Comparison of two digital hearing instrument fitting strategies.

Two different hearing instrument fitting strategies were compared in the laboratory and in a field test with regard to the benefit for hearing aid users and their satisfaction with the fitting. DSL [input/output (i/o)] fittings based on hearing threshold and uncomfortable levels for the subject were evaluated vs a prescriptive fitting method based on unaided loudness scaling. Twenty-one subjects were fitted diotically with both fitting strategies implemented in a digital hearing instrument (Siemens Prisma). The patients tested both fitting strategies sequentially in a 4 + 4-week field trial using a crossover study design. Speech recognition threshold measurements, sound quality ratings and paired comparisons of sound quality were performed for all conditions (unaided, DSL[i/o] fitting and loudness-based fitting). In addition, subjective benefit and preference were assessed with questionnaires. Speech audiometry did not reveal significant differences between the two fittings. DSL[i/o] fittings showed superior results in most sound quality tests and in the self-assessment of communication abilities while the loudness-based approach was slightly preferred in noisy environments. The results seemed to be influenced by the higher gain predicted by DSL[i/o]. This study provides no evidence that effort spent on loudness scaling leads to improved fitting results.

Development and evaluation of a German sentence test for objective and subjective speech intelligibility assessment.

A German sentence test was developed which is comprised of 20 test lists of ten sentences each. The test corpus is a selection from sentences for speech quality evaluation recorded with a male unschooled speaker. Performance-intensity curves were measured for each individual sentence in a speech-simulating babble noise with a total of 40 normal-hearing listeners. Based on these data and the phonemic transcription of the 200 sentences selected from the underlying speech corpus, 20 test lists were composed using a numerical optimization process. These 20 test lists are highly equivalent with respect to their performance-intensity curves, the number of words within each test list, the number of phonemes within each test list, and approximately the frequency distribution of the phonemes which approximates the phoneme frequency distribution of the German language. The equivalence of the respective performance-intensity curves was demonstrated in an independent experiment with 20 normal-hearing listeners. In addition, a comparison was performed between the "objective" intelligibility measurements and two "subjective" speech intelligibility rating methods employing the same materials. As a result, both subjective assessment procedures correlate highly with each other and with the "objective" procedure across sentences. This underlines the applicability and validity of the test in combination with time-saving subjective assessment methods. Moreover, the variability in performance across different sentences correlates inversely with the RMS level of the respective sentence. This indicates that an adjustment of sentence material with respect to RMS level already yield reasonably homogeneous test material with respect to intelligibility.