title: An evidence-based systematic review of directional microphones and digital noise reduction hearing aids in school-age children with hearing loss.
abstract: OBJECTIVE
  The purpose of this evidence-based systematic review was to evaluate the efficacy of digital noise reduction and directional microphones for outcome measures of audibility, speech recognition, speech and language, and self- or parent-report in pediatric hearing aid users.
  
  
  METHODS
  The authors searched 26 databases for experimental studies published after 1980 addressing one or more clinical questions and meeting all inclusion criteria. The authors evaluated studies for methodological quality and reported or calculated   p values and effect sizes when possible.
  
  
  RESULTS
  A systematic search of the literature resulted in the inclusion of 4 digital noise reduction and 7 directional microphone studies (in 9 journal articles) that addressed speech recognition, speech and language, and/or self- or parent-report outcomes. No digital noise reduction or directional microphone studies addressed audibility outcomes.
  
  
  CONCLUSIONS
  On the basis of a moderate level of evidence, digital noise reduction was not found to improve or degrade speech understanding. Additional research is needed before conclusions can be drawn regarding the impact of digital noise reduction on important speech, language, hearing, and satisfaction outcomes. Moderate evidence also indicates that directional microphones resulted in improved speech recognition in controlled optimal settings; however, additional research is needed to determine the effectiveness of directional microphones in actual everyday listening environments.
authors.affiliation: Boys Town National Research Hospital, Omaha, NE, USA. Ryan.McCreery@boystown.org
authors.forename: Ryan W
authors.initials: RW
authors.lastname: McCreery
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Venediktov
authors.forename: Jaumeiko J
authors.initials: JJ
authors.lastname: Coleman
authors.forename: Hillary M
authors.initials: HM
authors.lastname: Leech
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D006310:Hearing Aids; D034381:Hearing Loss / Q000628:therapy*; D006801:Humans; D009622:Noise / Q000517:prevention & control*; D013067:Speech Perception; D016896:Treatment Outcome