Purpose To evaluate two measures of listening effort (a self-report measure and a word-recall measure) regarding their suitability for inclusion in a comprehensive audiologic testing protocol. The relationship between the two measures was explored and both measures were examined with regard to validity, sensitivity, and impact on speech intelligibility performance. Method Thirty adults with normal hearing participated. Speech intelligibility performance was evaluated at 4 SNRs using keywords embedded in both high and low-context sentences. Listening effort was evaluated at set intervals throughout the speech intelligibility task. Results Results obtained with the two measures were consistent with expected changes in listening effort. However, data obtained with the self-report method demonstrated greater sensitivity to these changes. The two measures were uncorrelated. Under certain conditions, speech intelligibility performance was more negatively impacted when the word-recall measure was used. Exploration of additional theoretical and practical considerations supported a conclusion that the self-report measure was preferable for measuring listening effort simultaneously with speech intelligibility. Conclusions The results of this study provide a rationale for preferring the self-report measure of listening effort over the word recall measure when testing audiologic outcomes.

Objectives One of the challenges facing hearing care providers when recommending hearing aids is the choice of device technology level. Major manufacturers market families of hearing aids that are described as spanning the range from basic technology to premium technology. Premium technology hearing aids include acoustical processing capabilities (features) that are not found in basic technology instruments. These premium features are intended to yield improved hearing in daily life compared to basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared to basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium-feature and basic-feature hearing aids in their daily lives. Design This was a single-blinded, repeated, crossover trial in which the participants were blinded. All procedures were carefully controlled to limit researcher bias. Forty-five participants used carefully fitted bilateral hearing aids for one month and then provided data to describe the hearing improvements or deficiencies noted in daily life. Typical participants were 70 years old with mild to moderate adult-onset hearing loss bilaterally. Each participant used 4 pairs of hearing aids: premium- and basic-feature devices from brands marketed by each of two major manufacturers. Participants were blinded about the devices they used and about the research questions. Results All of the outcomes were designed to capture the participant’s point of view about the benefits of the hearing aids. Three types of data were collected: change in hearing-related quality of life, extent of agreement with six positively worded statements about everyday hearing with the hearing aids, and reported preferences between the premium- and basic-feature devices from each brand as well as across all four research hearing aids combined. None of these measures yielded a statistically significant difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. Conclusions It could reasonably be asserted that the patient’s perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the current research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient’s point of view. All of the research hearin...

Overall, problems understanding amplified speech did not decrease in frequency when hearing aids transitioned from linear to compression processing; however, the compression capabilities of current hearing aids (with a possible contribution from noise reduction algorithms) have resulted in less negative reactions to amplified environmental sounds. This suggests that modern technology has ameliorated (to some extent) the common complaint that hearing aids cause many everyday sounds to become objectionably loud. Although the results of this study suggest that the advantages of improved technology do not lie in the domains of improved subjective speech communication performance, substantial improvement in the rate of successful adjustment to hearing aids between the 1995 and 2005 subject groups provides evidence that modern hearing aid technology has produced progress in other outcome domains.

Background: Hearing loss is one of the most common chronic health conditions of older people. Hearing aids are the customary treatment and they improve quality of life in older adults. Even so, relatively few older adults with uncomplicated, mild to moderate, adult-onset, sensorineural hearing loss use hearing aids. One reason for this is a belief that hearing aids do not provide sufficient value to justify their expense. Although modern hearing aids are available at several price points, there is minimal evidence about the relative benefits of premium-level versus basic-level hearing aid technologies. Objective: This research was designed to demonstrate the relative effectiveness of premium hearing aids compared with basic hearing aids in improving speech understanding and quality of life. Methods: 25 participants, including both new and experienced hearing aid users, completed blinded month-long field trials with each of four pairs of hearing aids: two basic and two premium level. Outcomes were laboratory speech understanding tests, standardized questionnaires and open-ended diary items. Results: Participants reacted very positively to all the hearing aids. Both everyday speech understanding and quality of life were substantially improved with hearing aids. Results for both new and experienced users were consistent with a conclusion that there were no statistically significant or clinically important differences in improvement between the premium- and basic-level hearing aids. Conclusions: It should not be assumed that more costly hearing aids always produce better outcomes. With contemporary hearing aids from two major manufacturers, the subjects obtained as much improvement in speech understanding and quality of life from lower-cost basic-level instruments as from higher-cost premium-level instruments. Regardless of technology level, comprehensive best-practice fitting protocols should be followed to optimize results for every patient. © 2014 S. Karger AG, Basel

We investigated the prevalence of cochlear dead regions in listeners with hearing losses similar to those of many hearing aid wearers, and explored the impact of these dead regions on speech perception. Prevalence of dead regions was assessed using the Threshold Equalizing Noise test (TEN(HL)). Speech recognition was measured using high-frequency emphasis (HFE) Quick Speech In Noise (QSIN) test stimuli and low-pass filtered HFE QSIN stimuli. About one third of subjects tested positive for a dead region at one or more frequencies. Also, groups without and with dead regions both benefited from additional high-frequency speech cues.