- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03897634
Remote Microphone Candidacy Study
Clinical Trial of Roger Adaptive Digital Technology
Despite improvements in digital hearing aid technology, many hearing aid users continue to report difficulty understanding speech in challenging listening environments. Remote microphones have been shown to provide benefit in the most common of these challenging listening environments: distant speakers, background noise, and reverberation. Despite demonstrated benefit, there is a low rate of remote microphone use among adult hearing aid users. One reason for low uptake may be an uncertainty among hearing healthcare providers and potential users regarding expected clinically relevant benefit. This clinical trial will attempt the following:
- To describe the range of remote microphone benefit among adults with mild-to-moderate sensorineural hearing loss
- To determine specific individual factors beyond the audiogram that are associated with greater benefit from remote microphones
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
2.0 Background / Literature Review / Rationale for the study:
Even when wearing well-fit hearing aids, many individuals with hearing loss continue to report difficulty communicating in background noise is one of the most common complaints of individuals with hearing loss. Directional microphones can improve speech perception in noise, but often fail to provide benefit in cases where the talker is distant from the listener, where there are multiple or moving noise sources, or in reverberation. Digital noise reduction may reduce listening effort and improve listening comfort, but has minimal effect on speech perception.
Placing the microphone in close proximity to the talker reduces the effective distance between speaker and listener, compensating for the effects of background noise and reverberation on the target signal. Use of a remote microphone can significantly improve signal-to-noise ratio (SNR), thereby improving speech perception in noise and at a distance. Recent studies demonstrated that remote-microphone devices that utilize adaptive digital technology (i.e, Roger) provide significantly more benefit for speech understanding in noise than non-adaptive remote microphones. Those advantages are likely related to the adaptive nature of the device, whereby the microphone gain varies according to the level of noise in the environment. In addition, interference is reduced via transmission of short digital bursts (160 μs) across a range of channels (2.4-2.4835 GHz). Further, the ability to utilize the hearing aids' onboard directional microphones in conjunction with a remote microphone gives listeners the benefits of remote microphone use without sacrificing nearfield intelligibility. The Roger system has also been shown to improve cell phone communication amongst cochlear implant patients.
Despite demonstrated advantages, use of remote microphone assistive devices among adults is low. In a recent study of listeners with severe hearing loss-a group which has substantial difficulty communicating in background noise, and is likely to receive significant benefits from remote-microphone devices-less than 10% reported use of a remote microphone. While cost may be a barrier for some users, even when such systems are available for free (as in the Veterans Administration), use is still low. One reason may be uncertainty among both providers and potential users as to expected benefit for a given listener. For example, Lewis et al. failed to demonstrate a clinically-significant benefit of remote microphone use using a work-life outcomes scale in a cohort of mostly nonworking (retired) participants. Wolfe et al. found significant improvements in objective speech recognition on average, but with a wide range of benefit (from 10% to 60% improvement across individual participants). That study also suggested that individual factors may affect remote microphone benefit, in that the magnitude of improved recognition was correlated with the ability to use spatial cues to improve recognition.
Research Locations:
All study tasks will take place in the Hearing Aid Lab and/or Northwestern's Center for Audiology, Speech, Language and Learning.
When testing in the Hearing Aid Lab, Frances Searle building room 1-451, we will either use the sound booth or lab space. All hearing related tasks take place in a sound booth which is a sound treated 8'x 8' room within the larger lab space. When taking histories or cognitive measures we will use the office space located within the lab or an additional nearby (i.e. same building) testing room. The additional test room is only used if participant confidentiality can be maintained (i.e. conversation is not audible to those outside the room). When using the Center for Audiology, Speech, Language and Learning all tasks will take place in a sound proof booth, in a clinical Hearing Aid fit room, or the virtual sound environment (ViSoR). ViSoR is a 16' by 14' by 9' space capable of simulating the acoustics and background noise properties of any environment by using an array of speakers.
