scholarly journals Differences in Sensation Level between the Widex SoundTracker and Two Real-Ear Analyzers

2013 ◽  
Vol 24 (08) ◽  
pp. 660-670 ◽  
Author(s):  
Kristi Oeding ◽  
Michael Valente

Background: SoundTracker is an algorithm in Widex's Compass fitting software that could potentially be used to estimate a patient's aided sensation level (SL). SoundTracker's accuracy of estimating a patient's SL has never been verified in comparison to SL measured with commercially available real-ear analyzers. Purpose: Determine whether statistically significant differences are present between the estimated SL of the Widex SoundTracker software application and the measured SL of the Audioscan Verifit and Frye 6500 real-ear analyzers at 500, 1000, 2000, and 4000 Hz. Research Design: This study used a randomized repeated measures design to determine differences in SL between SoundTracker and the Verifit and 6500. Study Sample: Ten subjects (N = 20 ears) were recruited who were experienced users of behind-the-ear hearing aids with conventional vented earmolds and had bilateral sensorineural hearing loss that was >30 dB HL below 1000 Hz and ≤70 dB HL to 4000 Hz. Data Collection and Analysis: Real-ear in-situ thresholds (dB sound pressure level [SPL]) and real-ear aided responses (REAR; dB SPL) were measured at 500, 1000, 2000, and 4000 Hz to determine differences in SL between SoundTracker, Verifit, and 6500. A three-factor repeated measures analysis of variance (ANOVA) was utilized to determine differences between method (real-ear analyzers and SoundTracker), analyzer (Verifit and 6500), and frequency (500, 1000, 2000, and 4000 Hz). Results: Mean differences in measured SL for the Verifit and 6500 were ≤2 dB when compared to the estimated SL using SoundTracker. A statistically significant difference in SL was present between the Verifit and SoundTracker at 2000 Hz (p < 0.01), but no significant differences were present at 500, 1000, and 4000 Hz. A statistically significant difference in SL was present between the 6500 and SoundTracker at 4000 Hz (p < 0.01), but no significant differences were present at 500, 1000, and 2000 Hz. Mean differences in measured SL between the real-ear analyzers (difference of SoundTracker SL minus Verifit SL compared to the difference of SoundTracker SL minus 6500 SL) were ≤2 dB with a statistically significant difference present at 2000 Hz (p < 0.01), but no statistically significant differences were present at 500, 1000, or 4000 Hz. Conclusions: Nearly 85% of the differences between the estimated SoundTracker SL and the measured SLs of the Verifit and 6500 were ≤2 dB. Despite some limitations of this study, SoundTracker could be useful as a counseling tool to illustrate to patients which sounds are audible or inaudible when unaided and aided.

2012 ◽  
Vol 23 (10) ◽  
pp. 768-778 ◽  
Author(s):  
Harvey B. Abrams ◽  
Theresa H. Chisolm ◽  
Megan McManus ◽  
Rachel McArdle

