable for open-fit hearing aids, attributed to low-frequency leakage caused by the vent. Here, in-situ audiometry was investigated for six receiver-in-canal hearing aids from different manufacturers through three experiments. In Experiment I, the hearing aid gain was measured to investigate whether corrections were implemented to the prescribed target gain. In Experiment II, the in-situ stimuli were recorded to investigate if corrections were directly incorporated to the delivered in-situ stimulus. Finally, in Experiment III, hearing thresholds using in-situ and conventional audiometry were measured with real patients wearing open-fit hearing aids. Results indicated that (1) the hearing aid gain remained unaffected when measured with in-situ or conventional audiometry for all open-fit measurements, (2) the in-situ stimuli were adjusted for up to 30 dB at frequencies below 1000 Hz for all open-fit hearing aids except one, which also recommends the use of closed domes for all in-situ measurements, and (3) the mean interparticipant threshold difference fell within 5 dB for frequencies between 250 and 6000 Hz. The results clearly indicated that modern measured in-situ thresholds align (within 5 dB) with conventional thresholds measured, indicating the potential of in-situ audiometry for remote hearing care.
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Affiliation(s)
- Maaike Van Eeckhoutte
- Hearing Systems, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
- Copenhagen Hearing and Balance Centre - Ear, Nose, Throat & Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bettina Skjold Jasper
- Hearing Systems, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
- Copenhagen Hearing and Balance Centre - Ear, Nose, Throat & Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Erik Finn Kjærbøl
- Copenhagen Hearing and Balance Centre - Ear, Nose, Throat & Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - David Harbo Jordell
- Copenhagen Hearing and Balance Centre - Ear, Nose, Throat & Audiology Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Torsten Dau
- Hearing Systems, Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
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Sheffield SW, Jacobs M, Ellis C, Gerasimchik A. Comparing Direct-to-Consumer Devices to Hearing Aids: Amplification Accuracy for Three Types of Hearing Loss. Am J Audiol 2023:1-12. [PMID: 38052055 DOI: 10.1044/2023_aja-22-00170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
PURPOSE The U.S. Food and Drug Administration finalized regulations for over-the-counter hearing aids (OTC-HAs) on August 17, 2022. Little is known about the comparative performance of OTC-HAs and prescription HAs. This study compared amplification accuracy of prescription HAs and direct-to-consumer devices (DTCDs, including personal sound amplification products [PSAPs] and OTC-HAs). METHOD Eleven devices were programmed to meet prescriptive targets in an acoustic manikin for three degrees of hearing loss. Devices consisted of high- and low-end HAs, PSAPS, and OTC-HAs. Each was tested, and deviations from target measured with an HA analyzer at every combination of 10 frequencies and low-, average-, and high-level inputs. Accuracy was compared using a multilevel Poisson model with device-specific intercepts controlling for input level, frequency, and device type. RESULTS For mild-moderate hearing loss, deviations from targets were not statistically different between high- and low-end HAs, but PSAPs (5.50 dB, SE = 0.92 dB) and OTC-HAs (8.83 dB, SE = 1.10 dB) had larger differentials. For flat moderate hearing loss, compared to high-end HAs, average differentials were larger for all device types at all input levels and frequencies (Low HA: 3.82 dB, SE = 1.10 dB; PSAP: 9.24 dB, SE = 1.22 dB; OTC-HA: 8.61 dB, SE = 1.19 dB). For mild sloping to severe hearing loss, compared to high-end HAs, OTC-HAs (9.72 dB, SE = 1.20 dB) and PSAPs (7.34 dB, SE = 1.07 dB) had larger differentials and significant variability at the highest and lowest frequencies. Half (three) of the PSAPs and OTC-HAs met most targets within ±5 dB. CONCLUSIONS DTCDs were unable to meet prescriptive targets for severe types of hearing loss but could meet them for mild hearing loss. This study provides an examination of current hearing devices. More research is needed to determine whether meeting prescriptive targets provides any benefit in the outcomes and performance with DTCD devices.
