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

描述（由申请人提供）：助听器使用者在噪音方面对助听器有相当大的不满。当前用于设置助听器参数（多频增益和压缩）的基于听音图的方法是基于安静情况下语音的预测响度和/或可理解性；噪声环境下的语音参数设置尚无基于研究的处方方法。与此同时，越来越多的证据表明，听力受损的人在理解噪音中的言语的能力上存在很大差异，即使他们的听音图非常相似。考虑到噪声环境下语音理解的差异，我们可以合理地预期，在嘈杂环境下的最佳听力设置下，助听器用户之间的差异至少会同样大。如果是这样的话，那么对于许多助听器用户来说，目前设置用于噪声的助听器参数的方法几乎肯定会产生次优结果。无线控制助听器的出现提供了一个机会，直接解决与用户发现最有益的助听器参数设置相关的问题。模拟不同声音环境的复杂系统的可用性，将使在不同声音环境中收集助听器设置偏好的大量数据成为可能，这些数据仍处于严密的实验控制之下。这里提出的工作是一个系统的探索优选助听器设置如何在不同的助听器用户和不同的声音环境中变化。以下假设将被测试：a.安静设置的首选设置与嘈杂设置的首选设置不同。b.助听器使用者偏好设置的差异在嘈杂环境下比在安静环境下更大。c.通过临床和实验室对噪声环境下言语理解的测量，可以预测首选的噪声环境。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设置助听器的设置提供更大的感知用户利益。e.部分用户将从听力中获益

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.