一种用于噪声中聆听的助听器增益处方新方法：NAL-NL3 噪声舒适度模块

文献信息

中文摘要

目的： 描述 NAL-NL3 噪声舒适度模块的开发与评估；这是一种用于确定助听器增益的新算法，属于 NAL-NL3 验配系统的一部分。
设计： 单中心多研究设计，每项研究及后续的感知建模为模块增益目标的改进提供依据。参与者完成实验室研究，以调查增益偏好并评估该模块对噪声中言语理解的影响。参与者还使用基于智能手机的生态瞬时评估应用程序，对不同品牌的助听器进行了真实世界评估。
研究样本： 83 名患有轻度至重度听力损失的成年助听器使用者。
结果： 与 NAL-NL3 处方相比，新模块通过对总响度施加限制来选择性地降低增益。迭代改进使使用者偏好逐步增加，在噪声中相对于 NAL-NL3 处方更倾向于新模块，尤其是在聆听舒适度方面。基于实验室的测试未发现对噪声中言语感知有不利影响。
结论： 与安静环境相比，降低噪声中助听器使用者的处方增益水平可提高舒适度，而不会显著降低言语理解。这项工作支持 NAL-NL3 验配系统的更广泛理念，即为不同人群、情境和设备技术提供专门的目标。

英文摘要

OBJECTIVE: To describe the development and evaluation of the NAL-NL3 Comfort in Noise Module; a new algorithm for determining hearing-aid gain that is part of the NAL-NL3 fitting system.
DESIGN: Single-site multi-study design with each study and subsequent perceptual modelling informing refinements to module gain targets. Participants completed laboratory studies to investigate gain preferences and to evaluate the effect of the module on speech understanding in noise. Participants also completed real-world evaluations using a smartphone-based Ecological Momentary Assessment app with different brands of hearing aids.
STUDY SAMPLE: 83 adult hearing aid users with mild to severe hearing loss.
RESULTS: The new module selectively reduced gain (compared with the NAL-NL3 Prescription) by imposing a limit on the total loudness. Iterative refinements led to progressive increases in user preferences favouring the new module over the NAL-NL3 Prescription in noise with respect to listening comfort. Laboratory-based testing identified no detrimental impact on speech perception in noise.
CONCLUSIONS: Reducing the level of prescribed gain for hearing aid users in noise compared to in quiet improves comfort without significantly degrading speech understanding. This work supports the broader philosophy of the NAL-NL3 fitting system to provide specialised targets for different populations, situations and device technologies.