Background: Despite evidence suggesting inaccuracy in the default fittings provided by hearing aid manufacturers, the use of probe-microphone measures for the verification of fitting accuracy is routinely used by fewer than half of practicing audiologists. Purpose: The present study examined whether self-perception of hearing aid benefit, as measured through the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox and Alexander, 1995), differed as a function of hearing aid fitting method, specifically, manufacturer's initial-fit approach versus a verified prescription. The prescriptive fit began at NAL-NL1 targets, with adjustments based on participant request. Each of the two fittings included probe-microphone measurement. Research Design: A counterbalanced, cross-over, repeated-measures, single-blinded design was utilized to address the research objectives. Study Sample: Twenty-two experienced hearing aid users from the general Bay Pines VA Healthcare System audiology clinic population were randomized into one of two intervention groups. Intervention: At the first visit, half of the participants were fit with new hearing aids via the manufacturer's initial fit while the second half were fit to a verified prescription using probe-microphone measurement. After a wear period of 4–6 wk, the participants' hearing aids were refit via the alternate method and worn for an additional 4–6 wk. Participants were blinded to the method of fitting by utilizing probe-microphone measures with both approaches. Data Collection and Analysis: The APHAB was administered at baseline and at the end of each intervention trial. At the end of the second trial period, the participants were asked to identify which hearing aid fitting was “preferred.” The APHAB data were subjected to a general linear model repeated-measures analysis of variance. Results: For the three APHAB communication subscales (i.e., Ease of Communication, Reverberation, and Background Noise) mean scores obtained with the verified prescription were higher than those obtained with the initial-fit approach, indicating greater benefit with the former. The main effect of hearing aid fitting method was statistically significant [F (1, 21) = 4.69, p = 0.042] and accounted for 18% of the variance in the data (partial eta squared = 0.183). Although the mean benefit score for the APHAB Aversiveness subscale was also better (i.e., lower) for the verified prescription than the initial-fit approach, the difference was not statistically significant. Of the 22 participants, 7 preferred their hearing aids programmed to initial-fit settings and 15 preferred their hearing aids programmed to the verified prescription. Conclusions: The data support the conclusion that hearing aids fit to experienced hearing aid wearers using a verified prescription are more likely to yield better self-perceived benefit as measured by the APHAB than if fit using the manufacturer's initial-fit approach.


2012 ◽  
Vol 23 (05) ◽  
pp. 366-378 ◽  
Author(s):  
Daniel B. Putterman ◽  
Michael Valente

Background: A telecoil (t-coil) is essential for hearing aid users when listening on the telephone because using the hearing aid microphone when communicating on the telephone can cause feedback due to telephone handset proximity to the hearing aid microphone. Clinicians may overlook the role of the t-coil due to a primary concern of matching the microphone frequency response to a valid prescriptive target. Little has been published to support the idea that the t-coil frequency response should match the microphone frequency response to provide “seamless” and perhaps optimal performance on the telephone. If the clinical goal were to match both frequency responses, it would be useful to know the relative differences, if any, that currently exist between these two transducers. Purpose: The primary purpose of this study was to determine if statistically significant differences were present between the mean output (in dB SPL) of the programmed microphone program and the hearing aid manufacturer's default t-coil program as a function of discrete test frequencies. In addition, pilot data are presented on the feasibility of measuring the microphone and t-coil frequency response with real-ear measures using a digital speech-weighted noise. Research Design: A repeated-measures design was utilized for a 2-cc coupler measurement condition. Independent variables were the transducer (microphone, t-coil) and 11 discrete test frequencies (15 discrete frequencies in the real-ear pilot condition). Study Sample: The study sample was comprised of behind-the-ear (BTE) hearing aids from one manufacturer. Fifty-two hearing aids were measured in a coupler condition, 39 of which were measured in the real-ear pilot condition. Hearing aids were previously programmed and verified using real-ear measures to the NAL-NL1 (National Acoustic Laboratories—Non-linear 1) prescriptive target by a licensed audiologist. Data Collection and Analysis: Hearing aid output was measured with a Fonix 7000 hearing aid analyzer (Frye Electronics, Inc.) in a HA-2 2-cc coupler condition using a pure-tone sweep at an input level of 60 dB SPL with the hearing aid in the microphone program and 31.6 mA/M in the t-coil program. A digital speech weighted noise input signal presented at additional input levels was used in the real-ear pilot condition. A mixed-model repeated-measures analysis of variance (ANOVA) and the Tukey Honestly Significant Difference (HSD) post hoc test were utilized to determine if significant differences were present in performance across treatment levels. Results: There was no significant difference between mean overall t-coil and microphone output averaged across 11 discrete frequencies (F(1,102) = 0, p < 0.98). A mixed-model repeated-measures ANOVA revealed a significant transducer by frequency interaction (F(10,102) = 13.0, p < 0.0001). Significant differences were present at 200 and 400 Hz where the mean t-coil output was less than the mean microphone output, and at 4000, 5000, and 6300 Hz where the mean t-coil output was greater than the mean microphone output. Conclusions: The mean t-coil output was significantly lower than the mean microphone output at 400 Hz, a frequency that lies within the typical telephone bandwidth of 300–3300 Hz. This difference may partially help to explain why some patients often complain the t-coil fails to provide sufficient loudness for telephone communication.


