Microcomputer applications for hearing aid selection and fitting.

An issue, and perhaps a limitation, which is common to all the software packages reviewed is: How well does the program fit into the dispenser's practice? Ideally the programs would be integrated so that, for example, the patient's name and address would not have to entered repeatedly into different software modules. An audiogram entered once would not have to be duplicated. An audiogram stored in a computer file would not also have to be stored on paper. Tympanogram information or other diagnostic tests (e.g., auditory brainstem response, word recognition scores) would be stored within the same patient record. Ideally, the software would be part of the hearing aid test systems so that real ear and coupler measures could be easily compared to the targets. The dots (representing loudness calculations) from VIOLA would appear on the screen of the test box running the hearing aid's input-output function. The same software used to select ideal characteristics of the hearing aid would also be used to adjust the aid, as in the case of a programmable. Or, for conventional hearing aids, a direct link to the manufacturer's database would be useful for matching a matrix. It would also be useful, when trying to match a target coupler gain curve, to simulate the effect of making an adjustment to a trim pot. Then, the hearing aid could be ordered online, and billing would be facilitated by the software. Perhaps the NOAH software platform, together with cooperation from hearing aid manufactures and software developers, will help make such high level integration a practical reality. While improvements will surely come, a variety of hearing aid selection programs are currently available. Each program has its own set of features, philosophy, and is geared toward different aspects of the fitting process. Some of the procedures are more abstract and theoretical, others are practical and concrete. Certain procedures emphasize the prediction of hearing aid characteristics from threshold data, while others require measurement of loudness perceptions. Hearing aid dispensers also have preferences and a perspective shaped by their personality and experiences. This dictates what they value. Some perceive the hearing aid fitting to be a conceptual experience to be researched or taught to students, others see it as a social experience shared with the patient for whom they care. Others may visualize it as an integral part of the business they have labored to create. Regardless of the perspective, each person can find something to appreciate in the software that has been reviewed. Powerful, inexpensive microcomputers are readily available. A minimal amount of time (less than a few minutes) is often needed to enter data and receive prescriptions that incorporate decades of research. Patients have more confidence in the opinions of their dispensers when they can see the reasoning that went into the recommendations. Allowing patients to watch the computer screen, even though they cannot appreciate most of the details, is an engaging process and allows them to feel they are an active participant. Hopefully, readers will be encouraged to try some of these software tools to add more science and objectivity to the art of hearing aid fitting.