A systematic review and meta-analysis of digital noise reduction hearing aids in adults

Lakshmi, Magudilu Srishyla Kumar; Rout, Ayasakanta; O'Donoghue, Cynthia R.

doi:10.1080/17483107.2019.1642394

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…A recent white paper observed a 3 dB improvement in SNR when using DNR with adaptive directionality compared with an omnidirectional condition (Taylor & Jensen 2022). This 3 dB effect is much larger than expected from DNR alone (Lakshmi et al 2021), and is likely due primarily to the directionality. Another white paper observed no difference in speech intelligibility when using noise reduction (Gastler & Pisa 2010).…”

Section: Discussionmentioning

confidence: 66%

“…DNR is a hearing aid processing strategy that aims to reduce the amplification for especially noisy time-portions of a speech signal. DNR is used in the majority of wearable hearing aids; however, a recent systematic review found that there was no significant benefit of DNR for speech recognition, whether applied alone or in conjunction with directionality (Lakshmi et al 2021). One study even found that DNR processing reduced speech intelligibility (Reinhart et al 2020).…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Signal to Noise Ratio, T 60, Wide-Dynamic Range Compression Speed, and Digital Noise Reduction in a Virtual Restaurant Setting

Ellis,

Crukley,

Souza

2024

Ear &Amp; Hearing

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Objectives: Hearing aid processing in realistic listening environments is difficult to study effectively. Often the environment is unpredictable or unknown, such as in wearable aid trials with subjective report by the wearer. Some laboratory experiments create listening environments to exert tight experimental control, but those environments are often limited by physical space, a small number of sound sources, or room absorptive properties. Simulation techniques bridge this gap by providing greater experimental control over listening environments, effectively bringing aspects of the real-world into the laboratory. This project used simulation to study the effects of wide-dynamic range compression (WDRC) and digital noise reduction (DNR) on speech intelligibility in a reverberant environment with six spatialized competing talkers. The primary objective of this study was to determine the efficacy of WDRC and DNR in a complex listening environment using virtual auditory space techniques. Design: Participants of greatest interest were listeners with hearing impairment. A group of listeners with clinically normal hearing was included to assess the effects of the simulation absent the complex effects of hearing loss. Virtual auditory space techniques were used to simulate a small restaurant listening environment with two different reverberation times (0.8 and 1.8 sec) in a range of signal to noise ratios (SNRs) (−8.5 to 11.5 dB SNR). Six spatialized competing talkers were included to further enhance realism. A hearing aid simulation was used to examine the degree to which speech intelligibility was affected by slow and fast WDRC in conjunction with the presence or absence of DNR. The WDRC and DNR settings were chosen to be reasonable estimates of hearing aids currently available to consumers. Results: A WDRC × DNR × Hearing Status interaction was observed, such that DNR was beneficial for speech intelligibility when combined with fast WDRC speeds, but DNR was detrimental to speech intelligibility when WDRC speeds were slow. The pattern of the WDRC × DNR interaction was observed for both listener groups. Significant main effects of reverberation time and SNR were observed, indicating better performance with lower reverberation times and more positive SNR. Conclusions: DNR reduced low-amplitude noise before WDRC-amplified the low-intensity portions of the signal, negating one potential downside of fast WDRC and leading to an improvement in speech intelligibility in this simulation. These data suggest that, in some real-world environments that include both reverberation and noise, older listeners with hearing impairment may find speech to be more intelligible if DNR is activated when the hearing aid has fast compression time constants. Additional research is needed to determine the appropriate DNR strength and to confirm results in wearable hearing aids and a wider range of listening environments.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

The Effects of Signal to Noise Ratio, T 60, Wide-Dynamic Range Compression Speed, and Digital Noise Reduction in a Virtual Restaurant Setting

Ellis,

Crukley,

Souza

2024

Ear &Amp; Hearing

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“…This standard item focuses on the selection and fitting of hearing aid signal processing, including gain and special features. The standard is based, among other things, on decades of research into benefits (e.g., on speech recognition, subjective hearing aid benefit, sound quality ratings) of input-specific gain configuration as specified by prescriptive fitting methods, 38 66 67 68 69 digital noise reduction, 70 71 72 73 unilateral beamforming, 5 74 75 bilateral beamformer microphones, 76 77 78 and frequency lowering. 79 80 81 82 Although these features and signal processing strategies have documented benefits, it is noteworthy the benefits can be small and person-specific.…”

