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Can real-ear insertion gain deviations from generic fitting prescriptions predict self-reported outcomes?

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journal contribution
posted on 2022-04-07, 14:20 authored by Sreeram Kaithali Narayanan, Palle Rye, Tobias Piechowiak, Gert Ravn, Anne Wolff, Sabina Storbjerg Houmøller, Jesper Hvass Schmidt, Dorte Hammershøi

The aim of this study was to determine whether the differences in insertion gains from the first fit to generic prescriptions of hearing aids can predict the self-reported hearing aid (HA) outcomes for first-time and experienced HA users.

This was a prospective observational study.

The study included 885 first-time and 330 experienced HA users with a valid real-ear measurement on both ears and answers to the abbreviated version of the Speech, Spatial, and Quality of Hearing (SSQ12) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires.

K-means clustering of gain differences between individual real-ear insertion gain to three generic gain prescriptions (NAL-NL2, NAL-RP, and one-third gain rules) was performed. The gain difference at higher frequencies generally differentiated the clusters. The experienced users in the cluster with fittings closest to NAL-NL2 and NAL-RP prescription were found to exhibit a higher IOI-HA Factor 1 score (representing the overall benefit of the hearing aid use). The gain differences to generic prescription did not affect other self-reported outcomes for first-time and experienced HA users.

The experienced HA users with minimal gain deviations from generic prescriptions reported better self-perceived benefits than users with larger deviations. However, this was not apparent in first-time users.


This work was supported by Innovation Fund Denmark [Grand Solutions 5164-00011B] (Better hEAring Rehabilitation project), Oticon, GN Hearing, Widex-Sivantos Audiology, and other partners (Aalborg University, University of Southern Denmark, the Technical University of Denmark, Force, Aalborg, Odense and Copenhagen University Hospitals).