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Affiliation(s)
- Sterling W Sheffield
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Molly Jacobs
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Amber Gerasimchik
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Singh J, Dhar S. Customer Archetypes in Hearing Health Care. Am J Audiol 2023; 32:941-949. [PMID: 37902440 PMCID: PMC11001421 DOI: 10.1044/2023_aja-23-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE The purpose of this study is to determine if there are unique customer archetypes that can describe the motivations behind consumer buying choice (in person or online) for hearing aids in hearing health care. METHOD A consumer survey was developed from themes that arose during 11 semistructured interviews with adults who had no previous hearing aid experience. Using Qualtrics research panels, a 28-item questionnaire was distributed online to U.S. residents above the age of 50 years with no previous hearing aid experience. A quota of 1,000 completed responses was set, with a maximum of 70% of respondents identifying as White. Completed surveys were obtained from 1,377 individuals. Three hundred forty responses were excluded due to ineligibility and/or poor response quality. RESULTS Two unique customer archetypes were developed using five factors identified in the data set: Physician Trust, Sociability, Comfort Buying Online, Verify Sources, and Reliance on Others. Eighty-four percent of respondents chose an in-person pathway for hearing health care. There was no association between customer archetype and pathway selection choice. CONCLUSIONS The two archetypes reflect those with greater comfort with consuming health care online and in person, respectively. However, both archetypes are likely to use in-person models of hearing health care at the present time. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24431212.
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Affiliation(s)
- Jasleen Singh
- The Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Sumitrajit Dhar
- The Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Venkitakrishnan S, Urbanski D, Wu YH. Efficacy and Effectiveness of Evidence-Based Non-Self-Fitting Presets Compared to Prescription Hearing Aid Fittings and a Personal Sound Amplification Product. Am J Audiol 2023; 33:1-24. [PMID: 37956699 PMCID: PMC11001427 DOI: 10.1044/2023_aja-23-00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/15/2023] Open
Abstract
PURPOSE In this study, we compare the efficacy and effectiveness of gain-frequency responses of evidence-based presets developed by our lab for over-the-counter hearing aids to conventional National Acoustic Laboratories' nonlinear fitting procedure, version 2 (NAL-NL2) gain-frequency response and to gain-frequency response of a personal sound amplification product (PSAP). We hypothesized that the hearing aids with our presets would perform better than a PSAP with poor frequency response and comparably to the hearing aid with NAL-NL2 frequency response. METHOD We used a single-blinded, randomized cross-over design to compare audibility, speech recognition, sound quality, listening effort, and subjective preferences in 37 participants in laboratory settings and following field trials. RESULTS The presets developed in our lab showed comparable outcomes to the hearing aids with NAL-NL2 gain-frequency response in most measured domains. Performance with the presets was better than the PSAP gain-frequency response in the domains of listening effort and sound quality in laboratory testing and speech recognition in our real-world measures. We also found that most participants (54.05%) preferred our presets over the PSAPs and were willing to pay significantly more to purchase the hearing aids with our presets. CONCLUSION Our evidence-based presets have better outcomes than a PSAP with a single, poorly suited frequency response while performing comparably to the clinical best-practice National Acoustic Laboratories condition.
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Affiliation(s)
- Soumya Venkitakrishnan
- Department of Communication Sciences and Disorders, California State University, Sacramento
| | - Dana Urbanski
- Department of Communication Sciences and Disorders, University of Minnesota Duluth
| | - Yu-Hsiang Wu
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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Boven C, Roberts R, Biggus J, Patel M, Matsuoka AJ, Richter CP. In-situ hearing threshold estimation using Gaussian process classification. Sci Rep 2023; 13:14667. [PMID: 37673944 PMCID: PMC10482858 DOI: 10.1038/s41598-023-40495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023] Open
Abstract
One in six Americans suffers from hearing loss. While treatment with amplification is possible for many, the acceptance rate of hearing aids is low. Poor device fitting is one of the reasons. The hearing aid fitting starts with a detailed hearing assessment by a trained audiologist in a sound-controlled environment, using standard equipment. The hearing aid is adjusted step-by-step, following well-described procedures based on the audiogram. However, for many patients in rural settings, considerable travel time to a hearing center discourages them from receiving a hearing test and treatment. We hypothesize that hearing assessment with the patient's hearing aid can reliably substitute the hearing test in the clinic. Over-the-counter hearing aids could be programmed from a distance and fine-tuned by the hearing aid wearer. This study shows that a patient-controlled hearing assessment via a hearing aid in a non-clinical setting is not statistically different from an audiologist-controlled hearing assessment in a clinical setting. The differences in hearing obtained with our device and the Gaussian Process are within 3 dB of the standard audiogram. At 250 Hz, the sound delivery with the hearing aid used in this study added an additional reduction of sound level, which was not compensated.
