Consistency of Hearing Aid Setting Preference in Simulated Real-World Environments: Implications for Trainable Hearing Aids.

Trainable hearing aids let users fine-tune their hearing aid settings in their own listening environment: Based on consistent user-adjustments and information about the acoustic environment, the trainable aids will change environment-specific settings to the user's preference. A requirement for effective fine-tuning is consistency of preference for similar settings in similar environments. The aim of this study was to evaluate consistency of preference for settings differing in intensity, gain-frequency slope, and directionality when listening in simulated real-world environments and to determine if participants with more consistent preferences could be identified based on profile measures. A total of 52 adults (63-88 years) with hearing varying from normal to a moderate sensorineural hearing loss selected their preferred setting from pairs differing in intensity (3 or 6 dB), gain-frequency slope (±1.3 or ± 2.7 dB/octave), or directionality (omnidirectional vs. cardioid) in four simulated real-world environments: traffic noise, a monologue in traffic noise at 5 dB signal-to-noise ratio, and a dialogue in café noise at 5 and at 0 dB signal-to-noise ratio. Forced-choice comparisons were made 10 times for each combination of pairs of settings and environment. Participants also completed nine psychoacoustic, cognitive, and personality measures. Consistency of preference, defined by a setting preferred at least 9 out of 10 times, varied across participants. More participants obtained consistent preferences for larger differences between settings and less difficult environments. The profile measures did not predict consistency of preference. Trainable aid users could benefit from counselling to ensure realistic expectations for particular adjustments and listening situations.