Characterizing variability in hearing aid outcomes among older adults

描述（由申请人提供）：数字助听器中使用的先进信号处理算法提高了助听器的平均效益和满意度。然而，对助听器的反应是高度可变的，有些人报告比其他人受益更多。这种差异在年长的听众中最为明显。一个重要的问题是什么水平的高级助听器处理是必要的，以实现成功的助听器在个人听众。每种形式的非线性信号处理都有其自己的一套权衡， 相对于由信号处理引起的信号的增加的修改，改善的可听度。然而，没有有效的程序来确定谁将从处理中受益，或者应该如何为单个听众调整处理。这项研究的长期目标是使用基于证据的临床测试来指导选择最适合在自己的听力环境中佩戴助听器的老年人的信号处理。本研究的第一个具体目的是描述老年人对信号操纵的反应的变异性，并确定哪些患者因素与该变异性相关。第一个实验测量在受控实验室条件下对由几种类型的助听器处理引起的信号修改的响应，并将这些响应与患者因素联系起来。第二个实验将这些概念扩展到听者自己环境中的可穿戴助听器。第二个具体目标是前瞻性地确定个人助听器信号操作的适当水平，并在临床条件下验证该确定。第三个实验将把前两个实验的结果转化为一组患者测试，这些测试可以在临床上用于预测个体的最佳信号处理。对助听器信号处理的预期响应将包括辅助语音清晰度、辅助声音质量和/或听力障碍的感知减少。患者因素包括听力图、频谱-时间处理能力和认知能力。

DESCRIPTION (provided by applicant): The advanced signal-processing algorithms used in digital hearing aids have improved average hearing aid benefit and satisfaction. However, response to hearing aids is highly variable, with some individuals reporting much more benefit than others. This variability is most evident among older listeners. An important issue is what levels of advanced hearing aid processing are necessary to achieve success with hearing aids in individual listeners. Every form of nonlinear signal processing has its own set of trade-offs of improved audibility versus increased modification of the signal caused by the signal processing. However, there are no effective procedures for determining who will benefit from the processing or how the processing should be adjusted for the individual listener. The long term goal of this research is use evidence-based clinical tests to guide the selection of signal processing that is most appropriate for individual older adults wearing hearing aids in their own listening environments. The first specific aim of this study is to characterize variability in response to signal manipulation among older adults and to determine what patient factors are related to that variability. The first experiment measures response to signal modification caused by several types of hearing aid processing under controlled laboratory conditions and relates those responses to patient factors. The second experiment extends those concepts to wearable hearing aids in the listener's own environment. The second specific aim is to determine prospectively the appropriate level of hearing-aid signal manipulation for an individual and to validate that determination, under clinical conditions. The third experiment will translate the results from the first two experiments into a set of patient tests that can be used clinically to predict the optimal signal processing for an individual. Listener response to hearing aid signal processing will include aided speech intelligibility, aided sound quality, and/or perceived reduction of hearing handicap. Patient factors will include the audiogram, spectral-temporal processing abilities, and cognitive abilities.