Prediction of IOI-HA scores using speech reception thresholds and speech discrimination scores in quiet.

BACKGROUND: Outcome measures can be used to improve the quality of the rehabilitation by identifying and understanding which variables influence the outcome. This information can be used to improve outcomes for clients. In clinical practice, pure-tone audiometry, speech reception thresholds (SRTs), and speech discrimination scores (SDSs) in quiet or in noise are common assessments made prior to hearing aid (HA) fittings. It is not known whether SRT and SDS in quiet relate to HA outcome measured with the International Outcome Inventory for Hearing Aids (IOI-HA). PURPOSE: The aim of the present study was to investigate the relationship between pure-tone average (PTA), SRT, and SDS in quiet and IOI-HA in both first-time and experienced HA users. RESEARCH DESIGN: SRT and SDS were measured in a sample of HA users who also responded to the IOI-HA. STUDY SAMPLE: Fifty-eight Danish-speaking adult HA users. DATA COLLECTION AND ANALYSIS: The psychometric properties were evaluated and compared to previous studies using the IOI-HA. The associations and differences between the outcome scores and a number of descriptive variables (age, gender, fitted monaurally/binaurally with HA, first-time/experienced HA users, years of HA use, time since last HA fitting, best ear PTA, best ear SRT, or best ear SDS) were examined. A multiple forward stepwise regression analysis was conducted using scores on the separate IOI-HA items, the global score, and scores on the introspection and interaction subscales as dependent variables to examine whether the descriptive variables could predict these outcome measures. RESULTS: Scores on single IOI-HA items, the global score, and scores on the introspection (items 1, 2, 4, and 7) and interaction (items 3, 5, and 6) subscales closely resemble those previously reported. Multiple regression analysis showed that the best ear SDS predicts about 18-19% of the outcome on items 3 and 5 separately, and about 16% on the interaction subscale (sum of items 3, 5, and 6) CONCLUSIONS: The best ears SDS explains some of the variance displayed in the IOI-HA global score and the interaction subscale. The relation between SDS and IOI-HA suggests that a poor unaided SDS might in itself be a limiting factor for the HA rehabilitation efficacy and hence the IOI-HA outcome. The clinician could use this information to align the user's HA expectations to what is within possible reach.

Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users.

OBJECTIVE: The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users' ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA). DESIGN: ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire. STUDY SAMPLE: Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire. RESULTS: ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5-8.8 dB. IOI-HA scores were not associated to ANL. CONCLUSIONS: Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.

Acceptable noise level: repeatability with Danish and non-semantic speech materials for adults with normal hearing.

OBJECTIVE: The acceptable noise level (ANL) is used to quantify the amount of background noise that subjects can accept while listening to speech, and is suggested for prediction of individual hearing-aid use. The aim of this study was to assess the repeatability of the ANL measured in normal-hearing subjects using running Danish and non-semantic speech materials as stimuli and modulated speech-spectrum and multi-talker babble noises as competing stimuli. DESIGN: ANL was measured in both ears at two test sessions separated by a period ranging from 12 to 77 days. At each session the measurements at the first and the second ear were separated in time by 15-30 minutes. Bland-Altman plots and calculation of the coefficient of repeatability (CR) were used to estimate the repeatability. STUDY SAMPLE: Thirty nine normal-hearing subjects. RESULTS: The ANL CR was 6.0-8.9 dB for repeated tests separated by about 15-30 minutes and 7.2-10.2 dB for repeated tests separated by 12 days or more. CONCLUSIONS: The ANL test has poor repeatability when assessed with Danish and non-semantic speech materials on normal-hearing subjects. The same CR among hearing-impaired subjects would imply too poor repeatability to predict individual patterns of future hearing-aid use.

Acceptable noise level with Danish, Swedish, and non-semantic speech materials.

OBJECTIVE: Acceptable noise level (ANL) has been established as a method to quantify the acceptance of background noise while listening to speech presented at the most comfortable level. The aim of the present study was to generate Danish, Swedish, and a non-semantic version of the ANL test and investigate normal-hearing Danish and Swedish subjects' performance on these tests. DESIGN: ANL was measured using Danish and Swedish running speech with two different noises: Speech-weighted amplitude-modulated noise, and multitalker speech babble. ANL was also measured using the non-semantic international speech test signal (ISTS) as speech signal together with the speech-weighted amplitude-modulated noise. The latter condition was identical in both populations. STUDY SAMPLE: Forty Danish and 40 Swedish normal-hearing subjects. RESULTS: In both populations ANL results were similar to previously reported results from American studies. Generally, significant differences were seen between test conditions using different types of noise within ears in each population. Significant differences were seen for ANL across populations, also when the non-semantic ISTS was used as speech signal. CONCLUSIONS: The present findings indicate that there are extrinsic factors, such as instructions, affecting the ANL results.

Interaural attenuation for Sennheiser HDA 200 circumaural earphones.

Interaural attenuation (IA) was evaluated for pure tones (frequency range 125 to 16000 Hz) using Sennheiser HDA 200 circumaural earphones and Telephonics TDH-39P earphones in nine unilaterally deaf subjects. Audiometry was conducted in 1-dB steps using the manual ascending technique in accordance with ISO 8253-1. For all subjects and for all tested frequencies, the lowest IA value for HDA 200 was 42 dB. The present IA values for TDH-39P earphones closely resemble previously reported data. The findings show that the HDA 200 earphones provide more IA than the TDH-39P, especially at lower frequencies (

Real-ear measurement verification for open, non-occluding hearing instruments.

Real-ear measurements using the modified pressure method with concurrent (real-time) equalization can be inaccurate, when amplified sound leaks out of the ear canal and reaches the reference microphone. In such situations the reference microphone will detect an increased sound level and reduce the output of the loudspeaker to maintain the desired level. The risk of having errors due to leaks increases if digital feedback suppression (DFS) is used, thus achieving higher feedback-free gain levels. The following hypotheses were tested: a) using the concurrent equalization method for fitting hearing instruments with DFS may result in underestimated real-ear insertion gain (especially when using open fittings) and b) as the benefit of the DFS system increases, this error also increases. Real-ear measurements were carried out in twenty-one subjects using the modified pressure method with stored equalization as well as with concurrent equalization. The results of the study supports both hypotheses. As a consequence it is recommended to use a stored equalization method for real-ear measurements of hearing instruments with DFS and open fitting.