Abstract

Hearing-aid (HA) prescription rules (such as NAL-NL2, DSL-v5, and CAM2) are used by HA audiologists to define initial HA settings (e.g., insertion gains, IGs) for patients. This initial fitting is later individually adjusted for each patient to improve clinical outcomes in terms of speech intelligibility and listening comfort. During this fine-tuning stage, speech-intelligibility tests are often carried out with the patient to assess the benefits associated with different HA settings. As these tests tend to be time-consuming and performance on them depends on the patient's level of fatigue and familiarity with the test material, only a limited number of HA settings can be explored. Consequently, it is likely that a suboptimal fitting is used for the patient. Recent studies have shown that automatic speech recognition (ASR) can be used to predict the effects of IGs on speech intelligibility for patients with age-related hearing loss (ARHL). The aim of the present study was to extend this approach by optimizing, in addition to IGs, compression thresholds (CTs). However, increasing the number of parameters to be fitted increases exponentially the number of configurations to be assessed. To limit the number of HA settings to be tested, three random-search (RS) genetic algorithms were used. The resulting new HA fitting method, combining ASR and RS, is referred to as “objective prescription rule based on ASR and random search" (OPRA-RS). Optimal HA settings were computed for 12 audiograms, representing average and individual audiometric profiles typical for various levels of ARHL severity, and associated ASR performances were compared to those obtained with the settings recommended by CAM2. Each RS algorithm was run twice to assess its reliability. For all RS algorithms, ASR scores obtained with OPRA-RS were significantly higher than those associated with CAM2. Each RS algorithm converged on similar optimal HA settings across repetitions. However, significant differences were observed between RS algorithms in terms of maximum ASR performance and processing costs. These promising results open the way to the use of ASR and RS algorithms for the fine-tuning of HAs with potential speech-intelligibility benefits for the patient.

Highlights

  • The aim of hearing-aid (HA) prescription rules is to provide an appropriate level of amplification to restore audibility to hearing-impaired (HI) listeners while avoiding uncomfortable loudness levels

  • To compare the automatic speech recognition (ASR) scores associated with OPRA-RS and CAM2, the optimal compression thresholds (CTs) selected by OPRA-RS algorithms were inputted to CAM2Bv2, as this software does not provide CTs

  • ASR scores associated with CAM2 prescriptions are more broadly distributed, and their median values are lower (88% for GEN1, 86% for GEN2, and 94% for GEN3)

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Summary

Introduction

The aim of hearing-aid (HA) prescription rules is to provide an appropriate level of amplification to restore audibility to hearing-impaired (HI) listeners while avoiding uncomfortable loudness levels. The amount of signal amplification is determined by frequency-specific insertion gains (IGs). As people with age-related hearing loss (ARHL) show a reduced dynamic range due to the elevation of hearing thresholds and loudness recruitment, compression of the signal amplitude is applied. When the input level exceeds a given threshold (referred to as the compression threshold, CT), the amount of amplification applied by the HA decreases more or less abruptly depending on the compression ratio (CR), defined as the increase in input level required for a 1-dB increase in output level. To determine IGs, in addition to the audiogram, prescription rules take into account the number of HA channels, the maximum CR, the CTs, and the compression speed

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