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Affiliation(s)
- Christopher Boven
- Soundwave Hearing, LLC, 619 Enterprise Drive #205, Oakbrook, IL, 60523, USA
| | - Reagan Roberts
- Soundwave Hearing, LLC, 619 Enterprise Drive #205, Oakbrook, IL, 60523, USA
| | - Jeff Biggus
- Soundwave Hearing, LLC, 619 Enterprise Drive #205, Oakbrook, IL, 60523, USA
| | - Malini Patel
- Northwestern Medical Group, 675 N. St. Clair, Suite 15-200, Chicago, IL, 60611, USA
| | - Akihiro J Matsuoka
- Northwestern Medical Group, 675 N. St. Clair, Suite 15-200, Chicago, IL, 60611, USA
- Department of Otolaryngology, Northwestern University, 320 E. Superior Street, Chicago, IL, 60611, USA
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, 60201, USA
- The Hugh Knowles Center for Clinical and Basic Science in Hearing and Its Disorders, Evanston, IL, 60201, USA
- Center for Advanced Regenerative Engineering, Evanston, IL, 60201, USA
| | - Claus-Peter Richter
- Department of Otolaryngology, Northwestern University, 320 E. Superior Street, Chicago, IL, 60611, USA.
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL, 60201, USA.
- The Hugh Knowles Center for Clinical and Basic Science in Hearing and Its Disorders, Evanston, IL, 60201, USA.
- Department of Biomedical Engineering, Northwestern University, 320 E. Superior Street, Chicago, IL, 60611, USA.
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Searle Building 12-470; 303 E. Chicago Avenue, Chicago, IL, 60611-3008, USA.
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Penno KA, Zakis JA. Exploring Hearing Care Technology from Clinic to Capability. Semin Hear 2023; 44:287-301. [PMID: 37484987 PMCID: PMC10361792 DOI: 10.1055/s-0043-1769741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Healthcare systems are traditionally a clinician-led and reactive structure that does not promote clients managing their health issues or concerns from an early stage. However, when clients are proactive in starting their healthcare earlier than later, they can achieve better outcomes and quality of life. Hearing healthcare and the rehabilitation journey currently fit into this reactive and traditional model of care. With the development of service delivery models evolving to offer services to the consumer online and where they are predominately getting their healthcare information from the internet and the advancement of digital applications and hearing devices beyond traditional hearing aid structures, we are seeing a change in how consumers engage in hearing care. Similarly, as the range of hearing devices evolves with increasingly blended and standard levels of technology across consumer earbuds/headphones and medical grade hearing aids, we are seeing a convergence of consumers engaging earlier and becoming increasingly aware of hearing health needs. This article will discuss how the channels, service, and technology are coming together to reform traditionally clinician-led healthcare models to an earlier consumer-led model and the benefits and limitations associated with it. Additionally, we look to explore advances in hearing technologies and services, and if these will or can contribute to a behavioral change in the hearing healthcare journey of consumers.
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Affiliation(s)
- Kathryn A. Penno
- Department of Anatomy, Physiology & Human Biology, School of Human Science, University of Western Australia, Perth, Western Australia, Australia
- Nuheara, Perth, Western Australia, Australia
| | - Justin A. Zakis
- Sonova Audiological Care Australia, Melbourne, Victoria, Australia
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Ferguson MA, Eikelboom RH, Sucher CM, Maidment DW, Bennett RJ. Remote Technologies to Enhance Service Delivery for Adults: Clinical Research Perspectives. Semin Hear 2023; 44:328-350. [PMID: 37484990 PMCID: PMC10361795 DOI: 10.1055/s-0043-1769742] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
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Affiliation(s)
- Melanie A. Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M. Sucher
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca J. Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
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12
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Brice S, Almond H. Behavior Change in Chronic Health: Reviewing What We Know, What Is Happening, and What Is Next for Hearing Loss. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085605. [PMID: 37107887 PMCID: PMC10138368 DOI: 10.3390/ijerph20085605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023]
Abstract
Untreated age-related sensorineural hearing loss is challenged by low adoption and adherence to hearing aids for treatment. Hearing care has evolved from traditional clinic-controlled treatment to online consumer-centered hearing care, supported by the increasingly person-centered design of hearing aid technology. Greater evidence and a more nuanced understanding of the personal need for adoption versus adherence to the use of consumer hearing care devices are required. Research considering consumer hearing aid acceptance behavior rests on behavior modification theories to guide clinical approaches to increasing hearing aid adoption and adherence. However, in the context of complex chronic health management, there may be a gap in how these theories effectively align with the needs of consumers. Similarly, market data indicates evolving consumer behavior patterns have implications for hearing care theory and implementation, particularly in terms of sustained behavior change. This essay proposes that evidence, including theory and application, be strengthened by revising basic theoretical premises of personal experience with complex chronic health, in addition to considering recent changes in commercial contexts.