Approach
The trial will use a within-subjects design consisting of baseline assessment (see assessments), hearing aid with Roger connect fitting, a four week trial period of use in the participant's everyday environment(s), and outcome measures.
Participants who qualify for a dome fitting will start their trial the same day as their baseline assessment. Participants who require a custom mold fitting will have earmold impressions taken at their baseline assessment and then be fit with the trial devices after the custom earmold has arrived back in the lab, usually about one week later. During an earmold impression the ear is visually inspected with an otoscope (magnifying scope with light). A cotton block and soft material are placed in the ear. The resulting impression created by the soft material is used to order an earmold for later testing. This is a standard clinical procedure.
A licensed clinical audiologist will perform the assessments, fitting and counseling of hearing aids and Roger system, and conduct the outcome measures. To ensure appropriate fit and use by the participants, there will be a follow-up one week after being fit with the devices. During this appointment participants will be evaluated and their hearing aid logging will be checked for compliance.
Hearing aid/Roger fitting: Trial hearing aids and clinically-appropriate earmolds or domes will be provided by Phonak at no charge to the participants for the duration of the trial. Those aids are expected to be drawn from Phonak's advanced technology level and to provide datalogging via 7 base programs. Aids will be set to NAL-NL2 targets using probe microphone measurements. Directional microphones will be enabled and verified via probe-microphone testing. Roger will be verified via probe-microphone testing, following clinical best practice. Appropriate hearing aid adjustments (as judged by the study audiologist) will be permitted to provide acceptable sound quality and loudness. Final REARs will be recorded. The study audiologist will instruct participants regarding hearing aid and Roger device use. PHAST-R and a Roger competency questionnaire (to be developed with input from Phonak) will be used to document understanding of device function at the fitting and one week follow-up appointments. Participants will then wear the hearing aids and use the Roger system for 1 month in their everyday listening environments. At the completion of the trial, participants will return to the lab for outcome assessments and to provide spontaneous feedback regarding their experiences. Hearing aids and remote microphone will be returned to the study site following completion of the trial.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Illinois
-
Evanston, Illinois, United States, 60208
- Northwestern University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adults age 18-85 years
- Speak English as their primary language
- Normal or corrected to normal vision
- Sensorineural hearing loss with pure-tone thresholds 20-85 dB HL at octave frequencies between 500 and 3000 Hz
- Current hearing aid wearer with at least 3 months of experience
Exclusion Criteria:
- Clinically significant unstable or progressive medical conditions, or conditions which, in the opinion of the investigator places the participant at unacceptable risk if he or she were to participate in the study
- Participants who do not pass a cognitive screening test (e.g., MoCA)
- Significant history of otologic or neurologic disorders
- Conductive hearing loss pathology or fluctuating hearing loss
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Experiences Hearing Aid user
Single arm study, all participants in this arm.
Participants will be experienced hearing aid users.
|
Experienced hearing aid users will be trained on and use a remote microphone for 30 days.
Pre- and Post- measures will be taken to determine benefit.
Participant characteristics will also be assessed (such as self-efficacy) to explore personality factors that may contribute to benefit from devices.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Abbreviated Profile of Hearing Aid Benefit (APHAB)
Time Frame: Change from baseline to final appointment will be assessed. Participants will take a baseline at the start of the trial and then complete post-intervention at the end of the 30-day trial.
|
Self assessment, disability based inventory that is used to document outcomes of hearing aid fittings.
The APHAB uses a percentile scale (Percent of Problems).
This measure has 4 subscales: Ease of communication (EC), Reverberation (RV), Background Noise (BN), and Aversiveness (AV).
A lower score indicates a better outcome.
We will look at both the global change (defined as EC, RV, and BN scores improving by at least 5 points each) and individual subscales (For EC, RV, or BN a change in 22 points is considered significant and for AV a change of 31 points is needed to be considered significant).
|
Change from baseline to final appointment will be assessed. Participants will take a baseline at the start of the trial and then complete post-intervention at the end of the 30-day trial.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Speech, Spatial, and Qualities of Hearing (SSQ)
Time Frame: Change from baseline to final appointment will be assessed. Participants will take a baseline at the start of the trial and then complete post-intervention at the end of the 30-day trial.
|
Questionnaire, clinical patient interview design where participants respond on a scale of 0 to 10, with 10 indicating perfect hearing ability and 0 indicating complete inability.There are 3 subscales calculated by averaged the responses to the questions for each subscale.
