Tracking of Noise Tolerance to Measure Hearing Aid Benefit.
The benefits offered by noise reduction (NR) features on a hearing aid had been studied traditionally using test conditions that set the hearing aids into a stable state of performance. While adequate, this approach does not allow the differentiation of two NR algorithms that differ in their timing characteristics (i.e., activation and stabilization time). The current study investigated a new method of measuring noise tolerance (Tracking of Noise Tolerance [TNT]) as a means to differentiate hearing aid technologies. The study determined the within-session and between-session reliability of the procedure. The benefits provided by various hearing aid conditions (aided, two NR algorithms, and a directional microphone algorithm) were measured using this procedure. Performance on normal-hearing listeners was also measured for referencing. A single-blinded, repeated-measures design was used. Thirteen experienced hearing aid wearers with a bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study. In addition, seven normal-hearing listeners were tested in the unaided condition. Participants tracked the noise level that met the criterion of tolerable noise level (TNL) in the presence of an 85 dB SPL continuous discourse passage. The test conditions included an unaided condition and an aided condition with combinations of NR and microphone modes within the UNIQUE hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR; directional microphone, no NR; and directional microphone, NR) and the DREAM hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR). Each tracking trial lasted 2 min for each hearing aid condition. Normal-hearing listeners tracked in the unaided condition only. Nine of the 13 hearing-impaired listeners returned after 3 mo for retesting in the unaided and aided conditions with the UNIQUE hearing aid. The individual TNL was estimated for each participant for all test conditions. The TNT index was calculated as the difference between 85 dB SPL and the TNL. The TNT index varied from 2.2 dB in the omnidirectional microphone, no NR condition to -4.4 dB in the directional microphone, NR on condition. Normal-hearing listeners reported a TNT index of -5.7 dB using this procedure. The averaged improvement in TNT offered by the NR algorithm on the UNIQUE varied from 2.1 dB when used with a directional microphone to 3.0 dB when used with the omnidirectional microphone. The time course of the NR algorithm was different between the UNIQUE and the DREAM hearing aids, with the UNIQUE reaching a stable TNL sooner than the DREAM. The averaged improvement in TNT index from the UNIQUE directional microphone was 3.6 dB when NR was activated and 4.4 dB when NR was deactivated. Together, directional microphone and NR resulted in a total TNT improvement of 6.5 dB. The test-retest reliability of the procedure was high, with an intrasession 95% confidence interval (CI) of 2.2 dB and an intersession 95% CI of 4.2 dB. The effect of the NR and directional microphone algorithms was measured to be 2-3 and 3.6-4.4 dB, respectively, using the TNT procedure. Because of its tracking property and reliability, this procedure may hold promise in differentiating among some hearing aid features that also differ in their time course of action.