Results showed that more than 90% of the study participants using Oticon Dual were “satisfied” or “very satisfied”. The hearing instrument was rated highly for its aesthetics, sound quality, and speech understanding in complex listening environments by users and professionals.
For most people with hearing loss, a good hearing instrument is one that improves speech understanding in complex listening environments. Despite the best efforts by hearing care professionals, many clients feel less than satisfied following fitting of hearing instruments. Physical factors and cosmetics related to the hearing instruments play an important role in clients’ resistance to wearing hearing aids. However, even when resistance is overcome, a lack of confidence in the performance of hearing instruments and fear of communication failure can contribute to clients feeling dissatisfied.
Kochkin1 indicated that when hearing aid users are satisfied in a variety of listening environments, the overall satisfaction with their instruments is high. Several studies have shown a positive correlation between performance of hearing instruments and user satisfaction.2 Thus, devices with newer advanced signal processing algorithms, as well as connectivity to external devices (eg, TV or phone), have the potential to facilitate greater client satisfaction.
Lise Bruun Hansen, MA, is senior clinical audiologist, and Ravi Sockalingam, PhD, is senior audiologist at Oticon A/S, Smørum, Denmark. Correspondence can be addressed to HR or Lise Bruun Hansen at .
Previous research at Oticon showed Dual to be significantly better than participants’ own hearing aids in terms of speech understanding, spatial perception, and overall impression of the instrument (Johansen J, Sockalingam R. Real World Performance of Oticon Dual XW: A Field Report. White Paper; Oticon A/S, Denmark; unpublished data). Another laboratory-based independent study3 demonstrated the benefit of binaural connectivity between instruments. To summarize, when both instruments were binaurally coordinated, they were significantly better at helping clients localize sounds in noise. The natural sound quality was also shown to be significantly better in a simulated café environment when the two instruments communicated binaurally.
The present study was designed to gain further insights from both end-users and dispensing professionals regarding the attributes of Dual.
Participants and hearing aid fittings. Professionals from six countries (Australia, Germany, Italy, Netherlands, United Kingdom, and the United States) agreed to participate. Three groups of participants were studied: 111 new users, 47 experienced users, and 31 hearing care professionals.
New users ranged in age from 10 to 86 years (mean of 65 years), and experienced users ranged from ages 31 to 84 (mean of 65 years). The average hearing loss of these study participants is shown in Figure 1. All were fitted by professionals per the hearing instrument fitting procedure using the Oticon Genie 2008.2 fitting software. Thus, no inclusion or exclusion criterion was applied to the type of clients, the model of Dual instruments, frequency of visits, or the duration of the fitting session.
All Dual models were represented in this study. Most clients were fitted bilaterally. The majority of clients (63% of new users and 81% of experienced users) were fitted with Dual Connect models. There were clear differences between the new-user and experienced-user groups in terms of the type of Dual models used (Figure 2). Experienced users were more often fitted with the Dual Connect models, underscoring the importance of performance for this group; new users were more likely to be fitted with the slightly smaller Dual mini models, underscoring the importance of physical size for this group.
Questionnaires. Questionnaires (see Appendix 1, available in the online version of this article) were employed to evaluate Dual qualitatively, and consisted mainly of closed-set questions. In the closed-set questionnaires, the descriptors in the ratings scales completed by new users were different from those of experienced users, although both groups used a 5-point rating scale.
Experienced users were required to rate Dual against their previous instrument by selecting one of the following descriptors: 1) Old instrument much better; 2) Old instrument somewhat better; 3) Cannot tell a difference; 4) New instrument somewhat better, or 5) New instrument much better.New users were asked to rate Dual with one of the following descriptors: 1) Poor; 2) Below average; 3) Average; 4) Above average; or 5) Excellent.
Results and Discussion
Duration of use. A total of 85% of experienced users reported using Dual more than 8 hours per day. Half of all experienced users reported using Dual more than their previous instruments, while the remaining half reported using Dual just as much as their previous instrument. More than half of all new users reported using Dual more than 8 hours per day.
Factors influencing the trial and purchase of instrument. The design of Dual was a key deciding factor for many new and experienced users. Design was the reason 44% of new users and 31% of experienced users decided to try or buy Dual. Sound and technology were also major influencing factors for both groups (Figure 3).
