Characterizing Variability in Hearing Aid Outcomes Among Older Adults

老年人助听器效果的差异性特征

• 批准号: 9898343
• 负责人: PAMELA E. SOUZA
• 金额: $ 36.5万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9898343
• 关键词: Acoustics; Address; Affect; Age; Algorithms; Auditory; Characteristics; Clinic; Clinical; Clinical Protocols; Communication; Computer software; Computers; Controlled Study; Data; Data Set; Databases; Elderly; Environment; Feedback; Frequencies; Funding; Goals; Health; Hearing Aids; Hearing Tests; Individual; Laboratories; Manufacturer Name; Measurement; Measures; Modeling; Modification; Noise; Outcome; Output; Participant; Patient-Focused Outcomes; Patients; Procedures; Reporting; Research; Series; Short-Term Memory; Signal Transduction; Site; Speech Intelligibility; Speed; System; Testing; Time; Translating; Visit; Work; base; clinical application; clinical implementation; clinical practice; cognitive ability; commercial application; digital; evidence base; hearing impairment; hearing range; improved; individual patient; microphone; patient population; patient response; preference; prototype; response; satisfaction; signal processing; standard of care; success; tool; usability

Project abstract 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 in clinical fittings 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 proposed renewal application moves this work toward clinical application in three steps. The first specific aim is to characterize variability in response to signal manipulation among older adults and determine what patient factors are related to that variability under clinical conditions, and to use those data to modify our fitting metrics for more accurate application to clinical fittings. Data will be collected for hearing aids fit by audiologists using current best practice (i.e., standard of care) in our site clinics. Signal manipulation will be quantified and related to measures of aided intelligibility, quality, and preference. This dataset will allow us to extend our model-based approach to include a full continuum of signal processing for patients with a wide range of hearing loss configurations. In the second specific aim, the clinical toolset will be implemented in a computer-based application that can guide audiologists in the fitting and adjustment of signal processing based on individual listener characteristics. Application partners will work with us to develop the necessary software and hardware (a low-noise probe microphone system) capable of measuring hearing aid output and inputting those values to the computer application. The third specific aim is to validate clinical use of the toolset by comparing a population of patients fit with the toolset to those fit using current standard of care. Data will be collected on patient outcomes, clinical impact (number of visits needed to adjust the hearing aids) and audiologist feedback regarding professional confidence. Clinician feedback will also be collected to refine implementation of the clinical application and improve its usability. It is hypothesized that hearing aid fittings completed using the clinical toolset will result in better patient outcomes, fewer post-fitting visits and a higher level of clinician confidence compared to standard-of-care hearing aid fittings. Taken together, the questions addressed in this project will provide a comprehensive assessment of the effects of hearing aid processing in realistic listening environments, while considering specific abilities that affect response to signal processing.

项目摘要 数字助听器中使用的先进信号处理算法改善了平均助听器 利益和满意。但是，对助听器的回应是高度可变的，有些人报告 比其他人好得多。在老年听众中，这种差异最为明显。一个重要的问题是 在助听器中取得成功，需要采取哪些水平的高级助听器处理。 个人听众。每种形式的非线性信号处理都有自己的改进的一套权衡 由信号处理引起的信号的可听性与增加的修改。但是，没有 在临床配件中确定将从处理或如何从处理中受益的有效程序 应针对单个听众调整处理。这项研究的长期目标是使用证据 - 基于临床测试，以指导最适合个体较老的信号处理的选择 成年人在自己的听力环境中戴着助听器。拟议的续约应用程序将此移动 分为三个步骤进行临床应用。第一个具体目的是表征可变性 老年人之间的信号操纵并确定哪些患者因素与该变异性有关 临床条件，并使用这些数据修改我们的拟合指标，以更准确地应用于临床 配件。将使用当前的最佳实践（即，标准， 护理）在我们的网站诊所中。信号操纵将被量化并与辅助清晰度的度量有关， 质量和偏好。该数据集将使我们能够扩展基于模型的方法以包括完整的 具有广泛听力损失配置的患者的信号处理连续性。在第二个 具体目的，临床工具集将在基于计算机的应用程序中实施，以指导 基于单个听众特征的信号处理的拟合和调整，听力学家。 应用程序合作伙伴将与我们合作开发必要的软件和硬件（低噪声探针 麦克风系统）能够测量助听器输出并将这些值输入到计算机 应用。第三个具体目的是通过比较患者人群来验证刀具的临床使用 使用当前的护理标准，将其适合刀具集。将收集有关患者预后的数据， 临床影响（调整助听器所需的访问次数）和听力学家的反馈 专业的信心。还将收集临床医生的反馈以完善临床的实施 应用并提高其可用性。假设使用临床完成的助听器配件 工具集将导致更好的患者预后，较少的临时访问和更高水平的临床医生信心 与护理标准的助听器配件相比。综上所述，这个项目中解决的问题将 对助听器处理在现实聆听中的影响进行全面评估 环境，同时考虑影响对信号处理响应的特定能力。