Improving Amplification Outcomes in Noise by Self-Directed Hearing Aid Fitting

描述（由申请人提供）：助听器用户对助听器在噪音中的表现相当不满。目前用于设置助听器参数（多频增益和压缩）的基于音频图的方法是基于安静时语音的预测响度和/或可懂度;没有基于研究的处方方法用于设置噪声中语音的参数。与此同时，越来越多的证据表明，听力受损者在噪音中理解言语的能力差异很大，即使他们的听力图非常相似。考虑到噪声中语音理解的这种差异，可以合理地预期，在嘈杂环境的最佳听力设置中，助听器用户之间的差异至少会同样大。如果是这种情况，那么目前用于设置助听器参数以用于噪声的方法几乎肯定会对许多助听器用户产生次优结果。助听器无线控制的出现提供了一个直接解决与助听器参数设置相关的问题的机会，用户认为这些问题最有益。用于模拟不同声音环境的复杂系统的可用性将使得有可能收集关于仍然处于紧密实验控制下的不同声音环境中的助听器设置偏好的大量数据。这里提出的工作是一个系统的探索如何首选助听器设置不同的助听器用户和声音环境。将测试以下假设：a.安静设置的首选设置与嘈杂设置的首选设置不同。B.助听器用户之间的偏好设置的差异对于噪声设置比对于安静设置更大。C.通过临床和实验室测量噪声环境下的言语理解，可以预测受试者偏好的噪声环境。D.在安静和嘈杂的情况下，用户调整的设置将比使用当前临床实践获得的设置提供更大的感知用户受益。e.一些用户将从听力中获益 允许用户在现场随意调整的辅助工具。总的来说，研究结果将通过提供针对嘈杂环境设置助听器的新方法来改善助听器的效果，并允许用户在日常使用中设置自己的助听器。这两种结果都有可能通过增加诊所和日常生活中助听器设置的感知益处来提高对助听器的满意度。

DESCRIPTION (provided by applicant): Hearing aid users experience considerable dissatisfaction with hearing aids in noise. Current audiogram-based methods for setting hearing aid parameters (multifrequency gain and compression) are based on predicted loudness and/or intelligibility of speech in quiet; there is no research-based prescription method for setting parameters for speech in noise. At the same time, there is a growing body of evidence that hearing-impaired persons vary considerably in their ability to understand speech in noise, even when their audiograms are very similar. Given this variance in speech understanding in noise, it is reasonable to expect that the variance across hearing aid users in the optimal hearing settings for noisy environments will be at least as large. If this is the case, then the current methods for setting hearing aid parameters for use in noise are almost certainly producing suboptimal results for many hearing aid users. The advent of wireless control of hearing aids provides an opportunity to address directly questions related to the hearing aid parameter settings that users find most beneficial. Availability of a sophisticated system for simulating different sound environments will make is possible to collect a substantial body of data on hearing aid setting preferences in different sound environments that are still under close experimental control. Work proposed here is a systematic exploration of how preferred hearing aid settings vary across hearing aid users and across sound environments. The following hypotheses will be tested: a. Preferred settings are not the same for quiet settings as they are for noisy settings. b. Variance in preferred settings among hearing aid users is larger for noisy settings than it is for quiet settings. c. Preferred noisy settings can be predicted from clinical nd laboratory measures of speech understanding in noise. d. User-adjusted settings will provide greater perceived user benefit in both quiet and noisy situations than settings derived using current clinical practices for setting hearing aids. e. Some users will obtain benefit from hearing aids that allow at-will user adjustments in the field. Overall, results will improve hearing aid outcomes by providing new methods for setting hearing aids for noisy settings, and for allowing users to set their own hearing aids in daily use. Both outcomes have the potential of increasing satisfaction with hearing aids by increasing the perceived benefit of hearing aid settings made in the clinic and in everyday life.