AoB Plants ◽  
2019 ◽  
Vol 11 (5) ◽  
Author(s):  
Chellby R Kilheffer ◽  
H Brian Underwood ◽  
Lindsay Ries ◽  
Jordan Raphael ◽  
Donald J Leopold

Abstract We documented the impacts of an abundant deer population on dune vegetation recovering from severe storm surge on a barrier island through use of permanent plots and a repeated measures analysis. Three years after landfall of the storm, vegetation cover was dominated by American beachgrass, Ammophila breviligulata, though we observed 12 plant species among plots surveyed. We documented significantly greater vegetation cover in fenced than unfenced plots in overwash fans in two consecutive years. The difference in species richness between fenced and unfenced plots was significant, though richness was consistently low (≤4 species per plot) and we did not detect a statistically significant difference between years. Both deer trampling and foraging effects were captured in this study, though separation between these effects was not possible. Because trampling effects are often exacerbated on sandy soils, trampling and foraging effects should be isolated and investigated in future assessments of deer impacts on coastal vegetation. Managing deer to lower abundance may enhance coastal resilience if vegetation is allowed to recover unimpeded by foraging and trampling, though a better understanding of the precise nature of deer impacts on dune vegetation is necessary.


2010 ◽  
Vol 21 (04) ◽  
pp. 249-266 ◽  
Author(s):  
Lynzee N. Alworth ◽  
Patrick N. Plyler ◽  
Monika Bertges Reber ◽  
Patti M. Johnstone

Background: Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome. Purpose: To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr). Data Collection and Analysis: Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period. Results: Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments. Conclusions: Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (4) ◽  
pp. 816-819
Author(s):  
Jeanne B. Funk ◽  
John B. Chessare ◽  
Michael T. Weaver ◽  
Anita R. Exley

Given that children with attention deficit hyperactivity disorder (ADHD) are more impulsive than peers, this study explored whether they are correspondingly more creative, and whether creativity declines when impulsivity is decreased through methylphenidate (Ritalin) therapy. A repeated-measures quasi-experimental design was used to compare the performance of 19 boys with previously diagnosed ADHD and 21 comparison boys aged 8 through 11 on two administrations of alternate forms of the Torrance Tests of Creative Thinking-Figural (nonverbal). Boys with ADHD received prescribed methylphenidate only for the first session. Overall, mean Torrance summary scores for comparison boys (mean = 115.1, SD = 16.1) were higher than for boys with ADHD (mean = 107.6, SD = 12.7). However, the difference between means was small (7%) and did not meet the 25% criterion for a clinically significant difference. No changes in performance over time (comparison group) or medication state (ADHD group) were observed. These data suggest that, when measured nonverbally, the creative thinking performance of boys with ADHD is not superior to that of peers who do not have ADHD. Regarding the effects of methylphenidate, prescribed therapy did not influence performance on this measure of creative thinking.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P57-P57
Author(s):  
Drew M Horlbeck ◽  
Herman A Jenkins ◽  
Ben J Balough ◽  
Michael E Hoffer

