A context-based model to predict the intelligibility of sentences in non-stationary noises.

The context-based Extended Speech Transmission Index (cESTI) (van Schoonhoven et al., 2022, J. Acoust. Soc. Am. 151, 1404-1415) was successfully applied to predict the intelligibility of monosyllabic words with different degrees of context in interrupted noise. The current study aimed to use the same model for the prediction of sentence intelligibility in different types of non-stationary noise. The necessary context factors and transfer functions were based on values found in existing literature. The cESTI performed similar to or better than the original ESTI when noise had speech-like characteristics. We hypothesize that the remaining inaccuracies in model predictions can be attributed to the limits of the modelling approach with regard to mechanisms, such as modulation masking and informational masking.

A context-based approach to predict intelligibility of meaningful and nonsense words in interrupted noise: Model evaluation.

The context-based Extended Speech Transmission Index (cESTI) by Van Schoonhoven et al. (2022) was successfully used to predict the intelligibility of meaningful, monosyllabic words in interrupted noise. However, it is not clear how the model behaves when using different degrees of context. In the current paper, intelligibility of meaningful and nonsense CVC words in stationary and interrupted noise was measured in fourteen normally hearing adults. Intelligibility of nonsense words in interrupted noise at -18 dB SNR was relatively poor, possibly because listeners did not profit from coarticulatory cues as they did in stationary noise. With 75% of the total variance explained, the cESTI model performed better than the original ESTI model (R2 = 27%), especially due to better predictions at low interruption rates. However, predictions for meaningful word scores were relatively poor (R2 = 38%), mainly due to remaining inaccuracies at interruption rates below 4 Hz and a large effect of forward masking. Adjusting parameters of the forward masking function improved the accuracy of the model to a total explained variance of 83%, while the predicted power of previously published cESTI data remained similar.

A context-based approach to predict speech intelligibility in interrupted noise: Model design.

The Extended Speech Transmission Index (ESTI) by van Schoonhoven et al. [(2019). J. Acoust. Soc. Am. 145, 1178-1194] was used successfully to predict intelligibility of sentences in fluctuating background noise. However, prediction accuracy was poor when the modulation frequency of the masker was low (<8 Hz). In the current paper, the ESTI was calculated per phoneme to estimate phoneme intelligibility. In the next step, the ESTI model was combined with one of two context models {Boothroyd and Nittrouer, [(1988). J. Acoust. Soc. Am. 84, 101-114]; Bronkhorst et al., [(1993). J. Acoust. Soc. Am. 93, 499-509} in order to improve model predictions. This approach was validated using interrupted speech data, after which it was used to predict speech intelligibility of words in interrupted noise. Model predictions improved using this new method, especially for maskers with interruption rates below 5 Hz. Calculating the ESTI at phoneme level combined with a context model is therefore a viable option to improve prediction accuracy.

The Extended Speech Transmission Index: Predicting speech intelligibility in fluctuating noise and reverberant rooms.

The Speech Transmission Index (STI) is used to predict speech intelligibility in noise and reverberant environments. However, measurements and predictions in fluctuating noises lead to inaccuracies. In the current paper, the Extended Speech Transmission Index (ESTI) is presented in order to deal with these shortcomings. Speech intelligibility in normally hearing subjects was measured using stationary and fluctuating maskers. These results served to optimize model parameters. Data from the literature were then used to verify the ESTI-model. Model outcomes were accurate for stationary maskers, maskers with artificial fluctuations, and maskers with real life non-speech modulations. Maskers with speech-like characteristics introduced systematic errors in the model outcomes, probably due to a combination of modulation masking, context effects, and informational masking.

Towards measuring the Speech Transmission Index in fluctuating noise: Accuracy and limitations.

