title: A daily alternating method for comparing different signal-processing strategies in hearing aids and in cochlear implants.
abstract: BACKGROUND
  Although we always want to select the best signal-processing strategy for our hearing-aid and cochlear-implant patients, no efficient and valid procedure is available. Comparisons in the office are without listening experience, and short-term take-home trials are likely influenced by the order of strategies tried.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate a new procedure for comparing signal-processing strategies whereby patients listen with one strategy one day and another strategy the next day. They continue this daily comparison for several weeks. We determined (1) if differences existed between strategies without prior listening experience and (2) if performance differences (or lack there of) obtained at the first listening experience are consistent with performance after two to three months of alternating between strategies on a daily basis (equal listening experience).
  
  
  METHODS
  Eight subjects were tested pretrial with a vowel, sentence, and spondee recognition test, a localization task, and a quality rating test. They were required to listen to one of two different signal processing strategies alternating between strategies on a daily basis. After one to three months of listening, subjects returned for follow-up testing. Additionally, subjects were asked to make daily ratings and comments in a diary.
  
  
  RESULTS
  Pre-trial (no previous listening experience), a clear trend favoring one strategy was observed in four subjects. Four other subjects showed no clear advantage. Post-trial (after alternating daily between strategies), of the four subjects who showed a clear advantage for one signal processing strategy, only one subject showed that same advantage. One subject ended up with an advantage for the other strategy. Post-trial, of the four subjects who showed no advantage for a particular signal processing strategy, three did show an advantage for one strategy over the other.
  
  
  CONCLUSIONS
  Patients are willing to alternate between signal processing strategies on a daily basis for up to three months in an attempt to determine their optimal strategy. Although some patients showed superior performance with initial fittings (and some did not), the results of pre-trial comparison did not always persist after having equal listening experience. We recommend this daily alternating listening technique when there is interest in determining optimal performance among different signal processing strategies when fitting hearing aids or cochlear implants.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City 52242-1078, USA. rich-tyler@uiowa.edu
authors.forename: Richard S
authors.initials: RS
authors.lastname: Tyler
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Witt
authors.forename: Camille C
authors.initials: CC
authors.lastname: Dunn
authors.forename: Ann E
authors.initials: AE
authors.lastname: Perreau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001306:Auditory Pathways / Q000503:physiopathology; D003054:Cochlear Implants; D003638:Deafness / Q000503:physiopathology / Q000534:rehabilitation*; D004007:Dichotic Listening Tests; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D008875:Middle Aged; D009473:Neuronal Plasticity / Q000502:physiology; D017060:Patient Satisfaction; D010700:Phonetics; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013017:Sound Localization / Q000502:physiology; D013063:Speech Discrimination Tests / Q000379:methods*; D013069:Speech Reception Threshold Test; D000159:Vestibulocochlear Nerve / Q000503:physiopathology