Threshold measurements by self-fitting hearing aids: feasibility and challenges.

A self-fitting, self-contained hearing aid is a device that can be managed entirely by the user, without assistance from a hearing health care professional or the need for special equipment. A key component of such a device is an automated audiometer that will enable the user to self-administer measurements of in situ thresholds, which the hearing aid will use to prescribe a baseline setting for the wearer. The success of the device therefore depends on the validity and reliability of in situ threshold measurements and automatically measured thresholds. To produce a complete and self-contained device, the self-fitting hearing aid will also enable identification of audiograms that are contraindicative of hearing aid usage. The feasibility and challenges of achieving these characteristics are explored and discussed. While the overall concept seems feasible, several challenges were identified that need thorough investigation and/or development. These include the use of instructions to self-manage hearing aid insertion and in situ threshold measurements, selection of an appropriate transducer and instant-fit tip that will allow measurements of a wide range of threshold levels, control of ambient noise during threshold measurements, and self-manageable procedures that enable identification of such audiogram characteristics as asymmetry and conductive hearing loss.