Evaluation of three strategies for fitting hearing aids binaurally

Three strategies for evaluating optimum frequency shaping and noise reduction in binaural digital hearing aids were compared in a repeated-measures design, using a new preference-based prescriptive fitting method. These strategies consisted of using preferred frequency shaping and noise reduction values binaurally: (1) based on monaural testing; (2) based on separate evaluations of each ear; and (3) based on evaluation of a second ear while subjects wore an aid programmed with the preferred values in the first ear. Individually preferred characteristics were programmed for 17 hearing-impaired subjects, most of whom exhibited symmetrical sensorineural hearing loss. Each subject was administered intelligibility estimation and midplane localization measurements in the laboratory, as well as a questionnaire survey based on situational listening in the real world. No statistically significant differences in preferences for either frequency shaping or noise reduction were found for the three fitting strategies, suggesting that monaural testing is sufficient in symmetrical cases to provide information for binaural fitting. Related to this finding, differences across binaural conditions were minimal for both intelligibility estimation and localization results. A significant improvement in localization performance under binaural conditions over monaural listening, however, was documented by both the laboratory and the real world data. A strong overall preference for binaural over monaural amplification was also documented under real world conditions.