In the field of room acoustics, the modulation transfer function (MTF) can be used to predict speech intelligibility in stationary noise and reverberation and can be expressed in one single value: the Speech Transmission Index (STI). One drawback of the classical STI measurement method is that it is not validated for fluctuating background noise. As opposed to the classical measurement method, the MTF due to reverberation can also be calculated using an impulse response measurement. This indirect method presents an opportunity for STI measurements in fluctuating noise, and a first prerequisite is a reliable impulse response measurement. The conditions under which the impulse response can be measured with sufficient precision were investigated in the current study. Impulse response measurements were conducted using a sweep stimulus. Two experiments are discussed with variable absorption, different levels of stationary and fluctuating background noise, and different sweep levels. Additionally, simulations with different types of fluctuating noise were conducted in an attempt to extrapolate the experimental findings to other acoustical conditions. The experiments and simulations showed that a minimum impulse-to-noise ratio of +25 dB in fluctuating noise was needed.

Selecting Appropriate Tests to Assess the Benefits of Bilateral Amplification With Hearing Aids.

The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users.

The effectiveness of bilateral cochlear implants for severe-to-profound deafness in adults: a systematic review.

OBJECTIVE: Assessment of the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation or bimodal stimulation, in adults with severe-to-profound hearing loss. In 2007, the National Institute for Health and Clinical Excellence (NICE) in the U.K. conducted a systematic review on cochlear implantation. This study forms an update of the adult part of the NICE review. DATA SOURCES: The electronic databases MEDLINE and Embase were searched for English language studies published between October 2006 and March 2011. STUDY SELECTION: Studies were included that compared bilateral cochlear implantation with unilateral cochlear implantation and/or with bimodal stimulation, in adults with severe-to-profound sensorineural hearing loss. Speech perception in quiet and in noise, sound localization and lateralization, speech production, health-related quality of life, and functional outcomes were analyzed. DATA EXTRACTION: Data extraction forms were used to describe study characteristics and the level of evidence. DATA SYNTHESIS: The effect size was calculated to compare different outcome measures. CONCLUSION: Pooling of data was not possible because of the heterogeneity of the studies. As in the NICE review, the level of evidence of the included studies was low, although some of the additional studies showed less risk of bias. All studies showed a significant bilateral benefit in localization over unilateral cochlear implantation. Bilateral cochlear implants were beneficial for speech perception in noise under certain conditions and several self-reported measures. Most speech perception in quiet outcomes did not show a bilateral benefit. The current review provides additional evidence in favor of bilateral cochlear implantation, even in complex listening situations.

The effectiveness of bilateral cochlear implants for severe-to-profound deafness in children: a systematic review.

OBJECTIVE: To assess the clinical effectiveness of bilateral cochlear implantation compared with unilateral cochlear implantation alone or with a contralateral hearing aid (bimodal stimulation), in children with severe-to-profound hearing loss. Recently, the National Institute for Health and Clinical Excellence (NICE) in the U.K. has conducted a systematic review on cochlear implantation. We decided to update the pediatric part of the NICE review. DATA SOURCES: The electronic databases MEDLINE and Embase were searched for European, North American, and Australasian studies published between October 2006 and June 2009. Reference lists of the included articles were also searched for relevant articles. STUDY SELECTION: Studies were included if they comprised data on comparisons between bilateral cochlear implantation and unilateral cochlear implantation and/or bilateral cochlear implantation and bimodal stimulation, in children with severe-to-profound sensorineural hearing loss. The following outcome measures were analyzed: audiological, speech perception, speech production, functional capacities, health-related quality of life, and/or educational outcomes. DATA EXTRACTION: Characteristics of the participants, interventions, outcomes, and methodological comments were entered into data extraction forms and the level of evidence was assessed. DATA SYNTHESIS: Results were standardized for each outcome measure by calculating a standardized mean difference (effect size). CONCLUSION: Effect sizes could not be pooled because of the heterogeneity of the studies. Therefore, we presented the results qualitatively. Although the level of evidence was low, the advantages of bilateral cochlear implants corresponded with the primary benefits of bilateral hearing, that is, improved speech perception in quiet and noise. Localization results were less consistent. No data on audiologic, speech production, or educational outcomes were available.