Schinkel-Bielefeld Nadja, Ritslev Jana, Lelic Dina
R&D PSA SA DE ERL, WS Audiology, Erlangen, Germany.
Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark.
Front Digit Health. 2023 Aug 3;5:1134490. doi: 10.3389/fdgth.2023.1134490. eCollection 2023.
In past Ecological Momentary Assessment (EMA) studies, hearing aid outcome ratings have often been close to ceiling.
To analyze the underlying reasons for the very positive ratings, we conducted a study with 17 experienced hearing aid wearers who were fitted with study hearing aids. The acceptable noise level and the noise level where participants were unable to follow speech were measured. The participants then rated hearing aid satisfaction, speech understanding and listening effort for pre-defined SNRs between -10 and +20 dB SPL in the laboratory. These ratings were compared to ratings of a two-week EMA trial. Additionally, estimates of SNRs were collected from hearing aids during the EMA trial and we assessed whether the participants experienced those SNRs rated poorly in the laboratory in real life.
The results showed that for hearing aid satisfaction and speech understanding, the full rating scale was used in the laboratory, while the ratings in real life were strongly skewed towards the positive end of the scale. In the laboratory, SNRs where participants indicated they could not follow the narrator ("unable to follow" noise level) were rated clearly better than the lowest possible ratings. This indicates that very negative ratings may not be applicable in real-life testing. The lower part of the distribution of real-life SNR estimates was related to participants' individual "unable to follow" noise levels and the SNRs which were rated poorly in the laboratory made up less than 10% of the speech situations experienced in real life.
This indicates that people do not seem to frequently experience listening situations at SNRs where they are dissatisfied with their hearing aids and this could be the reason for the overly positive hearing aid outcome ratings in EMA studies. It remains unclear to what extent the scarcity of such situations is due lack of encounters or intentional avoidance.
在过去的生态瞬时评估（EMA）研究中，助听器效果评分常常接近上限。
为分析这些非常积极评分的潜在原因，我们对17名佩戴研究用助听器的有经验的助听器佩戴者进行了一项研究。测量了可接受噪声水平以及参与者无法听懂言语时的噪声水平。然后，参与者在实验室中针对-10至+20 dB SPL之间预先定义的信噪比，对助听器满意度、言语理解度和聆听努力程度进行评分。将这些评分与为期两周的EMA试验评分进行比较。此外，在EMA试验期间从助听器收集信噪比估计值，我们评估了参与者在现实生活中是否经历了在实验室中评分较低的那些信噪比情况。
结果表明，对于助听器满意度和言语理解度，在实验室中使用了完整的评分量表，而现实生活中的评分则严重偏向量表的积极一端。在实验室中，参与者表示无法跟上叙述者的信噪比（“无法跟上”噪声水平）的评分明显高于可能的最低评分。这表明非常负面的评分可能不适用于现实生活测试。现实生活中信噪比估计值分布的较低部分与参与者个体的“无法跟上”噪声水平相关，并且在实验室中评分较低的信噪比在现实生活中经历的言语情境中所占比例不到10%。
这表明人们似乎不会频繁经历对助听器不满意的信噪比聆听情境，这可能是EMA研究中助听器效果评分过高的原因。目前尚不清楚这种情况的稀缺在多大程度上是由于缺乏遭遇还是有意回避。