Objective The efficacy of the Otologics Fully Implantable Hearing Device (MET) was assessed in adult patients with bilateral moderate to severe sensorineural hearing loss. Methods Surgical insertion of this totally implanted system was identical to the Phase I study. A repeated-measures within-subjects design assessed aided sound field thresholds and speech performances with the subject's own, appropriately fit, walk-in hearing aid(s) and the Otologics Fully Implantable Hearing Device. Results Six- and 12-month Phase II data will be presented. Ten patients were implanted and activated as part Phase II clinical trial. Three patients were lost to long term follow-up due to two coil failures and one ossicular abnormality preventing proper device placement. No significant differences between preoperative (AC = 59 dB, BC = 55 dB) and postoperative (AC = 61 dB, BC = 54 dB) unaided pure tone averages were noted (p < 0.05). Pure tone average implant aided thresholds (41 dB) were equivalent to that of walk-in-aided (37 dB) condition with no significant difference (p < 0.05) between patients’ walk-in-aided individual frequency thresholds and implant-aided thresholds. Word recognition scores and hearing in noise scores were similar between the walk-in-aided and for the implant-aided condition. Patient benefit scales will be presented at all end points. Conclusions Results of the Otologics MET Fully Implantable Hearing Device Phase II trial provide evidence that this fully implantable device is a viable alternative to currently available hearing aids in patients with sensorineural hearing loss.


Author(s):  
Shahin Shyekhaghaei ◽  
Seyyed Jalal Sameni ◽  
Nariman Rahbar

Background and Aim: There are several prescriptive formulas for covering a variety of hearing loss, each of which applies relatively different amplifications at different frequencies. This study aims to compare the gains prescribed for digital behind-the-ear (BTE) hearing aids by the Desired Sensation Level Multi-Stage [Input/Output] (DSLm[I/O]), National Acoustic Laboratories-non linear2 (NAL-NL2) and manufacturer-specific formulas at different levels of input intensity. Methods: The gain values in 12-channel BTE hearing aids prepared from four companies (Oticon, Phonak, ReSound and Siemens) were measured at three levels of input intensity (45, 65, and 85 dB SPL) and at a frequency range of 250−8000 Hz for two moderately severe flat and mild sloping to severe hearing losses by using the DSLm[I/O], NAL-NL2 and manufacturerspecific formulas in the Frye FP35 test box. Results: There was no significant difference between the four selected hearing aids in terms of prescribed gain values using the prescriptive formulas (p > 0.05). Conclusion: The DSLm[I/O] formula prescribes higher gain in the 12-channel BTE hearing aids from Oticon, Phonak and Siemens companies at all input intensities and frequencies for moderately severe flat and mild sloping to severe hearing losses compared to the NAL-NL2 formula and manufacturer-specific formulas (Voice Aligned Compression (VAC), Adaptive Phonak, Connexx Fit and audiogram+). Keywords: National acoustic laboratories-non linear2; desired sensation level multi-stage [input/output]; gain; frequency; intensity levels


2014 ◽  
Vol 57 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Mary J. Sandage ◽  
Nadine P. Connor ◽  
David D. Pascoe

Purpose Phonation threshold pressure and perceived phonatory effort were hypothesized to increase and upper airway temperature to decrease following exposure to cold and/or dry air. Greater changes were expected with mouth versus nose breathing. Method In a within-participant repeated measures design, 15 consented participants (7 men, 8 women) completed 20-min duration trials to allow for adequate thermal equilibration for both nose and mouth breathing in 5 different environments: 3 temperatures (°C) matched for relative humidity (% RH), cold (15 °C, 40% RH), thermally neutral (25 °C, 40% RH), and hot (35 °C, 40% RH); and 2 temperatures with variable relative humidity to match vapor pressure for the neutral environment (25 °C, 40% RH), cold (15 °C, 74% RH) and hot (35 °C, 23% RH). Following each equilibration trial, measures were taken in this order: upper airway temperature (transnasal thermistor probe), phonation threshold pressure, and perceived phonatory effort. Results Data were analyzed using repeated measures analysis of variance, and no significant differences were established. Conclusions The study hypotheses were not supported. Findings suggest that the upper airway is tightly regulated for temperature when challenged by a realistic range of temperature and relative humidity environments. This is the first study of its kind to include measurement of upper airway temperature in conjunction with measures of vocal function.


