WHEN FITTINGS BASED ON AVERAGES AREN'T GOOD ENOUGH

Even with constant optimization and advanced options, today’s hearing aid fittings are based on averages of how people prefer to hear. But since every person and their hearing is unique, there’s a need for hearing aid personalization options for each individual user.
Sometimes it may seem like the best hearing aids fail you when you’re fitting your clients. Even if you follow best practices in your process and use the best technology, it’s probable that one-third of your clients won’t be pleased with the first fitting.

Why? Because the many fitting parameters are based on averages.

Why fitting parameters based on averages may fail your client


A new article published in Hearing Review examines why and how average-based fittings fail some users. The article points to four parameters that challenge hearing care professionals and users:
  • The preferred loudness for your first client of the day may not be what the last client of the day prefers. In fact, user preference may vary from target by +/- 6 dB, or even more.

  • Loudness discomfort levels vary even more: For a hearing loss of 50 dB HL, the loudness discomfort level has an average of 102 dB SPL, but that average is based on a range from 72 to 130 dB SPL – and only one-third of people are within 5 dB of the average. As a result, the programmed gain could be significantly too loud or too soft for many people.

  • When your client is out in the real world, they may find themselves in listening situations that don’t match the listening experience they had in the clinic.

  • Your client’s listening intention may not be met by the automatic classification system, because the automatic steering is based on what is assumed to be interesting in a listening situation. So, the system may accentuate speech in a situation where your client would, in fact, rather not hear what the loud-speaking person next to them is saying.
     

The Widex fitting approach takes several steps to individualize the fitting thoroughly from the very beginning, by using experienced vs. inexperienced fitting profiles, accounting for individual ear acoustics by using the Sensogram, and using advanced vent compensation corrections.

But even taking these factors into account, the fitting process can fail some clients – because the average doesn’t fit them.

How do we fix the issue of average-based fittings?


At first sight, giving users control over gain could seem to help. But it’s unlikely that the individual’s difference from the average is the same for all frequencies, and this makes it a problem to turn gain up or down across frequencies.

Also, the programmed loudness level is often adequate for one or more input levels but not for other inputs. So, changing gain to fix one problem may create a new one.

And, finally, the user would have to change gain every time they experienced that specific listening situation.

Some of these problems can be solved by fine-tuning the hearing aids. But that would require your clients to visit your clinic more frequently and to be extremely good at explaining their real-life hearing challenges – which is a very hard thing to do.

Instead, your clients need a solution that helps them make real-time changes to their hearing experience in an easy and intuitive way. That’s what AI-based SoundSense Learn does.

Easy, in-the-moment adjustments to personalize sound


SoundSense Learn is an advanced AI application that uses machine learning to adjust gain in three frequency bands based on user preference. It does so by individualizing hearing aid parameters according to the user’s preference in a listening situation.

The user will go through a series of A-B comparisons conducted through an app on the phone. With just a few comparisons, SoundSense Learn reaches the user’s optimum settings, which can be used just for that moment or saved as a program for later use. It’s possible to create as many programs for as many situations as the user wants.

These settings can also come in handy for hearing care professionals trying to understand their client’s real-life hearing and to tailor fine-tuning. That’s why it’s possible to share the settings with the hearing care professional directly through the app.

The use of SoundSense Learn could also mean a reduced need for visiting the hearing care professional and increased satisfaction with the hearing aid.

Research confirms the value of SoundSense Learn


There is ample evidence that SoundSense Learn helps users, from lab studies, real-life surveys and analyses of the large numbers of anonymous data that come out of SoundSense Learn usage.

Lab studies have shown that SoundSense Learn improves the experience in different sound scenarios and with varying listening intentions compared to the initial setting (the user’s Universal program).

In the lab study, participants rated listening comfort in three different sound environments and reported a significant increase in listening comfort for the SoundSense Learn setting. They also rated the overall sound quality of three different pieces of music, and the results showed a significant increase in reported sound quality with SoundSense Learn (figure 1).


Figure 1. Mean ratings of listening comfort and sound quality, across participants and three sound environments (per sound attribute).

The real-world effectiveness of SoundSense Learn has also been evaluated in a survey across nine countries.

In the survey, 72% of those who used SoundSense Learn reported that it helped improve specific listening situations, and 80% would recommend SoundSense Learn to others.

The use of SoundSense Learn also generates large numbers of anonymous data that help us improve hearing aid development and understand how users want to hear.

From the SoundSense Learn data in figure 2, we can see that people create highly personalized programs with SoundSense Learn. You could even argue that each dot represents a potential need for fine-tuning that did not require a visit to the clinic because the user had access to SoundSense Learn.



Figure 2: SoundSense Learn adjustments in three frequency bands for a subsample of 9,690 personal programs. Each dot represents a program; darker colors indicate programs with overlapping settings.

The data also show that the individual programs vary in gain settings, situations and intentions. For instance, conversation is much more important at work or in restaurants than at home or in transport.

All these data support the idea that there’s a need for personalization in real life and that users experience great value from having this option.

SoundSense Learn for fittings that rely less on averages


The Real-Life Insights program in COMPASS GPS provides professionals with insights about the individual hearing aid users and their hearing needs and preferences in real life.

Through Real-Life Insights, the hearing care professional can (with user consent) examine the SoundSense Learn programs the user has created and spot trends that can be used for more general hearing aid setting adjustments.

That way, the fitting becomes less based on averages. And the professional gets real-life insights into the client’s hearing, which enables them to conduct well-informed counselling sessions that are based on the user’s personal preference rather than predefined averages.

 

Do you have questions about our products or services?