title: Client-based adjustments of hearing aid gain: the effect of different control configurations.
abstract: OBJECTIVE
  Facilitating the fine-tuning of advanced hearing aids requires information about the acoustic environment. The concept of a "trainable" hearing aid may provide a more direct approach to hearing aid fine-tuning if the aid user is allowed to control the most important fitting parameters in his/her own acoustic environments.
  
  
  METHODS
  In a laboratory study, the concept of self-adjustment of the gain-frequency response was tested by 24 hearing aid users using four different controllers with a limited number of control functions. Research questions focused on the reproducibility of the fine-tuned responses, the efficiency of the control configurations, and the effects of the control configuration on the end results of the fine-tuning process.
  
  
  RESULTS
  The subjects were able to provide systematic and reproducible feedback with respect to their preferences in different acoustic conditions presented audiovisually, achieving an average shortterm test/retest standard deviation value of 2.8 dB. Two of the control configurations, featuring volume/slope and volume/bass/treble keys, were found to be more time-efficient and reliable, and were also preferred by 86% of the subjects. Although the control configuration did not have a strong influence on the end result, the gain-frequency response from which the subjects started their adjustments was found to have a significant effect on their preferred settings.
  
  
  CONCLUSIONS
  Client-based adjustments of hearing aid gain provide a reliable method of individual fine-tuning. The results also showed that a biased correction of amplification is reached via self-adjustment within one session, which reduces the effectiveness of fine-tuning in a traditional clinical setting.
authors.affiliation: Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. w.a.dreschler@amc.nl
authors.forename: Wouter A
authors.initials: WA
authors.lastname: Dreschler
authors.forename: Gitte
authors.initials: G
authors.lastname: Keidser
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Convery
authors.forename: Harvey
authors.initials: H
authors.lastname: Dillon
mesh_terms: D000161:Acoustic Stimulation / Q000295:instrumentation; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D003258:Consumer Behavior; D005246:Feedback; D005260:Female; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015203:Reproducibility of Results; D012720:Severity of Illness Index