2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 298-298
Author(s):  
Michael Szarek ◽  
Michael N. Needle ◽  
Brian I. Rini ◽  
Sumanta K. Pal ◽  
David F. McDermott ◽  
...  

298 Background: In the randomized phase III study TIVO-3, the VEGFR-TKI tivozanib (TIVO) increased progression-free survival with better tolerability but no difference in overall survival (OS) relative to sorafenib (SORA) as third- or fourth-line therapy in patients with metastatic RCC. These results provide motivation to apply quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) methods to quantify the net health benefits of TIVO, in the presence of similar survival, when compared to SORA. Methods: In application of Q-TWiST, patient-level OS was subdivided into three mutually exclusive states: time with toxicity (TOX), time without symptoms and toxicity (TWiST), and time after progression/relapse (REL). Mean Q-TWiST was calculated by applying utility coefficients of 0.5, 1.0, and 0.5 to the restricted mean (max 36 months follow-up) health states of TOX, TWiST, and REL, respectively; 95% CIs for the means and mean differences were estimated by bootstrap distributions. Relative Q-TWiST gain was defined as the mean absolute Q-TWiST difference divided by the SORA mean OS. Results: Mean TWiST was significantly longer for TIVO than for SORA (10.30 months v.5.35 months; Table). Mean REL time was significantly shorter for TIVO, with no difference in mean TOX time. Mean Q-TWiST was 15.04 and 12.78 months for TIVO and SORA, respectively, a statistically significant difference (p=0.0493). The relative gain for TIVO was 11.2%. Clinical trial information: NCT02627963 . Values in table are mean (95% CI) in months or p-value for difference in treatment group means. Conclusions: The difference in Q-TWiST in TIVO-3 was primarily driven by benefits of TIVO in TWiST, partially offset by superiority of SORA in REL time. As a third- or fourth-line treatment for RCC, TIVO significantly increased Q-TWiST relative to SORA, primarily through an increase in TWiST, which is generally considered to be the state with highest utility to patients. Consequently, Q-TWiST may be considered an alternative patient-centered measure of benefit of TIVO in these settings. [Table: see text]


2006 ◽  
Vol 15 (2) ◽  
pp. 206-216 ◽  
Author(s):  
Patricia A. Blissitt ◽  
Pamela H. Mitchell ◽  
David W. Newell ◽  
Susan L. Woods ◽  
Basia Belza

• Background In patients with aneurysmal subarachnoid hemorrhage, elevation of the head of the bed during vasospasm has been limited in an attempt to minimize vasospasm or its sequelae or both. Consequently, some patients have remained on bed rest for weeks. • Objectives To determine how elevations of the head of the bed of 20° and 45° affect cerebrovascular dynamics in adult patients with mild or moderate vasospasm after aneurysmal subarachnoid hemorrhage and to describe the response of mild or moderate vasospasm to head-of-bed elevations of 20° and 45° with respect to variables such as grade of subarachnoid hemorrhage and degree of vasospasm. • Methods A within-patient repeated-measures design was used. The head of the bed was positioned in the sequence of 0°-20°-45°-0° in 20 patients with mild or moderate vasospasm between days 3 and 14 after aneurysmal subarachnoid hemorrhage. Continuous transcranial Doppler recordings were obtained for 2 to 5 minutes after allowing approximately 2 minutes for stabilization in each position. • ResultsNo patterns or trends indicated that having the head of the bed elevated increases vasospasm. As a group, there were no significant differences within patients at the different positions of the head of the bed. Utilizing repeated-measures analysis of variance, P values ranged from .34 to .97, well beyond .05. No neurological deterioration occurred. • Conclusions In general, elevation of the head of the bed did not cause harmful changes in cerebral blood flow related to vasospasm.


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