Benefit of Hearing-Aid Amplification and Signal Enhancement for Speech Reception in Complex Listening Situations.

A major goal of hearing-device provision is to improve communication in daily life. However, there is still a large gap between the user's daily-life aided listening experience and hearing-aid benefit as assessed with established speech reception measurements in the laboratory and clinical practice. For a more realistic assessment, hearing-aid provision needs to be tested in suitable acoustic environments. In this study, using virtual acoustics, we developed complex acoustic scenarios to measure speech-intelligibility and listening-effort benefit obtained from hearing-aid amplification and signal enhancement strategies. Measurements were conducted using the participants' own devices and a research hearing aid, the Portable Hearing Laboratory (PHL). On the PHL, in addition to amplification, a monaural and a binaural directional filter, as well as a spectral filter were employed. We assessed the benefit from different signal enhancement strategies at the group and the individual level. At the group level, signal enhancement including directional filtering provided a higher hearing-aid benefit in challenging acoustic scenarios in terms of speech intelligibility compared to amplification alone or combined with spectral filtering. However, no difference between monaural and binaural signal enhancement occurred. On an individual level, we found large differences in hearing-aid benefit between participants. While some benefitted from signal-enhancement algorithms, others benefitted from amplification alone, but additional signal enhancement had a detrimental effect. This shows the importance of an individual selection of signal enhancement strategies as a part of the hearing-aid fitting process.