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Affiliation(s)
- Sophie Brice
- Department of Nursing and Allied Health Sciences, Faculty of Health Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- The Australian Institute of Health Service Management, College of Business and Economics, The University of Tasmania, Hobart, TAS 7000, Australia
- Correspondence:
| | - Helen Almond
- The Australian Institute of Health Service Management, College of Business and Economics, The University of Tasmania, Hobart, TAS 7000, Australia
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13
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Humes LE. U.S. Population Data on Self-Reported Trouble Hearing and Hearing-Aid Use in Adults: National Health Interview Survey, 2007-2018. Trends Hear 2023; 27:23312165231160967. [PMID: 36947453 PMCID: PMC10083510 DOI: 10.1177/23312165231160967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
The National Health Interview Survey (NHIS) data on self-reported trouble hearing and the use of hearing aids were examined for the 12 recent surveys from 2007 to 2018 for adults from 18 to 85+ years of age. The aggregate dataset for all years included data from 357,714 adult respondents. Sample size for annual data ranged from 22,058 (2008) to 36,798 (2014). The prevalence of self-reported trouble hearing and hearing aid use, both current use and ever-using hearing aids, are reported for males and females for each age decade. Measures of unmet hearing healthcare (HHC) need were derived from estimates of the prevalence of hearing aid use among those with self-reported trouble hearing. Logistic-regression analyses identified variables affecting the odds of having self-reported trouble hearing, of using or rejecting hearing aids, and of having unmet HHC needs. The results largely corroborate and extend the findings of recent analyses of data from the National Health and Nutrition Examination Survey (NHANES) for a similar period (2011-2020). Overall, for males, 18.5% (95% CI [18.2%-18.8%]) had self-reported trouble hearing and 76.6% [76.0%-77.2%] of these individuals had never used hearing aids and, for females 13.1% [12.9%-13.4%] had trouble hearing and 79.5% [78.9%-80.1%] of these individuals had never used hearing aids. Unmet HHC needs are highly prevalent in the United States and have been so for many years.
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Affiliation(s)
- Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
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14
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Machine Learning-Based Hearing Aid Fitting Personalization Using Clinical Fitting Data. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1667672. [PMID: 36285186 PMCID: PMC9588352 DOI: 10.1155/2022/1667672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/05/2022] [Indexed: 11/15/2022]
Abstract
The initial software fitting prescribed by the fitting formula largely depends on the patient's hearing loss, which may not be the optimal preference for a particular user. Certain criteria must also be readjusted by an audiologist to meet the user-specific requirements. Therefore, this study focuses on the novel application of a neural network (NN) technique to build a suitable fitting algorithm with prescribed hearing loss and the corresponding preferred gain to minimize the gap between optimized fittings. The algorithm intended to learn the hearing preferences of an individual user such that the initial fitting may be optimized. These findings demonstrate the efficiency of the algorithm, with and without additional features. Using the clinical fitting data, the average mean square error (MSE) for the simple NN algorithm was 5.4183%. By adding additional features to the data, the algorithm performed better, and the average MSE was as low as 5.2530%. However, the algorithm outperformed Company A fitting software, as the MSE was the highest at 5.4748%. As the company's automatic fitting has a noticeable discrepancy with clinical fitting records, the impeccable results from this study can lead to a better path towards fitting satisfaction, thus benefiting the hearing-impaired community to a larger extent.
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15
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Blustein J, Weinstein BE, Chodosh J. Over-the-counter hearing aids: What will it mean for older Americans? J Am Geriatr Soc 2022; 70:2115-2120. [PMID: 35397113 DOI: 10.1111/jgs.17781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 01/30/2023]
Abstract
In October 2021 the Food and Drug Administration released draft rules creating a new class of hearing aids to be sold over the counter. Since Medicare does not cover hearing aids, the ready availability of low-cost aids is potentially good news for the millions of older Americans with hearing loss, a disorder that is associated with isolation, depression and poor health. However, better financial access to hearing aids will not necessarily translate into better hearing: many older people will need assistance in fitting, using and maintaining their aids. Policymakers, managers, and clinicians need to consider how to structure, fund and deliver these vital adjunctive services.
