Clinical Implications of Word Recognition Differences in Earphone and Aided Conditions

Objective: To compare word recognition scores for adults with hearing loss measured using earphones and in the sound field without and with hearing aids (HA). Study Design: Independent review of presurgical audiological data from an active middle ear implant (MEI) FDA clinical trial. Setting: Multicenter prospective FDA clinical trial. Patients: Ninety-four adult HA users. Interventions/Main Outcomes Measured: Preoperative earphone, aided word recognition scores, and speech intelligibility index. Results: We performed an independent review of presurgical audiological data from an MEI FDA trial and compared unaided and aided word recognition scores with participants’ HAs fit according to the NAL-R algorithm. For 52 participants (55.3%), differences in scores between earphone and aided conditions were >10%; for 33 participants (35.1%), earphone scores were higher by 10% or more than aided scores. These participants had significantly higher pure-tone thresholds at 250, 500, and 1000 Hz, higher pure-tone averages, higher speech recognition thresholds (and higher earphone speech levels [p = 0.002]). No significant correlation was observed between word recognition scores measured with earphones and with hearing aids (r = 0.14; p = 0.16), whereas a moderately high positive correlation was observed between unaided and aided word recognition (r = 0.68; p 

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