A change of 2 points is considered a moderate effect with increase in score indicating improvement.
|
Change from baseline to final appointment will be assessed. Participants will take a baseline at the start of the trial and then complete post-intervention at the end of the 30-day trial.
|
% of Words Repeated Correctly in a Sentence Recognition Task With Variable Levels of Background Noise
Time Frame: End of trial: Objective speech intel was collected in one session at the end of the 30 day trial with the remote microphone. Order of conditions (Hearing aid only and Hearing Aid+ Remote Mic) was randomized.
|
Participants had to repeat sentences presented to them in varying levels of background noise.
Sentences are scores based on the number of key words (5) they get correct.
|
End of trial: Objective speech intel was collected in one session at the end of the 30 day trial with the remote microphone. Order of conditions (Hearing aid only and Hearing Aid+ Remote Mic) was randomized.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Pamela Souza, PhD, Northwestern University
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SP0053453
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hearing Loss, Sensorineural
-
Oticon MedicalNot yet recruitingSensorineural Hearing Loss, Bilateral | Sensorineural Hearing Loss, Severe | Sensorineural Hearing Loss, Profound
-
Otologics LLCUnknownMixed Conductive and Sensorineural Hearing Loss, Bilateral
-
CochlearCompletedUnilateral Mixed Conductive and Sensorineural Hearing Loss (Diagnosis) | Sensorineural Hearing Loss, Unilateral With Normal Hearing on the Contralateral SideCanada
-
University College, LondonUnknownSensorineural Hearing Loss | Sensory Hearing Loss | Sensorineural Hearing Loss in Left Ear | Sensorineural Hearing Loss in Right Ear | Sensorineural HearingUnited Kingdom
-
Fundación Pública Andaluza para la gestión de la...RecruitingBilateral Sensorineural Hearing Loss | Unilateral Sensorineural Hearing LossSpain
-
University Hospital, AntwerpCochlearRecruitingHearing Loss, Unilateral | Cochlear Implants | Hearing Loss, Sensorineural, Severe | Hearing Loss, Sensorineural, Bilateral | Hearing Loss, Sensorineural, ProfoundBelgium
-
Auris Medical, Inc.TerminatedHearing Loss, Idiopathic Sudden SensorineuralUnited States, Korea, Republic of, Canada
-
Manchester University NHS Foundation TrustUniversity of ManchesterCompletedCochlear Hearing Loss | Sensorineural Hearing Loss, BilateralUnited Kingdom
-
Cochlear Bone Anchored SolutionsCompletedSingle Sided Sensorineural Deafness | Mixed Hearing Loss, UnilateralDenmark, Spain, United Kingdom, Belgium
-
University of Colorado, DenverCompletedSudden Sensorineural Hearing Loss (SSNHL)United States
Clinical Trials on Remote Microphone
-
University College, LondonGN ResoundCompletedAuditory Processing Disorder
-
University of MiamiCompleted
-
Advanced BionicsEnrolling by invitationEar Diseases | Hearing Loss | Hearing Disorders | Otolaryngological DiseaseUnited States
-
Sonova AGHearts for HearingCompleted
-
Ligue Pulmonaire NeuchâteloiseNot yet recruitingChronic Obstructive Pulmonary Disease | Respiratory DiseaseSwitzerland
-
Sonova AGSonova Canada Inc.Completed
-
Sonova AGCompleted
-
University of UtahNational Heart, Lung, and Blood Institute (NHLBI); National Institute of Nursing... and other collaboratorsCompletedNoninvasive Ventilation | Speech IntelligibilityUnited States
-
Goalspal LLCRecruitingParkinson DiseaseUnited States