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Affiliation(s)
- Jan Blustein
- Robert F Wagner Graduate School, New York University, New York, New York, USA.,Department of Population Health, NYU Grossman School of Medicine, New York University, New York, New York, USA
| | - Barbara E Weinstein
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, NYU Grossman School of Medicine, New York University, New York, New York, USA.,Doctor of Audiology Program, CUNY Graduate Center, The City University of New York, New York, New York, USA
| | - Joshua Chodosh
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, New York, USA.,Division of Geriatric Medicine and Palliative Care, Department of Medicine, NYU Grossman School of Medicine, New York University, New York, New York, USA.,VA New York Harbor Health Care System, New York, New York, USA
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16
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Perry TT, Nelson PB. Self-Adjustment of Hearing Aid Amplification for Lower Speech Levels: Independent Ratings, Paired Comparisons, and Speech Recognition. Am J Audiol 2022; 31:305-321. [PMID: 35316099 DOI: 10.1044/2022_aja-21-00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Self-adjustment of hearing aid amplification enables wearers to customize the hearing aid output to match their preferences and could become an important tool for programming direct-to-consumer devices for people with mild-to-moderate hearing loss. One risk is that user-selected settings may provide inadequate audibility. This study assessed that risk by quantifying relationships between self-adjusted settings, subjective preferences, and speech recognition performance using speech at low levels in quiet, where achieving high speech audibility requires sufficient amplification. METHOD Fifteen people with symmetric, mild-to-moderate sensorineural hearing loss self-adjusted hearing aid amplification while listening to speech in quiet at 45, 55, and 65 dBA. After self-adjustment, 11 participants made blinded ratings of their self-adjusted fit, their NAL-NL2 prescriptive fit, and experimenter-created fits with reduced gain. Participants completed blinded paired comparisons and sentence recognition assessments using these settings. RESULTS The gain of self-adjusted fits showed a large range of variability between participants. On average, self-adjusted gain was similar to NAL-NL2 prescribed gain for input signals of 55 dBA and slightly greater than prescribed gain for 45-dBA signals. Speech recognition scores for NAL-NL2 fits were consistently high, and differences in speech recognition results were strongly correlated with the overall preferences obtained from paired comparisons. CONCLUSIONS Self-adjusted fits are highly variable between individuals for low-audibility conditions. Nonetheless, self-adjusted fits are at least as satisfactory as NAL-NL2 fits, and listeners tend to disfavor settings that result in poorer speech recognition. The findings argue against concerns that self-adjustment will result in inadequate audibility compared to prescribed settings.
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Affiliation(s)
- Trevor T. Perry
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, Minneapolis
- Center for Applied and Translational Sensory Science, University of Minnesota, Twin Cities, Minneapolis
| | - Peggy B. Nelson
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, Minneapolis
- Center for Applied and Translational Sensory Science, University of Minnesota, Twin Cities, Minneapolis
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17
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Fu F, Luximon Y. Comfort and fit perception based on 3D anthropometry for ear-related product design. APPLIED ERGONOMICS 2022; 100:103640. [PMID: 34809967 DOI: 10.1016/j.apergo.2021.103640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Anthropometry and human perception lie at the core of the ergonomic design process. Until now, relevant studies have been quite restricted, being unable to provide a holistic view of the perceived comfort and fit for ear-related products. The study examined the perceived comfort and fit using factor analysis and established a linkage between anthropometry and human perception for design uses. A total of 30 participants (15 male, 15 female) were recruited in the within-subject experiment. The results showed that ear symmetry, gender, concha length, and cavum concha width had either insignificant or weak correlation with the perception scores. Use condition and product size significantly influenced the perceived comfort and fit for ear-related products. Users preferred a larger product size in the dynamic condition than in the static condition. Moreover, the study proposed a novel method to quantify the relationship between anthropometric data and human perception for the ear-related product. For an in-the-ear product, trendlines were generated to link the product size based on 3D anthropometry with the comfort and fit scores.
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Affiliation(s)
- Fang Fu
- School of Design, The Hong Kong Polytechnic University, Hong Kong
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong.
