Purpose: Although many previous literatures investigated various outcomes of hearing aid fitting, a few studies explored the cost-effectiveness of hearing aid fitting and its underlying model. Examining cost effectiveness of hearing aid fitting provides comparative values of hearing aid fitting by measuring the economic gains of hearing aid interventions. The purpose of present study is to understand the cost-related outcomes and benefits of hearing aid uses and provide economic insights of hearing aid interventions. Methods: The study reviewed several literatures related to cost-effectiveness of hearing aid fitting as well as relevant services. In addition, the study proposed an adopted economic model as a future reference of hearing aid fitting in South Korea. Results: There were a few studies evaluating cost-effectiveness of hearing aid fitting and the overall results supported a considerable success with incremental cost-effectiveness of hearing aid intervention. A dynamic patient flow model is particularly useful to simulate ongoing decision problems in the use of hearing aids and to estimate cost-effectiveness of hearing aid intervention. Conclusion: The patient flow model proposed in this study involves various possible transitions of people with hearing complaints in South Korea and it applies to the measurement of cost benefits of hearing aid fitting.

Background and ObjectivesNot all impaired listeners may have the same speech perception ability although they will have similar pure-tone threshold and configuration. For this reason, the present study analyzes error patterns in the hearing-impaired compared to normal hearing (NH) listeners as a function of signal-to-noise ratio (SNR).Subjects and MethodsForty-four adults participated: 10 listeners with NH, 20 hearing aids (HA) users and 14 cochlear implants (CI) users. The Korean standardized monosyllables were presented as the stimuli in quiet and three different SNRs. Total error patterns were classified into types of substitution, omission, addition, fail, and no response, using stacked bar plots.ResultsTotal error percent for the three groups significantly increased as the SNRs decreased. For error pattern analysis, the NH group showed substitution errors dominantly regardless of the SNRs compared to the other groups. Both the HA and CI groups had substitution errors that declined, while no response errors appeared as the SNRs increased. The CI group was characterized by lower substitution and higher fail errors than did the HA group. Substitutions of initial and final phonemes in the HA and CI groups were limited by place of articulation errors. However, the HA group had missed consonant place cues, such as formant transitions and stop consonant bursts, whereas the CI group usually had limited confusions of nasal consonants with low frequency characteristics. Interestingly, all three groups showed /k/ addition in the final phoneme, a trend that magnified as noise increased.ConclusionsThe HA and CI groups had their unique error patterns even though the aided thresholds of the two groups were similar. We expect that the results of this study will focus on high error patterns in auditory training of hearing-impaired listeners, resulting in reducing those errors and improving their speech perception ability.

Background and ObjectivesIt is acknowledged that speech perceptual errors are increased in listeners who have sensorineural hearing loss as noise increases. However, there is a lack of detailed information for their error pattern. The purpose of the present study was to analyze substitution patterns of phoneme errors in Korean hearing aid (HA) and cochlear implant (CI) users who are postlingually deafened adults.Subjects and MethodsIn quiet and under two noise conditions, the phoneme errors of twenty HA and fourteen CI users were measured by using monosyllabic words, and a substitution pattern was analyzed in terms of manner of articulation.ResultsThe results showed that both groups had a high percentage of nasal and plosive substitutions regardless of background conditions.ConclusionsThis finding will provide vital information for understanding the speech perception of hearing-impaired listeners and for improving their ability to communicate when applied to auditory training.

Background and ObjectivesDeficits of the aging auditory system negatively affect older listeners in terms of speech communication, resulting in limitations to their social lives. To improve their perceptual skills, the goal of this study was to investigate the effects of time alteration, selective word stress, and varying sentence lengths on the speech perception of older listeners.Subjects and MethodsSeventeen older people with normal hearing were tested for seven conditions of different time-altered sentences (i.e., ±60%, ±40%, ±20%, 0%), two conditions of selective word stress (i.e., no-stress and stress), and three different lengths of sentences (i.e., short, medium, and long) at the most comfortable level for individuals in quiet circumstances.ResultsAs time compression increased, sentence perception scores decreased statistically. Compared to a natural (or no stress) condition, the selectively stressed words significantly improved the perceptual scores of these older listeners. Long sentences yielded the worst scores under all time-altered conditions. Interestingly, there was a noticeable positive effect for the selective word stress at the 20% time compression.ConclusionsThis pattern of results suggests that a combination of time compression and selective word stress is more effective for understanding speech in older listeners than using the time-expanded condition only.

Although it is well-known that environmental noise can lead to hearing loss in individuals, the true extent of subway noise effects in the general population remains poorly understood. The purpose of the present study is to see changes of acoustic reflex thresholds and speech perception scores when passengers listen to music presented from their personal listening device in the subway. Forty subjects with normal hearing participated being divided into two groups, experimental and control groups. As a baseline, all subjects were measured by acoustic reflex thresholds in five test frequencies and Korean speech perception in noise (KSPIN) test at 0 and -5 dB SNR. In the experiment, the control group read newspaper or magazine in the subway noise, whereas the experimental group listened to music presented from their smartphone under the subway noise through speakers at 73.45 dBA for 60 min. After completing the experiment, two groups also conducted both acoustic reflex thresholds and KSPIN tests in the same condition as the baseline. The results showed that there was a significant difference of correct percent in speech-in-noise test between experimental and control groups and of that between two signal-to-noise ratios, which means the double noise exposure of 60 min might cause some degradation of speech perception when noise increases compared to only subway noise condition that was not statistically significant difference. We concluded that a risk of some degraded speech perception ability would be expected when passengers have a habit of listening to music in the subway noisy situation for a long duration.