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Longitudinal electronic health records from a large sample of new hearing-aid (HA) recipients in the US Veterans Affairs healthcare system were used to evaluate associations of fitting laterality with long-term HA use persistence as measured by battery order records, as well as with short-term HA use and satisfaction as assessed using the International Outcome Inventory for Hearing Aids (IOI-HA), completed within 180 days of HA fitting. The large size of our dataset allowed us to address two aspects of fitting laterality that have not received much attention, namely the degree of hearing asymmetry and the question of which ear to fit if fitting unilaterally. The key findings were that long-term HA use persistence was considerably lower for unilateral fittings for symmetric hearing loss (HL) and for unilateral worse-ear fittings for asymmetric HL, as compared to bilateral and unilateral better-ear fittings. In contrast, no differences across laterality categories were observed for short-term self-reported HA usage. Total IOI-HA score was poorer for unilateral fittings of symmetric HL and for unilateral better-ear fittings compared to bilateral for asymmetric HL. We thus conclude that bilateral fittings yield the best short- and long-term outcomes, and while unilateral and bilateral fittings can result in similar outcomes on some measures, we did not identify any HL configuration for which a bilateral fitting would lead to poorer outcomes. However, if a single HA is to be fitted, then our results indicate that a better-ear fitting has a higher probability of long-term HA use persistence than a worse-ear fitting.

Objectives: In the personalisation of hearing-aid fittings, gain is often adjusted to suit patient preferences using live speech. When using brief sentences as stimuli, the minimum gain adjustments necessary to elicit consistent preferences ("preference thresholds") were previously found to be much greater than typical adjustments in current practice. The current study examined the role of duration on preference thresholds., Design: Participants heard 2, 4 and 6-s segments of a continuous monologue presented successively in pairs. The first segment of each pair was presented at each individual's real-ear or prescribed gain. The second segment was presented with a ±0-12 dB gain adjustment in one of three frequency bands. Participants judged whether the second was "better", "worse" or "no different" from the first., Study Sample: Twenty-nine adults, all with hearing-aid experience., Results: The minimum gain adjustments needed to elicit "better" or "worse" judgments decreased with increasing duration for most adjustments. Inter-participant agreement and intra-participant reliability increased with increasing duration up to 4 s, then remained stable., Conclusions: Providing longer stimuli improves the likelihood of patients providing reliable judgments of hearing-aid gain adjustments, but the effect is limited, and alternative fitting methods may be more viable for effective hearing-aid personalisation.

Objectives: Hearing-aid frequency-gain responses are routinely adjusted by clinicians to patient preferences and descriptions. This study measured the minimum gain adjustments required to elicit preferences, and the assignment of descriptors to gain adjustments, to perceptually evaluate description-based troubleshooting., Design: Participants judged whether short sentences with ±0-12 dB gain adjustments in one of three frequency bands were "better", "worse" or "no different" from the same sentence at their individual real-ear or prescribed gain. If judged "better" or "worse", participants were then asked to assign one of the six common sound-quality descriptors to their preference., Study Sample: Thirty-two adults (aged 51-75 years) all with hearing-aid experience., Results: Median preference thresholds, the minimum gain adjustments to elicit "better" or "worse" judgments, ranged from 4 to 12 dB, increasing with frequency. There was some between-participant agreement in preferences: participants generally preferred greater low-frequency gain. Within-participant reliability for preferences was moderate. There was, however, little between-participant agreement in descriptor selection for gain adjustments. Furthermore, within-participant reliability for descriptor selection was lacking., Conclusions: The scale of gain adjustments necessary to elicit preferences, along with the low agreement and reliability in descriptors for these adjustments questions the efficiency and efficacy of current description-based troubleshooting, especially with short speech stimuli.

Frequency-dependent gain adjustments are routine in hearing-aid fittings, whether in matching to real-ear targets or fine-tuning to patient feedback. Patient feedback may be unreliable and fittings inefficient if adjustments are not discriminable. To examine what gain adjustments are discriminable, we measured the just-noticeable differences (JNDs) for level increments in speech-shaped noises processed with prescription gains. JNDs were measured in the better ears of 38 participants with hearing impairment using a fixed-level, same-different task. JNDs were measured for increments at six individual frequency-bands: a 0.25-kHz low-pass band; octave-wide bands at 0.5, 1, 2, and 4 kHz; and a 6-kHz high-pass band. JNDs for broadband increments were also measured. JNDs were estimated at d' of 1 for a minimally discriminable increment in optimal laboratory conditions. The JND for frequency-band increments was 2.8 dB excluding the 0.25-kHz low-pass band, for which the JND was 4.5 dB. The JND for broadband increments was 1.5 dB. Participants' median frequency-band and broadband JNDs were positively correlated. JNDs were mostly independent of age, pure-tone thresholds, and cognitive score. In consideration of self-fitting adjustments in noisier conditions, JNDs were additionally estimated at a more sensitive d' of 2. These JNDs were 6 dB for bands below 1 kHz, and 5 dB for bands at and above 1 kHz. Overall, the results suggest noticeable fine-tuning adjustments of 3 dB and self-fitting adjustments of 5 dB.

Objective: Loudness perception of binaural broadband signals, e.g. speech shaped noise, shows large individual differences using frequency-dependent amplification which was adjusted to restore the loudness perception of monaural narrowband signals in hearing-impaired (HI) listeners. To better understand and quantify this highly individual effect, loudness perception of broadband stimuli consisting of a number of spectrally separated narrowband components which where individually adjusted to equal loudness is of interest., Design: Based on categorical loudness scaling, the loudness of an equal categorical loudness noise (ECLN) consisting of six third-octave noises was assessed. For loudness categories "medium" und "very loud" the required narrowband loudness was analysed., Study Sample: Nine normal-hearing (NH) and ten HI listeners., Results: HI listeners showed lower narrowband loudness values compared to NH listeners, indicating an increased spectral loudness summation. More than 50% of the HI listeners showed higher binaural spectral loudness summation compared to NH listeners. The amount of binaural spectral loudness summation was highly correlated (r 2  = 0.92) with the loudness level at "very loud" of aided speech shaped noise., Conclusions: The suggested ECLN measurement is suited to assess individual (binaural) broadband loudness in aided conditions, providing valuable information for hearing-aid fitting.

