title: Audiologist-driven versus patient-driven fine tuning of hearing instruments.
abstract: Two methods of fine tuning the initial settings of hearing aids were compared: An audiologist-driven approach--using real ear measurements and a patient-driven fine-tuning approach--using feedback from real-life situations. The patient-driven fine tuning was conducted by employing the Amplifit(®) II system using audiovideo clips. The audiologist-driven fine tuning was based on the NAL-NL1 prescription rule. Both settings were compared using the same hearing aids in two 6-week trial periods following a randomized blinded cross-over design. After each trial period, the settings were evaluated by insertion-gain measurements. Performance was evaluated by speech tests in quiet, in noise, and in time-reversed speech, presented at 0° and with spatially separated sound sources. Subjective results were evaluated using extensive questionnaires and audiovisual video clips. A total of 73 participants were included. On average, higher gain values were found for the audiologist-driven settings than for the patient-driven settings, especially at 1000 and 2000 Hz. Better objective performance was obtained for the audiologist-driven settings for speech perception in quiet and in time-reversed speech. This was supported by better scores on a number of subjective judgments and in the subjective ratings of video clips. The perception of loud sounds scored higher than when patient-driven, but the overall preference was in favor of the audiologist-driven settings for 67% of the participants.
authors.affiliation: Academic Medical Center Amsterdam, Department of Clinical and Experimental Audiology, Amsterdam, The Netherlands. M.Boymans@amc.nl
authors.forename: Monique
authors.initials: M
authors.lastname: Boymans
authors.forename: Wouter A
authors.initials: WA
authors.lastname: Dreschler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001302:Audiometry, Speech; D001309:Auditory Threshold; D002138:Calibration; D003258:Consumer Behavior; D012048:Correction of Hearing Impairment / Q000523:psychology; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006310:Hearing Aids / Q000592:standards*; D006801:Humans; D008144:Loudness Perception; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009622:Noise / Q000009:adverse effects; D010470:Perceptual Masking; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D013065:Speech Intelligibility; D013067:Speech Perception; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013997:Time Factors; D014741:Video Recording