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18
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Amplification Self-Adjustment: Controls and Repeatability. Ear Hear 2021; 43:808-821. [PMID: 34653029 PMCID: PMC9005587 DOI: 10.1097/aud.0000000000001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study was a continuation of work on an explore-and-select approach to the self-adjustment of amplification. Goals were to determine (i) the effect of changing the number of adjustment controls from three to two, (ii) the effect of changing the initial adjustment from overall output to high-frequency output, (iii) individual repeatability, (iv) the effect on phoneme recognition of increasing and decreasing overall output relative to the starting and adjusted conditions, and (v) listener reactions to, and opinions of, the self-adjustment procedure. DESIGN Twenty-two adults with hearing loss, 10 of whom were hearing aid users, adjusted level and spectrum of connected speech to preference, using three configurations of number and order of adjustment parameters. The three adjustments were replicated to give a total of six. Presentation was monaural, in quiet, using the ear with the better threshold at 2 kHz. The starting condition was a generic prescription for a typical mild-to-moderate hearing loss. Real ear output spectra were measured for the 6 self-adjustments, the generic starting condition, and the individual NAL-NL2 prescriptions for speech at 65 dB SPL. Monaural phoneme recognition in monosyllables was assessed, in quiet, at levels of -14, -7, 0 and +7 dB relative to both the starting and the self-adjusted conditions. Participants completed a questionnaire and their comments on each question were transcribed. RESULTS Changing the number of listener controls from 3 to 2 reduced mean adjustment time by around 50% but had negligible effect on group-mean output response. Starting adjustment with high-frequency output rather than overall output resulted in a 2 to 3 dB reduction of group-mean self-adjusted output below 1 kHz. Individual self-adjustments were within ±5 dB of NAL-NL2 prescription (for a 65 dB SPL speech input) for two-thirds of the participants in the high frequencies and for just over half in the low frequencies. In six self-adjustments, individuals self-adjusted, on average, to within ±4 dB of their own mean in both high and low frequencies. There was no evidence that these findings differed for hearing aid users and nonusers. Changes of overall output by ±7 dB after self-adjustment did not significantly affect group mean phoneme recognition. Preference for number and order of self-adjustment differed among participants, as did opinions on self-fitting of hearing aids. CONCLUSIONS These findings support the conclusion that, for many adults with hearing loss, an explore-and-select procedure for self-adjustment of amplification leads to output values that are repeatable within a few dB, are relatively immune to the number and order of adjustment parameters, and place the average listener well along the plateau of a phoneme recognition versus amplitude function.
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19
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Effectiveness of a Self-Fitting Tool for User-Driven Fitting of Hearing Aids. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010596. [PMID: 34682341 PMCID: PMC8535815 DOI: 10.3390/ijerph182010596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022]
Abstract
Hearing aids can be effective devices to compensate for age- or non-age-related hearing losses. Their overall adoption in the affected population is still low, especially in underdeveloped countries in the subpopulation experiencing milder hearing loss. One of the major reasons for low adoption is the need for repeated complex fitting by professional audiologists, which is often not completed for various reasons. As a result, self-fitting procedures have been appearing as an alternative. Key open questions with these digital tools are linked to their effectiveness, utilized algorithms, and achievable end-results. A digital self-fitting prototype tool with a novel quick four-step fitting workflow was evaluated in a study on 19 individuals with moderate hearing loss. The tool was evaluated in a double-blinded, randomized study, having two study aims: comparing traditional audiological fitting with the new self-fitting tool, which can also be used as a remote tool. The main reported results show moderately high usability and user satisfaction obtained during self-fitting, and quasi-equivalence of the performance of the classical audiological fitting approach. The digital self-fitting tool enables multiple sessions and easy re-fitting, with the potential to outperform the classical fitting approach.
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20
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Convery E, Heeris J, Ferguson M, Edwards B. Human-Technology Interaction Considerations in Hearing Health Care: An Introduction for Audiologists. Am J Audiol 2020; 29:538-545. [PMID: 32852226 DOI: 10.1044/2020_aja-19-00068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Innovations in user-driven hearing technology and services have placed greater control in the hands of the patient. While these advances could address issues of hearing health care accessibility, their success rests on the assumption that patients possess sufficient technological competence to self-manage these products and services successfully. The purpose of this tutorial is to highlight the importance of focusing on usability, rather than just performance outcomes, during the design, development, and evaluation of user-driven hearing technology and services. Method This tutorial explores human-technology interaction and usability and discusses practical methods for applying these concepts in hearing health care research and development. Two case studies illustrate how usability can inform the design and development of interactive educational materials for patients and the evaluation of a commercially available mHealth app. Conclusions In order to derive benefit from innovations in hearing health care, products and services must be intuitively usable in addition to being accessible and affordable. The discipline of human-technology interaction provides a relevant and useful framework to guide future research and development efforts in user-driven hearing health care.
