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J Am Acad Audiol 2019; 30(04): 302-314
DOI: 10.3766/jaaa.17101
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tracking of Noise Tolerance to Predict Hearing Aid Satisfaction in Loud Noisy Environments

Eric Seper
*   Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, IL
,
Francis Kuk
*   Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, IL
,
Petri Korhonen
*   Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, IL
,
Christopher Slugocki
*   Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, IL
› Author Affiliations
Further Information

Publication History

28 July 2017

01 November 2017

Publication Date:
26 May 2020 (online)

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Abstract

Background:

A method that tracked tolerable noise level (TNL) over time while maintaining subjective speech intelligibility was reported previously. Although this method was reliable and efficacious as a research tool, its clinical efficacy and predictive ability of real-life hearing aid satisfaction were not measured.

Purpose:

The study evaluated an adaptive method to estimate TNL using slope and variance of tracked noise level as criteria in a clinical setting. The relationship between TNL and subjective hearing aid satisfaction in noisy environments was also investigated.

Research Design:

A single-blinded, repeated-measures design.

Study Sample:

Seventeen experienced hearing aid wearers with bilateral mild-to-moderately-severe sensorineural hearing loss.

Data Collection and Analysis:

Participants listened to 82-dB SPL continuous speech and tracked the background noise level that they could “put up with” while subjectively understanding >90% of the speech material. Two trials with each babble noise and continuous speech-shaped noise were measured in a single session. All four trials were completed aided using the participants’ own hearing aids. The stimuli were presented in the sound field with speech from 0° and noise from the 180° azimuth. The instantaneous tolerable noise level was measured using a custom program and scored in two ways; the averaged TNL (aTNL) over the 2-min trial and the estimated TNL (eTNL) as soon as the listeners reached a stable noise estimate. Correlation between TNL and proportion of satisfied noisy environments was examined using the MarkeTrak questionnaire.

Results:

All listeners completed the tracking of noise tolerance procedure within 2 min with good reliability. Sixty-five percent of the listeners yielded a stable noise estimate after 59.9 sec of actual test time. The eTNL for all trials was 78.6 dB SPL (standard deviation [SD] = 4.4 dB). The aTNL for all trials was 78.0 dB SPL (SD = 3.3 dB) after 120 sec. The aTNL was 79.2 dB SPL (SD = 5.4 dB) for babble noise and 77.0 dB SPL (SD = 5.9 dB) for speech-shaped noise. High within-session test–retest reliability was evident. The 95% confidence interval was 1.5 dB for babble noise and 2.8 dB for continuous speech-shaped noise. No significant correlation was measured between overall hearing aid satisfaction and the aTNL (ρ = 0.20 for both noises); however, a significant relationship between aTNL and proportion of satisfied noisy situations was evident (ρ = 0.48 for babble noise and ρ = 0.55 for speech-shaped noise).

Conclusion:

The eTNL scoring method yielded similar results as the aTNL method although requiring only half the time for 65% of the listeners. This time efficiency, along with its reliability and the potential relationship between TNL and hearing aid satisfaction in noisy listening situations suggests that this procedure may be a good clinical tool to evaluate whether specific features on a hearing aid would improve noise tolerance and predict wearer satisfaction with the selected hearing aid in real-life loud noisy situations. A larger sample of hearing aid wearers is needed to further validate these potential uses.

Key Words

hearing aid satisfaction - reliability - tolerable noise level - tracking of noise tolerance

Eric Seper is now at the University of Chicago Medicine.


 

