Tracking of Noise Tolerance to Predict Hearing Aid Satisfaction in Loud Noisy Environments
Authors: Seper Eric , Kuk Francis , Korhonen Petri , Slugocki Christopher 
Published: September 2018

Background:A method that tracked tolerable noise level (TNL) over time while maintaining subjective speech intelligibility was reported previously. Although this method was reliable and efficacious as a research tool, its clinical efficacy and predictive ability of real-life
hearing aid satisfaction were not measured.Purpose:The study evaluated an adaptive method to estimate TNL using slope and variance of tracked noise level as criteria in a clinical setting. The relationship between TNL and subjective hearing aid satisfaction in noisy environments was
also investigated.Research Design:A single-blinded, repeated-measures design.Study Sample:Seventeen experienced hearing aid wearers with bilateral mild-to-moderately-severe sensorineural hearing loss.Data Collection and Analysis:Participants listened to 82-dB SPL continuous
speech and tracked the background noise level that they could “put up with” while subjectively understanding >90% of the speech material. Two trials with each babble noise and continuous speech-shaped noise were measured in a single session. All four trials were completed aided
using the participants’ own hearing aids. The stimuli were presented in the sound field with speech from 0° and noise from the 180° azimuth. The instantaneous tolerable noise level was measured using a custom program and scored in two ways; the averaged TNL (aTNL) over the 2-min
trial and the estimated TNL (eTNL) as soon as the listeners reached a stable noise estimate. Correlation between TNL and proportion of satisfied noisy environments was examined using the MarkeTrak questionnaire.Results:All listeners completed the tracking of noise tolerance procedure
within 2 min with good reliability. Sixty-five percent of the listeners yielded a stable noise estimate after 59.9 sec of actual test time. The eTNL for all trials was 78.6 dB SPL (standard deviation [SD] = 4.4 dB). The aTNL for all trials was 78.0 dB SPL (SD = 3.3 dB) after 120 sec. The aTNL
was 79.2 dB SPL (SD = 5.4 dB) for babble noise and 77.0 dB SPL (SD = 5.9 dB) for speech-shaped noise. High within-session test‐retest reliability was evident. The 95% confidence interval was 1.5 dB for babble noise and 2.8 dB for continuous speech-shaped noise. No significant correlation
was measured between overall hearing aid satisfaction and the aTNL (ρ = 0.20 for both noises); however, a significant relationship between aTNL and proportion of satisfied noisy situations was evident (ρ = 0.48 for babble noise and ρ = 0.55 for speech-shaped noise).Conclusion:The
eTNL scoring method yielded similar results as the aTNL method although requiring only half the time for 65% of the listeners. This time efficiency, along with its reliability and the potential relationship between TNL and hearing aid satisfaction in noisy listening situations suggests that
this procedure may be a good clinical tool to evaluate whether specific features on a hearing aid would improve noise tolerance and predict wearer satisfaction with the selected hearing aid in real-life loud noisy situations. A larger sample of hearing aid wearers is needed to further validate
these potential uses.