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Affiliation(s)
| | - Jason Heeris
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Melanie Ferguson
- National Acoustic Laboratories, Sydney, New South Wales, Australia
| | - Brent Edwards
- National Acoustic Laboratories, Sydney, New South Wales, Australia
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21
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Abstract
Hearing loss is a pervasive global health care burden affecting up to one in every seven persons of whom 90% reside in low- and middle-income countries. Traditional service-delivery models are unable to support and promote accessible and affordable hearing care in these setting. Major barriers include a severe shortage of hearing health care professionals, costs associated with equipment, facilities and treatments, and centralized service-delivery models. Convergence of digital and connectivity revolutions are combining to enable new ways of delivering decentralized audiological services along the entire patient journey using integrated eHealth solutions. eHealth technologies are allowing nonprofessionals in communities (e.g., community health workers) to provide hearing services with point-of-care devices at reduced cost with remote surveillance and support by professionals. A growing body of recent evidence showcases community-based hearing care within an integrated eHealth framework that addresses some of the barriers of traditional service-delivery models at reduced cost. Future research, especially in low- and middle-income countries, must explore eHealth-supported hearing care services from detection through to treatment.
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Affiliation(s)
- De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.,Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia.,Ear Science Institute Australia, Subiaco, Australia
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22
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Edwards B. Emerging Technologies, Market Segments, and MarkeTrak 10 Insights in Hearing Health Technology. Semin Hear 2020; 41:37-54. [PMID: 32047347 DOI: 10.1055/s-0040-1701244] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Hearing health care is rapidly changing through innovation in technology, services, business models, and product categories. The introduction of hearables and over-the-counter (OTC) hearing aids in particular will change the market for hearing help and the role of the hearing care professionals (HCPs). This article focuses on how these products will be differentiated from HCP-fit hearing aids through their ability to address the unmet needs of different consumer segments within the population of people with hearing dysfunction. The unmet hearing needs of each segment are discussed, and the size of each segment estimated, demonstrating a large potential market for hearables and a smaller potential market for hearing aids than has been previously mentioned in the literature. The results from MarkeTrak 10's survey of consumers' attitudes toward an OTC model are reviewed, showing that approximately half of both hearing aid owners and nonowners are uncomfortable doing hearing- and hearing aid-related tasks on their own without the assistance of an HCP and would be unlikely to purchase OTC hearing aids if available today. MarkeTrak data are also shown that demonstrate that the majority of hearing aid and personal sound amplification product owners believe that the HCP helped or would have helped with their hearing devices. Finally, challenges to OTC hearing aids becoming successful are discussed.
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23
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Orji A, Kamenov K, Dirac M, Davis A, Chadha S, Vos T. Global and regional needs, unmet needs and access to hearing aids. Int J Audiol 2020; 59:166-172. [DOI: 10.1080/14992027.2020.1721577] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Aislyn Orji
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kaloyan Kamenov
- Department of noncommunicable diseases, World Health Organization, Geneva, Switzerland
| | - Mae Dirac
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Adrian Davis
- The Ear Institute, University College London, London, UK
| | - Shelly Chadha
- Department of noncommunicable diseases, World Health Organization, Geneva, Switzerland
| | - Theo Vos
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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24
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Keidser G, Matthews N, Convery E. A Qualitative Examination of User Perceptions of User-Driven and App-Controlled Hearing Technologies. Am J Audiol 2019; 28:993-1005. [PMID: 31769997 DOI: 10.1044/2019_aja-19-0022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery. Method Eleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fitting hearing aid for 12 weeks, participated in a semistructured interview. Participants were over 55 years of age and had varied experience with hearing aids and smartphones. A template analysis was applied to data. Results Five themes emerged from the interviews: (a) prerequisites to the successful implementation of user-driven and app-controlled technologies, (b) benefits and advantages of user-driven and app-controlled technologies, (c) barriers to the acceptance and use of user-driven and app-controlled technologies, (d) beliefs that age is a significant factor in how well people will adopt new technology, and (e) consequences that flow from the adoption of user-driven and app-controlled technologies. Specifically, suggested benefits of the technology included fostering empowerment and providing cheaper and more discrete options, while challenges included lack of technological self-efficacy among older adults. Training and support were emphasized as necessary for successful adaptation and were suggested to be a focus of audiologic services in the future. Conclusion User perceptions of user-driven and app-controlled hearing technologies challenge the audiologic profession to provide adequate support and training for use of the technology and manufacturers to make the technology more accessible to older people.