Longitudinal electronic health records from a large sample of new hearing-aid (HA) recipients in the US Veterans Affairs healthcare system were used to evaluate associations of fitting laterality with long-term HA use persistence as measured by battery order records, as well as with short-term HA use and satisfaction as assessed using the International Outcome Inventory for Hearing Aids (IOI-HA), completed within 180 days of HA fitting. The large size of our dataset allowed us to address two aspects of fitting laterality that have not received much attention, namely the degree of hearing asymmetry and the question of which ear to fit if fitting unilaterally. The key findings were that long-term HA use persistence was considerably lower for unilateral fittings for symmetric hearing loss (HL) and for unilateral worse-ear fittings for asymmetric HL, as compared to bilateral and unilateral better-ear fittings. In contrast, no differences across laterality categories were observed for short-term self-reported HA usage. Total IOI-HA score was poorer for unilateral fittings of symmetric HL and for unilateral better-ear fittings compared to bilateral for asymmetric HL. We thus conclude that bilateral fittings yield the best short- and long-term outcomes, and while unilateral and bilateral fittings can result in similar outcomes on some measures, we did not identify any HL configuration for which a bilateral fitting would lead to poorer outcomes. However, if a single HA is to be fitted, then our results indicate that a better- ear fitting has a higher probability of long-term HA use persistence than a worse-ear fitting. [ABSTRACT FROM AUTHOR]

Background: The noises in modern soundscapes continue to increase and are a major origin for annoyance. For a hearing-impaired person, a hearing aid is often beneficial, but noise and annoying sounds can result in non-use of the hearing aid, temporary or permanently. Objective: The purpose of this study was to identify annoying sounds in a daily soundscape for hearing-aid users. Design: A diary was used to collect data where the participants answered four questions per day about annoying sounds in the daily soundscape over a two-week period. Study sample: Sixty adult hearing-aid users. Results: Of the 60 participants 91% experienced annoying sounds daily when using hearing aids. The annoying sound mentioned by most users, was verbal human sounds, followed by other daily sound sources categorized into 17 groups such as TV/radio, vehicles, and machine tools. When the hearing-aid users were grouped in relation to age, hearing loss, gender, hearing-aid experience, and type of signal processing used in their hearing aids, small and only few significant differences were found when comparing their experience of annoying sounds. Conclusions: The results indicate that hearing-aid users often experience annoying sounds and improved clinical fitting routines may reduce the problem. [ABSTRACT FROM AUTHOR]

This study evaluated the use of multiple auditory steady-state responses (ASSRs) to estimate the growth of loudness in listeners with normal hearing. Individual intensity functions were obtained from measures of loudness growth using the contour test and from the electrophysiological amplitude measures of multiple amplitude-modulated (77-105Hz) tones (500, 1000, 2000, and 4000Hz) simultaneously presented to both ears and recorded over the scalp. Slope analyses for the behavioural and electrophysiological intensity functions were separately performed. Response amplitudes of the ASSRs and loudness sensation judgements increase as the stimulus intensity increases for the four frequencies studied. A significant relationship was obtained between loudness and the ASSRs. The results of this study suggest that the amplitude of the ASSRs may be used to estimate loudness growth at least for individuals with normal hearing. [ABSTRACT FROM AUTHOR]

The Speech Intelligibility Index (SII) was used along with paired-comparison judgements and speech recognition scores to compare the speech intelligibility provided by two hearing-aid frequency responses in two different background noises. The purpose was to validate an SII-based procedure. Test subjects were 26 hearing-aid users representing a wide range of hearing loss configurations. One hearing-aid setting was in close agreement with the NAL-R prescription, whereas the other setting was achieved by reducing the high-frequency gain by about 10 dB compared to NAL-R. There were good overall agreements between results of the three methods. Average speech recognition scores were about 4 percentage points higher for the NAL-R frequency response, which also was subjectively judged as significantly better in terms of speech intelligibility. The SII based procedure was found to be suitable for comparing hearing-aid characteristics within subjects. [ABSTRACT FROM AUTHOR]

A successful Hearing-Aid Fitting (HAF) is more than just selecting an appropriate Hearing Aid (HA) device for a patient with Hearing Loss (HL). The initial fitting is given by the prescription based on user's hearing loss; however, it is often necessary for the audiologist to readjust some parameters to satisfy the user demands. Therefore, in this paper, we concentrated on a new application of Neural Network (NN) combined with a Transfer Learning (TL) strategy to develop a fitting algorithm with the prescription database for hearing loss and readjusted gain to minimize the gap between fitting satisfaction. As prior information, we generated the data set from two popular hearing-aid fitting software, then fed the training data to our proposed model, and verified the performance of the architecture. Pondering real life circumstances, where numerous fitting records may not always be accessible, we first investigated the number of minimum fitting records required for possible sufficient training. After that, we evaluated the performance of the proposed algorithm in two phases: (a) NN with refined hyper parameter showed enhanced performance in compare to state-of-the-art DNN approach, and (b) the TL approach boosted the performance of the NN algorithm in a broad way. Altogether, our model provides a pragmatic and promising tool for HAF. [ABSTRACT FROM AUTHOR]