The perceptual limitations of troubleshooting hearing-aids based on patients’ descriptions

Abstract

Objectives

Hearing-aid frequency-gain responses are routinely adjusted by clinicians to patient preferences and descriptions. This study measured the minimum gain adjustments required to elicit preferences, and the assignment of descriptors to gain adjustments, to perceptually evaluate description-based troubleshooting.

Design

Participants judged whether short sentences with ±0–12 dB gain adjustments in one of three frequency bands were “better”, “worse” or “no different” from the same sentence at their individual real-ear or prescribed gain. If judged “better” or “worse”, participants were then asked to assign one of the six common sound-quality descriptors to their preference.

Study sample

Thirty-two adults (aged 51–75 years) all with hearing-aid experience.

Results

Median preference thresholds, the minimum gain adjustments to elicit “better” or “worse” judgments, ranged from 4 to 12 dB, increasing with frequency. There was some between-participant agreement in preferences: participants generally preferred greater low-frequency gain. Within-participant reliability for preferences was moderate. There was, however, little between-participant agreement in descriptor selection for gain adjustments. Furthermore, within-participant reliability for descriptor selection was lacking.

Conclusions

The scale of gain adjustments necessary to elicit preferences, along with the low agreement and reliability in descriptors for these adjustments questions the efficiency and efficacy of current description-based troubleshooting, especially with short speech stimuli.

Keywords:

• Hearing-aid fitting
• fine-tuning
• gain
• descriptors

Acknowledgements

The authors thank Prof. Brian Moore and Dr. Rachel Smith for their feedback on previous versions of this work, and Prof. Graham Naylor for helpful comments on this manuscript. The authors also thank Dr. Gitte Keidser and the three anonymous reviewers for their helpful comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by funding from the Medical Research Council [grant numbers 1601056 and MR/S003576/1]; and the Chief Scientist Office of the Scottish Government.