Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
Oticon A/S, Centre for Applied Audiology Research; and Clinical Audiological Development, Smoerum, Denmark.
Ear Hear. 2024;45(5):1313-1325. doi: 10.1097/AUD.0000000000001520. Epub 2024 May 24.
The study compared the utility of two approaches for collecting real-world listening experiences to predict hearing-aid preference: a retrospective questionnaire (Speech, Spatial, and Qualities of Hearing Scale [SSQ]) and in-situ Ecological Momentary Assessment (EMA). The rationale being that each approach likely provides different and yet complementary information. In addition, it was examined how self-reported listening activity and hearing-aid data-logging can augment EMAs for individualized and contextualized hearing outcome assessments.
Experienced hearing-aid users (N = 40) with mild-to-moderate symmetrical sensorineural hearing loss completed the SSQ questionnaire and gave repeated EMAs for two wear periods of 2-weeks each with two different hearing-aid models that differed mainly in their noise reduction technology. The EMAs were linked to a self-reported listening activity and sound environment parameters (from hearing-aid data-logging) recorded at the time of EMA completion. Wear order was randomized by hearing-aid model. Linear mixed-effects models and Random Forest models with five-fold cross-validation were used to assess the statistical associations between listening experiences and end-of-trial preferences, and to evaluate how accurately EMAs predicted preference within individuals.
Only 6 of the 49 SSQ items significantly discriminated between responses made for the end-of-trial preferred versus nonpreferred hearing-aid model. For the EMAs, questions related to perception of the sound from the hearing aids were all significantly associated with preference, and these associations were strongest in EMAs completed in sound environments with predominantly low SNR and listening activities related to television, people talking, nonspecific listening, and music listening. Mean differences in listening experiences from SSQ and EMA correctly predicted preference in 71.8% and 72.5% of included participants, respectively. However, a prognostic classification of single EMAs into end-of-trial preference with a Random Forest model achieved a 93.8% accuracy when contextual information was included.
SSQ and EMA predicted preference equally well when considering mean differences, however, EMAs had a high prognostic classifications accuracy due to the repeated-measures nature, which make them ideal for individualized hearing outcome investigations, especially when responses are combined with contextual information about the sound environment.
本研究比较了两种收集真实听力体验的方法在预测助听器偏好方面的效用:回顾性问卷(言语、空间和听觉质量量表[SSQ])和现场生态瞬时评估(EMA)。其原理是,每种方法可能提供不同但又互补的信息。此外,还研究了自我报告的听力活动和助听器数据记录如何增强 EMA,以进行个性化和情境化的听力结果评估。
有轻度至中度对称感音神经性听力损失的经验丰富的助听器使用者(N=40)完成了 SSQ 问卷,并在两个为期两周的佩戴期内重复进行了 EMA,每个佩戴期使用两种不同的助听器模型,主要区别在于其降噪技术。EMAs 与自我报告的听力活动和声音环境参数(来自助听器数据记录)相关联,这些参数在 EMA 完成时记录。佩戴顺序由助听器模型随机化。使用线性混合效应模型和具有五重交叉验证的随机森林模型评估听力体验与试验结束时偏好之间的统计关联,并评估 EMA 在个体内预测偏好的准确性。
在 49 个 SSQ 项目中,仅有 6 个项目对试验结束时首选和非首选助听器模型的反应有显著区分。对于 EMA,与助听器声音感知相关的问题均与偏好显著相关,并且在 SNR 主要较低的声音环境中和与电视、人交谈、非特定听力和音乐听力相关的听力活动中,这些关联最强。SSQ 和 EMA 中的听力体验均值差异分别正确预测了 71.8%和 72.5%的纳入参与者的偏好。然而,当纳入情境信息时,使用随机森林模型将单个 EMA 分类为试验结束时的偏好,准确率达到 93.8%。
考虑均值差异时,SSQ 和 EMA 对偏好的预测效果相当,但由于重复测量的性质,EMA 具有较高的预后分类准确性,使其成为个性化听力结果研究的理想选择,特别是当将响应与声音环境的情境信息相结合时。