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Affiliation(s)
- Gitte Keidser
- National Acoustic Laboratories, Sydney, New South Wales, Australia
- Hearing Cooperative Research Centre, Melbourne, Victoria, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Nicole Matthews
- Department of Media, Music, Communication and Cultural Studies, Macquarie University, Sydney, New South Wales, Australia
| | - Elizabeth Convery
- National Acoustic Laboratories, Sydney, New South Wales, Australia
- Hearing Cooperative Research Centre, Melbourne, Victoria, Australia
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25
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Convery E, Keidser G, McLelland M, Groth J. A Smartphone App to Facilitate Remote Patient-Provider Communication in Hearing Health Care: Usability and Effect on Hearing Aid Outcomes. Telemed J E Health 2019; 26:798-804. [PMID: 31433259 PMCID: PMC7301323 DOI: 10.1089/tmj.2019.0109] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Patients often need multiple fine-tuning appointments with their hearing health care provider to achieve satisfactory hearing aid outcomes. A smartphone app that enables patients to remotely request and receive new hearing aid settings could improve hearing health care access and efficiency. Introduction: We assessed the usability of ReSound Assist™, (ReSound America, Bloomington, MN) the remote communication feature of a hearing aid app, and investigated whether hearing aid outcomes are influenced by app-based versus in-person patient-provider communication. Materials and Methods: Thirty adults were fit bilaterally with hearing aids and randomized to intervention and control groups. During a 6-week field trial, participants reported hearing aid problems via ReSound Assist (intervention) or at a scheduled face-to-face follow-up appointment (control). Usability of ReSound Assist was assessed with a questionnaire and interview. Hearing aid performance, benefit, satisfaction, and daily usage were compared for both groups. Results: ReSound Assist was rated as highly usable. Participants identified specific aspects of effectiveness and efficiency that could be improved. Similar problems were reported by intervention and control participants regardless of communication mode (app-based vs. in-person). However, almost half the requests received via ReSound Assist were for problems that required advice from the provider or physical modifications to the hearing aids rather than fine-tuning, highlighting the continued importance of in-person hearing health care. There was no significant difference in hearing aid outcomes between intervention and control participants. Conclusions: Apps enabling remote patient-provider communication are a viable method for hearing aid users to seek and receive help with hearing aid problems that can be addressed through fine-tuning.
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26
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Søgaard Jensen N, Hau O, Bagger Nielsen JB, Bundgaard Nielsen T, Vase Legarth S. Perceptual Effects of Adjusting Hearing-Aid Gain by Means of a Machine-Learning Approach Based on Individual User Preference. Trends Hear 2019; 23:2331216519847413. [PMID: 31104581 PMCID: PMC6535733 DOI: 10.1177/2331216519847413] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated a method to adjust hearing-aid gain by use of a machine-learning algorithm that estimates the optimal setting of gain parameters based on user preference indicated in an iterative paired-comparison procedure. Twenty hearing-impaired participants completed this procedure for 12 different sound scenarios. During the adjustment procedure, their task was to indicate a preference based on one of three sound attributes: Basic Audio Quality, Listening Comfort, or Speech Clarity. In a double-blind comparison of recordings of the processed scenarios, and using the same attributes as criteria, the adjusted gain settings were subsequently compared with two prescribed settings of the same hearing aid (with and without activation of an automatic sound-classification system). The results showed that the adjustment method provided a general improvement of Basic Audio Quality, an improvement of Listening Comfort in a traffic-noise scenario but not in three scenarios with speech babble, and no significant improvement of Speech Clarity. A large variation in gain adjustments was observed across participants, both among those who did benefit and among those who did not benefit from the adjustment. There was no clear connection between the gain adjustments and the perceived benefit, which indicates that the preferred gain settings for a given sound scenario and a given listening intention are highly individual and difficult to predict.
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