User Preferences for Hearing Aid Features: Outcomes, Concepts, and Test Construction
Abstract
Modern hearing aids can vary in both digital signal processing (DSP) and non-signal processing (non-DSP) features. The complexity and availability of these features can differ at opposite ends of the technology spectrum, potentially influencing aided benefit and preference. Furthermore, the amount of feature choices in modern hearing aids has led to increasing complexity in the selection process.
The first aim of this dissertation was to investigate the aided benefit and preference differences between premium and entry-level hearing aids, and to investigate the drivers of any preference differences. No significant differences were found between the entry-level and premium hearing aids in aided loudness ratings, speech quality, speech recognition, and consonant recognition. However, most participants preferred the premium hearing aids.
Investigation of this preference using group concept mapping revealed nine clusters, representing both DSP and non-DSP features. Three clusters were rated as significantly more important by participants that preferred the premium hearing aids. These three clusters represented technologies predominantly found in premium hearing aids (such as remote fitting compatibility).
The second aim was to design the Hearing Aid Feature Importance Evaluation (HAFIE) questionnaire. This provides clinicians with a methodology to gather patient feature importance ratings to facilitate hearing aid recommendations.
Questionnaire items were designed using concept mapping results as a theoretical framework. Hearing care professional focus groups provided feedback for modification. Validation of the 34-item questionnaire was conducted via Qualtrics. Exploratory factor analysis was used to assess factor structure, resulting in three subscales: “Advanced connectivity & streaming”, “Physical features & usability”, and “Sound quality & intelligibility”. Seven items were removed due to poor factor loading, resulting in a 28-item questionnaire with three subscales. Reliability of each of these subscales was assessed via Cronbach’s alpha and item-total correlation and was found to be appropriate.
This thesis has resulted in a conceptual framework of the different aspects of the hearing aid user experience, identifying features which may influence user preference. Furthermore, it has resulted in the development of an evidence-based hearing aid selection tool, providing a structured methodology which may potentially be useful in a clinical setting.