Adaptation. The vast majority of both experienced and new users (about 75%) adapted to Dual within a short period of time. This finding suggests that Dual is easy to accept for both experienced and reluctant users of amplification.
Overall satisfaction. The overall user satisfaction with Oticon Dual was reported as very high. For experienced and new users, 93% reported being “very satisfied” or “satisfied.” For clients who used Dual with a Streamer, the overall satisfaction with the Streamer was also rated high.
The professionals’ perception of their clients’ satisfaction with Dual concurred with that of the clients. About 9 in 10 (92%) professionals found clients fitted with Dual were either “very satisfied” or “satisfied.” When users of Streamer were asked whether the Streamer option had impacted their degree of satisfaction “negatively,” “not at all,” or “positively,” the overwhelming response was “positively.”
The survey also revealed that, for 76% of the new users, Dual exceeded their expectations. When new users were asked if they would recommend Dual, 92% of them indicated that they would not hesitate to do so. In fact, many commented they had already done so. A similar number of experienced users (96%) commented they, too, would recommend Dual.
User and dispenser ratings in closed-set questionnaire. Figure 5 shows the results of the closed-set questionnaire for users and dispensers of Dual across the different categories of outcomes: overall performance, sound quality, speech understanding, listening in complex environments, listening effort, forms factors, and fitting of instruments. Overall, experienced and new users rated Dual highly in all outcome categories. Over 85% of experienced users rated Dual better than their previously used instruments relative to overall performance, sound quality, and clarity of speech. Over 60% of these users also rated Dual to be better with regard to quality of own voice, ambient noise, and feedback. The ratings for overall performance and sound quality were high for the new users, with over 70% of them reporting above-average to excellent ratings across all outcomes in this category.
Another noteworthy finding is the ability to perform in complex environments was reported to be better with Dual than with previously used instrument for at least 75% of the experienced users. Even for new users, more than 40% of them rated Dual above-average to excellent for listening in complex environments. In terms of understanding speech in noise and listening effort, over 80% of experienced users rated Dual to be better than their previous instruments. New users rated Dual less positively, which is not surprising considering new users expect their newly fitted instruments to provide an immediate relief to the challenges of understanding speech in noisy environments.
The importance of physical appearance and cosmetic issues (ie, form factors) is not trivial. Dual was deliberately designed to fare very well in terms of form factors. In this study, aesthetics, physical appeal, and ease of fitting were the form factors evaluated by new and experienced users. Figure 5 demonstrates that 90% of new users rated Dual to be above average to excellent in all three factors. About 80% of experienced users rated Dual to be better than their previous instruments in aesthetic appeal and physical feel.
The ratings by 27 professionals generally mirrored those of the clients. For 8 out of 10 outcomes surveyed (speech quality, speech understanding in quiet, speech understanding in noise, localization ability, feedback, own voice, aesthetics, and ease of fitting), 80% rated Dual above average to excellent.
A total of 158 hearing aid users and 31 professionals participated in an international study to qualitatively rate the Oticon Dual on a number of attributes. Results showed that more than 90% of the group were “satisfied” or “very satisfied” with Dual. The device was rated very highly for its aesthetics, sound quality, and speech understanding in complex listening environments by users and professionals.
The unique combination of design and performance of Dual offers numerous benefits to new and experienced users as well as to professionals, in terms of sound quality, speech understanding, listening in complex environments, adaption time, form factors, and ease of fitting. These benefits can be attributed to the design and feel of the instrument and, more importantly, to the core of the instrument—the wireless RISE platform, 10 kHz extended bandwidth, binaural synchronization of automatics and compression, and the proprietary rationales of Voice Aligned Compression (VAC) and Clarity.
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- 2. Wong L, Hickson L, McPherson B. Hearing aid satisfaction: what does research from the past 20 years say? Trends Amplif. 2003;7(4):117-161.
- 3. Sockalingam R, Holmberg M, Eneroth K, Schulte M. Binaural hearing aid communication shown to improve sound quality and localization. Hear Jour. 2009;62(10):46-47.
Citation for this article:
Hansen LB, Sockalingam R. International study on users and dispensers of Oticon Dual. Hearing Review. 2010;17(3):50-52.