Introduction
New hearing-aid features and listening programs are designed to further improve hearing-aid users’ listening experiences, but they are rarely evaluated under real-life conditions. This means that impact on everyday hearing might be sub-optimal or even disadvantageous despite clear evidence of benefits from clinical laboratory tests.
Thus, real-world outcome measures can support clinically established benefits and help generalize the effects of certain hearing-aid interventions to daily life. This project includes PhD student Klaudia Andersson’s work and on-going work at Eriksholm Research Centre regarding the use and development of Ecological Momentary Assessments for real-life hearing-related outcomes.
Aims
The overall aim is to establish a methodology for capturing and understanding daily life hearing-health behavior and hearing-related outcomes in hearing-aid users. Outcomes include how hearing-aid use impacts users’ listening experiences and how intrinsic factors (such as mood) or extrinsic factors (such as background noise) impact these.
Hearing-health behavior is then characterized by the extent to which hearing-aid users navigate in complex listening situations (often consisting of a high proportion of noise), and actively use their hearing aids for compensation, if needed (e.g., changing listening program or volume). We expect that insights and findings are relevant for future hearing-aid development and can be helpful in clinical support of hearing-loss rehabilitation.
Ecological Momentary Assessments can be filled-out in everyday situations via a smartphone. Answers can be linked to contextual information about listening activity (self-reported) and sound environments (logged by hearing-aid microphones). Note: Data are based on a study with 40 experienced hearing aid users completing a 28-days field trial.
Methodology
The project mainly relies on field trials with continuous data-logging including either normal hearing participants or hearing-aid users. Smartphone-based applications are designed and optimized to capture subjective experiences of listening and hearing in everyday situations. Typically, this approach is referred to as Ecological Momentary Assessments, and the aim is to sample experiences throughout the day to better generalize potential effects of hearing-aid interventions. We also extract information about sound environments and listening conditions from test participants’ own hearing aids, which help contextualizing reported experiences.
Results
To date, the project includes a study by PhD student Klaudia Andersson (2021), which for the first time showed that a group of hearing-aid users benefit from having a noise management program (i.e., automatic noise reduction and beamforming) activated in daily-life environments characterized by a combination of speech and background noise.
On the other hand, a study by Bosman et al., (2021), using the same methodology, showed that a high-frequency gain boost for users of bone-conductive devices did not lead to an expected daily-life benefit. Instead, subjective data combined with data-logging showed that high-frequency gain causes experiences of excessive loudness in noisy situations and leads to a change in volume control, which indicate a need for compensation strategies.
More recently, we provided evidence in Christensen et al., (2024) that Deep Neural Network (DNN) based signal processing in hearing aids can lead to greater sound satisfaction, particularly in noisier environments encountered in daily life. This study spanned four weeks and included 40 test subjects with hearing aids that reported their listening experiences with two distinct systems (traditional versus DNN-based) through Ecological Momentary Assessments. The study also emphasizes the importance of considering the context in which EMA responses were given (e.g., sound environment) to reveal the real-life ecological benefits.