Abstract
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.
Highlights
Patient feedback is regularly used to fine-tune the electroacoustical parameters of hearing devices in the clinic (Anderson, Arehart, and Souza 2018; Jenstad, Van Tasell, and Ewert 2003; Kuk and Ludvigsen 1999; Thielemans et al 2017)
This study suggests that the across-listener translation of descriptors into gains may not be wholly valid given the individual variation in meaning and electroacoustic mapping
LF adjustments resulted in the fewest “no different” judgments; 37% of judgments for ±4 dB LF adjustments were judged either “better” or “worse”
Summary
Patient feedback is regularly used to fine-tune the electroacoustical parameters of hearing devices in the clinic (Anderson, Arehart, and Souza 2018; Jenstad, Van Tasell, and Ewert 2003; Kuk and Ludvigsen 1999; Thielemans et al 2017). Compared to steady-state noise, the JNDs measured with male, single-talker sentences were larger, the more so the narrower the bandwidth being adjusted; 6–10 dB for octave-band increments, 4–7 dB for wideband increments, and 2 dB for broadband increments (Caswell-Midwinter and Whitmer 2019b). The scale of these JNDs is partly explained by the sparseness of energy in any one frequency band at any given time in sentences. These JNDs indicate the limitations of using short sentences as the stimulus for adjusting gain in response to patient feedback
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