Impact of Hearing Aid Technology on Outcomes in Daily Life III: Localization

Abstract

Objective Compared to basic-feature hearing aids, premium-feature hearing aids have more advanced technologies and sophisticated features. The objective of this study was to explore the difference between premium-feature and basic-feature hearing aids in horizontal sound localization in both laboratory and daily life environments. We hypothesized that premium-feature hearing aids would yield better localization performance than basic-feature hearing aids. Design Exemplars of premium-feature and basic-feature hearing aids from two major manufacturers were evaluated. Forty-five older adults (mean age 70.3 years) with essentially symmetrical mild-to-moderate sensorineural hearing loss were bilaterally fitted with each of the four pairs of hearing aids. Each pair of hearing aids was worn during a 4-week field trial and then evaluated using laboratory localization tests and a standardized questionnaire. Laboratory localization tests were conducted in a sound treated room with a 360°, 24-loudspeaker array. Test stimuli were high-frequency and low-frequency filtered short sentences. The localization test in quiet was designed to assess the accuracy of front/back localization, while the localization test in noise was designed to assess the accuracy of locating sound-sources throughout a 360° azimuth in the horizontal plane. Results Laboratory data showed that unaided localization was not significantly different from aided localization when all hearing aids were combined. Questionnaire data showed that aided localization was significantly better than unaided localization in everyday situations. Regarding the difference between premium-feature and basic-feature hearing aids, laboratory data showed that, overall, the premium-feature hearing aids yielded more accurate localization than the basic-feature hearing aids when high frequency stimuli were used and the listening environment was quiet. Otherwise, the premium-feature and basic-feature hearing aids yielded essentially the same performance in other laboratory tests and in daily life. The findings were consistent for both manufacturers. Conclusions Laboratory tests for two of six major manufacturers showed that premium-feature hearing aids yielded better localization performance than basic-feature hearing aids in one out of four laboratory conditions. There was no difference between the two feature levels in self-reported everyday localization. Effectiveness research with different hearing aid technologies is necessary and more research with other manufacturer’s products is needed. Furthermore, these results confirm previous observations that research findings in laboratory conditions might not translate to everyday life.

Efficacy and Effectiveness of Advanced Hearing Aid Directional and Noise Reduction Technologies for Older Adults With Mild to Moderate Hearing Loss

“…Contrary to laboratory tests, retrospective self-reports did not demonstrate any differential effect of premium DM/NR features compared with basic features across all outcome domains ( Figure 5). Furthermore, consistent with the research by Cox and her colleagues (Cox et al 2014(Cox et al , 2016Johnson et al 2016Johnson et al , 2017, premium HAs and basic HAs yielded similar real-world outcomes. Retrospective self-reports, however, did indicate that DM/NR features significantly improved speech understanding (by 0.33 points, or 3.3%, for premium HAs) and satisfaction (by 4.4% and 4.2% for premium and basic HAs, respectively), although the small amount of improvement might not be clinically important.…”

“…In contrast, evidence supporting the effect of premium DM/NR features in the real world is limited. Recently Cox and her colleagues conducted a clinical trial to examine the relative effect of premium-feature HAs compared with basicfeature HAs in improving speech understanding, listening effort, sound localization, and quality of life (Cox et al 2014(Cox et al , 2016Johnson et al 2016Johnson et al , 2017. Results indicated that there were no statistically significant or clinically important differences in improvement between premium and basic HAs in most laboratory tests and in the real world.…”

Benefits from, Satisfaction with, and Self-Efficacy for Advanced Digital Hearing Aids in Users with Mild Sensorineural Hearing Loss

“…Johnson and colleagues 11 found that only 10 studies were available in the peer-reviewed literature that had reported HA outcomes for patients with MSNHL, and most of those investigations only involved low levels of evidence, were rather dated, and reported findings for analog and early digital devices. Cox et al and Johnson et al, [21][22][23] however, reported outcomes from studies that compared entry-to premium-level ADT HAs for patients with mild and moderate SNHL. Although the findings for persons with MSNHL were similar to those with moderate losses, outcomes were not reported separately for the group with MSNHL.…”

The Effect of Hearing Loss on Localization of Amplitude-Panned and Physical Sources

“…16,17 It is also the expected scenario for use of this technique in a clinical context. [25][26][27][28] For these reasons, free head movement was deemed to be an acceptable experimental choice in the present study.…”