Minimal technologies for hearing aid success in elderly adults

描述(由申请人提供)：本研究的目标是提高听力保健的可负担性和可及性--这是NIDCD/NIH的优先事项。在那些可以从助听器放大中受益的人中，轻度听力损失的人不到十分之一，中度到重度听力损失的人不到十分之四获得并使用助听器。人们不寻求干预的最常被报道的原因之一是助听器的高成本。目前，市场上有各种配备了相对低端技术的低成本助听器。因此，重要的是要检查听力受损的老年人是否需要昂贵的高端技术来获得最佳的助听器好处，因为他们通常比年轻的听众对交流的需求更少。本研究的第一个目的是调查技术水平与双侧轻、中度听力损失老年人助听器实际效果之间的关系，重点是定向麦克风和数字降噪技术。由于(1)这两种听力技术的效果高度依赖于听力情况，以及(2)经过长达一个月的现场试验，老年听者较难正确回忆情景依赖的效果，因此我们将采用具有足够情景分辨率且不受回忆偏差影响的真实世界结果测量系统来评估真实世界的助听器效果。该系统包括(1)主观生态瞬时评估，包括使用现代无线智能手机和互联网对听众在实时和自然环境中的感知进行重复采样；(2)客观的自动化系统，通过分析听众在日常活动中录制的音频，来表征和模拟听众的自然交流行为和环境。由于该系统尚未被用于评估听力技术，本研究的第二个目的是探索如何使用我们的结果测量系统、无线智能手机和互联网来确定听力保健的成功。在研究的每个现场试验部分，参与者将佩戴配备低端或高端定向麦克风和数字降噪技术的助听器四周，然后使用我们的结果测量系统评估助听器成功与否一周。将对这些技术的好处进行审查和比较，以确定老年听众所需的最低技术水平，这反过来将促进更适当和负担得起的听力保健。我们的可行性、可靠性和合规性 评估系统也将被审查。这些信息对自动化远程听力学的实施将是有价值的，这将大大增加听力保健的可及性。

DESCRIPTION (provided by applicant): The goal of this research is to increase the affordability and accessibility of hearing health care-a priority of the NIDCD/NIH. Of those who could benefit from hearing aid amplification, less than one in ten with mild hearing loss and less than four in ten with moderate-to-severe hearing loss acquire and use hearing aids. One of the most often reported reasons that people do not seek intervention is hearing aids' high cost. Currently a variety of low-cost hearing aids equipped with relatively low-end technologies are available on the market. Thus, it is important to examine if hearing-impaired elderly adults, who typically have fewer communication demands than younger listeners, need expensive high-end technologies to attain optimal hearing aid benefits. The first aim of this research is to investigae the relationship between technology level and the real-world effectiveness of hearing aids in elderly adults with bilateral mild to moderate hearing loss, focusing on directional microphone and digital noise reduction technologies. Because (1) the effects of these two hearing technologies are highly dependent on the listening situation and (2) elderly listeners are less able to correctly recall the situational-dependent effect after month-long field trials, we will employ a real-world outcome measure system that has sufficient situational resolution and is not subject to recall bias to assess real-world hearing aid effectiveness. The system consists of (1) a subjective Ecological Momentary Assessment, which involves repeated sampling of listeners' perception in real time and in natural environments using modern wireless smartphones and the Internet, and (2) an objective, automated system that could characterize and model the listeners' natural communication behaviors and environments by analyzing the audio recordings made during the listeners' daily activities. Since this system has not been used to evaluate hearing technologies, the second aim of this research is to explore how our outcome measure system, wireless smartphones, and the Internet could be used to determine the success of hearing health care. In each field trial section of the study, participants will wear hearing aids equipped with low- or high-end directional microphone and digital noise reduction technologies for four weeks and then use our outcome measure system to assess hearing aid success for one week. The benefits of the technologies will be examined and compared to determine the minimal technology level needed by elderly listeners, which in turn will facilitate more appropriate and affordable hearing health care. The feasibility, reliability, and compliance of our assessment system will also be examined. Such information will be valuable in the implementation of automated tele-audiology, which will greatly increase the accessibility of hearing health care.