  • REFERENCES

  • American Academy of Audiology (AAA), Task Force for Guidelines for the Audiologic Management of Adult Hearing Impairment 2006 Guidelines for the Audiologic Management of Adult Hearing Impairment.. Retrieved from https://audiology-web.s3.amazonaws.com/migrated/haguidelines.pdf_53994876e92e42.70908344.pdf . Accessed June 1, 2017
    PubMedGoogle Scholar
  • American National Standards Institute (ANSI) (1997) American National Standard: Methods for the Calculation of the Speech Intelligibility Index. ANSI S3.5. New York, NY: ANSI
  • Beattie RC, Boyd RL. 1986; Relationship between pure tone and speech loudness discomfort levels among hearing-impaired subjects. J Speech Hear Disord 51 (02) 120-124
    CrossrefPubMedGoogle Scholar
  • Bentler R, Wu YH, Kettel J, Hurtig R. 2008; Digital noise reduction: outcomes from laboratory and field studies. Int J Audiol 47 (08) 447-460
    CrossrefPubMedGoogle Scholar
  • Bertoli S, Staehelin K, Zemp E, Schindler C, Bodmer D, Probst R. 2009; Survey on hearing aid use and satisfaction in Switzerland and their determinants. Int J Audiol 48 (04) 183-195
    CrossrefPubMedGoogle Scholar
  • Brännström J, Olsen S, Holm L, Kastberg T, Ibertsson T. 2014; The effect of repeated measurements and working memory on the most comfortable level in the ANL test. Int J Audiol 53 (11) 787-795
    CrossrefPubMedGoogle Scholar
  • Brungart DS. 2001; Informational and energetic masking effects in the perception of two simultaneous talkers. J Acoust Soc Am 109 (03) 1101-1109
    CrossrefPubMedGoogle Scholar
  • Carhart R. 1947; Selection of hearing aids. Arch Otolaryngol 44: 1-18
    Google Scholar
  • Cooke M. 2006; A glimpsing model of speech perception in noise. J Acoust Soc Am 119 (03) 1562-1573
    CrossrefPubMedGoogle Scholar
  • Cox RM, Alexander GC. 1995; The abbreviated profile of hearing aid benefit. Ear Hear 16 (02) 176-186
    PubMedGoogle Scholar
  • Cox RM, Alexander GC. 2002; The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version. Int J Audiol 41 (01) 30-35
    CrossrefPubMedGoogle Scholar
  • Davis H, Hudgins C, Marquis R, Nichols R, Peterson G, Ross D, Stevens S. 1946; The selection of hearing aids. Laryngoscope 56: 85-115
    CrossrefPubMedGoogle Scholar
  • Dawes P, Maslin M, Munro KJ. 2014; ‘Getting used to’ hearing aids from the perspective of adult hearing aid users. Int J Audiol 53 (12) 861-870
    CrossrefPubMedGoogle Scholar
  • Dillon H. 2001. Hearing Aids. New York, NY: Thieme;
    Google Scholar
  • Filion P, Margolis RH. 1992; Comparison of clinical and real-life judgments of loudness discomfort. J Am Acad Audiol 3 (03) 193-199
    PubMedGoogle Scholar
  • Franklin CA, White LJ, Franklin TC. 2012; Relationship between loudness tolerance and the acceptance of background noise for young adults with normal hearing. Percept Mot Skills 114 (03) 717-722
    CrossrefPubMedGoogle Scholar
  • Freyaldenhoven MC, Nabelek AK, Burchfield SB, Thelin JW. 2005; Acceptable noise level as a measure of directional hearing aid benefit. J Am Acad Audiol 16 (04) 228-236
    Article in Thieme ConnectPubMedGoogle Scholar
  • Freyaldenhoven MC, Nabelek AK, Tampas JW. 2008; Relationship between acceptable noise level and the abbreviated profile of hearing aid benefit. J Speech Lang Hear Res 51 (01) 136-146
    CrossrefPubMedGoogle Scholar
  • Freyaldenhoven MC, Smiley DF, Muenchen RA, Knorad TN. 2006; Acceptable noise level: reliability measures and comparison to Preference for background sounds. J Am Acad Audiol 17 (09) 640-648
    Article in Thieme ConnectPubMedGoogle Scholar
  • Hawthorne G. 2008; Perceived social isolation in a community sample: its prevalence and correlates with aspects of peoples’ lives. Soc Psychiatry Psychiatr Epidemiol 43 (02) 140-150
    CrossrefPubMedGoogle Scholar
  • Ho HC, Wu YH, Hsiao SH, Zhang X. 2013; Acceptable noise level (ANL) and real-world hearing-aid success in Taiwanese listeners. Int J Audiol 52 (11) 762-770
    CrossrefPubMedGoogle Scholar
  • Jenstad LM, Van Tasell DJ, Ewert C. 2003; Hearing aid troubleshooting based on patients’ descriptions. J Am Acad Audiol 14 (07) 347-360
    Article in Thieme ConnectPubMedGoogle Scholar
  • Keidser G, Dillon H, Flax M, Ching T, Brewer S. 2011; The NAL-NL2 prescription procedure. Audiol Res 1 (01) e24
    PubMedGoogle Scholar
  • Kincaid JP, Fishburne RP, Rogers RL, Chissom BS. 1975 Derivation of new readability formulas: (automated readability index, fog count, and Flesch reading ease formula) for Navy enlisted personnel [Research Branch Report 8–75]. Chief of Naval Technical Training: Naval Air Station Memphis.