Section: Hearing Aid Processingmentioning

confidence: 99%

Applying the Hearing Aid Fitting Standard to Selection for Adults

et al. 2022

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The recent hearing aid fitting standard for adults outlines the minimum practice for audiologists fitting adult patients with hearing loss. This article focuses on three items of the standard (5, 6, and 7), which focus on the selection of unilateral/bilateral hearing aids, hearing aid style, and coupling, in addition to feature selection. The standard emphasizes that decisions around these three aspects should be recommended for a patient in an individualized manner, based on their needs assessment. For these decisions, the needs assessment might include measures of speech-in-noise ability, social network size, patient preference, and a trial period. Additional elements could include assessments of manual dexterity, binaural interference, and attitude toward hearing aids. However, there are a multitude of ways to practice clinically and still meet the items outlined in the standard. As long as the selection decisions consider individualized patient factors and are capable of meeting validated prescriptive targets, a clinician would be meeting the adult hearing aid fitting minimum standard guidance. In addition, despite the large number of past studies supporting these standards, additional, high-quality research including randomized, controlled, clinical trials are still needed to further support appropriate minimum standard recommendations.

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“…One commonly used group of techniques focus on the temporal domain. These exploit the fact that the amplitude envelope of speech tends to have a lower modulation frequency and depth than environmental noise ( Ding et al, 2017 ; Lakshmi et al, 2021 ). These techniques classify speech signals as having a modulation rate less than around 10–30 Hz and a modulation depth greater than around 15 dB (e.g., Schum, 2003 ).…”

Section: Haptic Signal-processing Approachesmentioning

confidence: 99%

“…These techniques might be adapted to focus on the typical characteristics of musical instruments (e.g., Ding et al, 2017 ), although it should be noted that these approaches were developed to extract a single sound source and that musical instruments often share temporal and spectral characteristics. Furthermore, a recent meta-analysis found no significant improvement in speech intelligibility with digital noise-reduction algorithms in HA users, although subjective outcomes, such as sound quality, did show moderate improvement ( Lakshmi et al, 2021 ).…”

Section: Haptic Signal-processing Approachesmentioning

confidence: 99%

Can Haptic Stimulation Enhance Music Perception in Hearing-Impaired Listeners?

Fletcher

2021

Front. Neurosci.

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Cochlear implants (CIs) have been remarkably successful at restoring hearing in severely-to-profoundly hearing-impaired individuals. However, users often struggle to deconstruct complex auditory scenes with multiple simultaneous sounds, which can result in reduced music enjoyment and impaired speech understanding in background noise. Hearing aid users often have similar issues, though these are typically less acute. Several recent studies have shown that haptic stimulation can enhance CI listening by giving access to sound features that are poorly transmitted through the electrical CI signal. This “electro-haptic stimulation” improves melody recognition and pitch discrimination, as well as speech-in-noise performance and sound localization. The success of this approach suggests it could also enhance auditory perception in hearing-aid users and other hearing-impaired listeners. This review focuses on the use of haptic stimulation to enhance music perception in hearing-impaired listeners. Music is prevalent throughout everyday life, being critical to media such as film and video games, and often being central to events such as weddings and funerals. It represents the biggest challenge for signal processing, as it is typically an extremely complex acoustic signal, containing multiple simultaneous harmonic and inharmonic sounds. Signal-processing approaches developed for enhancing music perception could therefore have significant utility for other key issues faced by hearing-impaired listeners, such as understanding speech in noisy environments. This review first discusses the limits of music perception in hearing-impaired listeners and the limits of the tactile system. It then discusses the evidence around integration of audio and haptic stimulation in the brain. Next, the features, suitability, and success of current haptic devices for enhancing music perception are reviewed, as well as the signal-processing approaches that could be deployed in future haptic devices. Finally, the cutting-edge technologies that could be exploited for enhancing music perception with haptics are discussed. These include the latest micro motor and driver technology, low-power wireless technology, machine learning, big data, and cloud computing. New approaches for enhancing music perception in hearing-impaired listeners could substantially improve quality of life. Furthermore, effective haptic techniques for providing complex sound information could offer a non-invasive, affordable means for enhancing listening more broadly in hearing-impaired individuals.

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A systematic review and meta-analysis of digital noise reduction hearing aids in adults

Cited by 10 publications

References 30 publications

The Effects of Signal to Noise Ratio, T 60, Wide-Dynamic Range Compression Speed, and Digital Noise Reduction in a Virtual Restaurant Setting

The Effects of Signal to Noise Ratio, T 60, Wide-Dynamic Range Compression Speed, and Digital Noise Reduction in a Virtual Restaurant Setting

Applying the Hearing Aid Fitting Standard to Selection for Adults

Can Haptic Stimulation Enhance Music Perception in Hearing-Impaired Listeners?

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