The perceptual limitations of troubleshooting hearing-aids based on patients’ descriptions

OBJECTIVES: Hearing-aid frequency-gain responses are routinely adjusted by clinicians to patient preferences and descriptions. This study measured the minimum gain adjustments required to elicit preferences, and the assignment of descriptors to gain adjustments, to perceptually evaluate description-based troubleshooting. DESIGN: Participants judged whether short sentences with ±0-12 dB gain adjustments in one of three frequency bands were "better", "worse" or "no different" from the same sentence at their individual real-ear or prescribed gain. If judged "better" or "worse", participants were then asked to assign one of the six common sound-quality descriptors to their preference. STUDY SAMPLE: Thirty-two adults (aged 51-75 years) all with hearing-aid experience. RESULTS: Median preference thresholds, the minimum gain adjustments to elicit "better" or "worse" judgments, ranged from 4 to 12 dB, increasing with frequency. There was some between-participant agreement in preferences: participants generally preferred greater low-frequency gain. Within-participant reliability for preferences was moderate. There was, however, little between-participant agreement in descriptor selection for gain adjustments. Furthermore, within-participant reliability for descriptor selection was lacking. CONCLUSIONS: The scale of gain adjustments necessary to elicit preferences, along with the low agreement and reliability in descriptors for these adjustments questions the efficiency and efficacy of current description-based troubleshooting, especially with short speech stimuli.