    PubMedGoogle Scholar
  • Kochkin S. 2000; MarkeTrak V: ‘why my hearing aids are in the drawer’: the consumers’ perspective. Hear J 53: 34-41
    Google Scholar
  • Kochkin S. 2010; MarkeTrak VIII: consumer satisfaction with hearing aids is slowly improving. Hear J 63 (01) 19-32
    Google Scholar
  • Krishnamurti S, Anderson L. 2008; Digital noise reduction processing in hearing aids: how much and where?. Hear Rev 15 (03) 90-93
    Google Scholar
  • Kuk F, Damsgaard A, Bulow M, Ludvigsen C. 2004; Using digital hearing aids to visualize real life effects of signal processing. Hear J 57 (04) 40-49
    Google Scholar
  • Kuk F, Lau CC, Korhonen P, Crose B. 2015; Speech intelligibility benefits of hearing aids at various input levels. J Am Acad Audiol 26 (03) 275-288
    Article in Thieme ConnectPubMedGoogle Scholar
  • Kuk F, Peeters H, Lau C, Korhonen P. 2011; Effect of maximum power output and noise reduction on speech recognition in noise. J Am Acad Audiol 22 (05) 265-273
    Article in Thieme ConnectPubMedGoogle Scholar
  • Kuk F, Seper E, Lau C, Korhonen P. 2017; Tracking of noise tolerance to measure hearing aid benefit. J Am Acad Audiol 28 (08) 698-707
    Article in Thieme ConnectPubMedGoogle Scholar
  • Morgan DE, Wilson RH, Dirks DD. 1974; Loudness discomfort level: selected methods and stimuli. J Acoust Soc Am 56 (02) 577-581
    CrossrefPubMedGoogle Scholar
  • Mueller HG. 2003; Fitting test protocols are more honored in the breach than in the observance. Hear J 56 (10) 19-26
    Google Scholar
  • Mueller HG, Bentler RA. 2005; Fitting hearing aids using clinical measures of loudness discomfort levels: an evidence-based review of effectiveness. J Am Acad Audiol 16 (07) 461-472
    Article in Thieme ConnectPubMedGoogle Scholar
  • Nabelek AK, Freyaldenhoven MC, Tampas JW, Burchfield SB, Muenchen RA. 2006; Acceptable noise level as a predictor of hearing aid use. J Am Acad Audiol 17 (09) 626-639
    Article in Thieme ConnectPubMedGoogle Scholar
  • Nabelek AK, Tucker FM, Letowski TR. 1991; Toleration of background noise: relationship with patterns of hearing aid use by elderly persons. J Speech Hear Res 34: 679-685
    CrossrefPubMedGoogle Scholar
  • Oeding K, Valente M. 2013; Differences in sensation level between the Widex soundtracker and two real-ear analyzers. J Am Acad Audiol 24 (08) 660-670
    Article in Thieme ConnectPubMedGoogle Scholar
  • Olsen SO, Brännström KJ. 2014; Does the acceptable noise level (ANL) predict hearing aid use?. Int J Audiol 53 (01) 2-20
    CrossrefPubMedGoogle Scholar
  • Olsen SO, Lantz J, Nielsen LH, Brännström KJ. 2012; Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users. Int J Audiol 51 (09) 678-688
    CrossrefPubMedGoogle Scholar
  • Olsen S, Nielsen L, Lantz J, Brännström J. 2013; Intertester reliability of the acceptable noise level. J Am Acad Audiol 24 (03) 241-243
    Article in Thieme ConnectPubMedGoogle Scholar
  • Pearsons K, Bennett R, Fidell S. 1977. Speech Levels in Various Noise Environments [Report No. EPA-600/1-77-025] . Washington, DC: US Environmental protection Agency;
    Google Scholar
  • Peeters H, Kuk F, Lau CC, Keenan D. 2009; Subjective and objective evaluation of noise management algorithms. J Am Acad Audiol 20 (02) 89-98
    Article in Thieme ConnectPubMedGoogle Scholar
  • Philibert B, Collet L, Vesson JF, Veuillet E. 2005; The auditory acclimatization effect in sensorineural hearing-impaired listeners: evidence for functional plasticity. Hear Res 205 (01) 131-142
    CrossrefPubMedGoogle Scholar
  • Stephens SDG, Anderson CMB. 1971; Experimental studies on the uncomfortable loudness level. J Speech Hear Res 14: 262-270
    PubMedGoogle Scholar
  • Taylor B. 2008; The acceptable noise level test as a predictor of real-world hearing aid benefit. Hear J 61 (09) 39-42
    Google Scholar
  • Walravens E, Keidser G, Hartley D, Hickson L. 2014; An Australian version of the acceptable noise level test and its predictive value for successful hearing aid use in an older population. Int J Audiol 53: S52-S59
    CrossrefPubMedGoogle Scholar
  • Watson L, Tolan T. 1949. Hearing Tests and Hearing Instruments. Baltimore, MD: Williams & Wilkins;
    Google Scholar
  • Wu YH, Ho HC, Hsiao SH, Brummet RB, Chipara O. 2016; Predicting three-month and 12-month post-fitting real-world hearing-aid outcome using pre-fitting acceptable noise level (ANL). Int J Audiol 55 (05) 285-294
    CrossrefPubMedGoogle Scholar
  • Wu YH, Stangl E. 2013; The effect of hearing aid signal-processing schemes on acceptable noise levels: perception and prediction. Ear Hear 34 (03) 333-341
    PubMedGoogle Scholar