PP420 - Impact of Hearing Aid Technology Levels on Auditory-Visual Speech Recognition in Noise

Abstract:
This study examines factors influencing hearing aid success from both technology and patient-centered perspectives. Laboratory and field trials were conducted to compare user performance across hearing aid technology levels and to assess how baseline auditory and cognitive functions impact outcomes. Findings highlight a difference in outcomes between auditory-only and auditory-visual tasks, with many users perceiving minimal differences across technology levels when provided with visual cues. Results aim to support evidence-based, transparent patient-provider discussions on hearing aid selection, emphasizing personalized recommendations. This research addresses gaps in guidelines for technology-level recommendations and promotes improved patient-centered hearing care.

Summary:
Rationale and Purpose
Hearing loss affects around 40 million Americans, particularly older adults, and can lead to declines in cognitive, social, and emotional well-being. Despite the potential benefits of hearing aids, their adoption remains low, in part due to a perceived imbalance between cost and benefit. This study aims to address the complex issue of balancing hearing aid cost and perceived benefit by identifying factors that contribute to success with different technologies of hearing aids by comparing user performance across different technology levels in various listening environments. The findings are intended to enhance evidence-based clinical guidance, helping clinicians select hearing aid technology that better aligns with individual patient needs.

Methods
The study enrolled 20 adults (aged 50-85) with moderate bilateral hearing loss. Over an 8-week period, participants completed both laboratory tests and real-world field trials using two hearing aid technology level—advanced and basic—from a single manufacturer. Each device was worn for 4 weeks in a randomized order to reduce bias. Devices were programmed using standard clinical protocols and adjusted based on participant feedback.

Speech understanding and listening effort were measured at the beginning and end of each trial period using the AZ Bio Speech Recognition in Noise Test, administered in both auditory-only (AO) and auditory-visual (AV) modes at signal-to-noise-ratios (SNRs) ranging from +10 to -15. Listening effort was assessed through pupil dilation changes, an objective measure of cognitive load. Subjective feedback on auditory function and satisfaction was also collected using the Speech, Spatial, and Qualities of Hearing Scale (SSQ) after each trial. This poster focuses on differences in speech-in-noise performance across hearing aid technology levels (Advanced vs. Basic) and test conditions (AO vs. AV). Data analysis involved paired sample t-tests and ANOVAs to compare performance metrics, including speech recognition accuracy and peak pupil dilation, between the two hearing aid models.

Results and Conclusions
Preliminary findings show that hearing aid performance varied by listening environment. In auditory-only conditions, advanced technology yielded significantly better outcomes, while in auditory-visual settings, the benefit of advanced technology was less pronounced. This suggests that visual cues may reduce reliance on advanced auditory processing features. These results indicate that clinicians should consider patients' typical listening environments when recommending hearing aid technology levels, potentially enabling more cost-effective, individualized solutions that better meet patients' listening needs.