I agree, after REM we should be pushing for this.
WH
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I don’t know why it’s not more common. The paper test is usually just to ensure we’re not over-amplifying high frequencies.
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Yes I can see where I would definitely benefit from that type of test.
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Thank you for your professional advice on this - In my entire life I have never had or heard of QSiN and the video on your last post just shows it. I will surely ask my audiologist if they can cater for this kind of test.
My mother is currently in Taiwan and she does not speak chinese unfortunately so the only test she’s had was an audiogram test. She will yet to be given a full proper test when she comes back to our homeland, and I will definitely request this type of test for her. She will need to be able to distinguish speech from noise in noisy area as she’s a teacher and lecturer. I do hope the More3’s will be suited to her hearing type.
In my case, I have a more severe hearing loss and will need More1’s . I am currently wearing Oticon Chilli SP7 - for more than 10 years. (I am sure the technology level of More3’s are more advanced than the SP7’s , if that is the case , it will be no brainer the More3’s should do the honours of helping her).
This definitely helps.
I agree! In nearly 40 years of HA use, I have never had a test like that. The VA concept of speech in noise is “Say the word ‘PLAY’” at 80db with a white noise mask of around 60db. The QSiN should be SOP for all hearing tests.
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I disagree. Testing with individual words rely on what you actually hear. A phrase or sentence also relies on how well your brain can fill in the missing word(s). To me the individual words would be a more accurate representation of what you actually hear rather than how well your brain fills in the missing bits. jmo
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I definitely agree with you, I use to spend a lot of time that delayed my response to question just filling in the gaps in the sentence or questions. I have to say with my More1 aids I respond to those questions much faster and more accurate.
While that may be true, I’d like to have the noise voice related rather than white noise.
WH
It doesn’t matter - the noises from one or two small transducers in an office are a far cry from multiple noise sources moving a LOT of air in different vectors with different room acoustics, sympathetic vibrations, delays, and overtones, such as are present in a big, live room. All on top of a puny human voice …
This recorded test is just marketing hype, IMO. YMMV… [Having a BIG transducer array like they have in the Oticon lab is another story.]
Agree to disagree then. Simply because single words in a noisy place is not realistic. We’re not testing what we actually hear in a vacuum. That’s what the original Word Recognition Test in a quiet soundproof booth is for, and of course it has its usefulness and that’s why it’s done.
But what we’re talking about here is in the context of the signal to noise separation performance in a real world test with surrounding noise. We don’t need to do another Word Recognition Test in noise. It’s useless to me because in this context, it’s not about what you actually “hear” (like you said), it’s about what you “understand”. I actually don’t really care what I “hear”, as long as I “understand” what is being said to me in a noisy place. If it involves my brain filling in the missing words, that’s fine with me.
It’s because your brain uses MANY things to isolate and understand speech, not just one thing. It’s not just what it hears, but how it hears it, like the tonal distinction between the speaker’s voice (like low for male or high for female), the loudness (or softness) of the speaker’s voice compared to others, and maybe the frequency of the speaker’s speech (how fast or slow they speak), and even what the babbles sound like differently from the speaker’s speech. All of that helps the brain isolate and formulate and arrive at an understanding.
In fact, if you simply do single word test in noise like you propose, chances are the result you achieve may fare worse than the result of a real-life complete sentences testing. That’s because the adjustment to improve what you “hear” can be overly corrected more than necessary for you to “understand”, possibly toward a more detrimental result instead of a more helpful result.
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Sorry - I’m getting mixed up as to who’s responding to whom!
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I don’t know about everyone else but if I set in a noisy restaurant, or lecture with a bunch talking all at once it all sounds like very loud white noise to me.
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To me it sounds like my white noise machine that I sleep with but much louder. But what is interesting if I am in a really noisy restaurant and I take out my aids the noise is 10 times louder then with my aids on and functioning.
Sorry too, I didn’t include the quote originally but by the time I was done writing apparently there were several posts in between so it was not obvious whom I was replying to anymore. I’ve since included the original quote to clarify.
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With all due respect, you’re a little too quick to confidently dismiss a valuable clinical tool. QSiN is an excellent assessment that has allowed me, more often than not, to confidently prescribe lower end devices, rather than simply suggest to all clients that the more they spend, the better they’ll hear. In that way, it achieves the exact opposite of a marketing tool.
Furthermore, regardless of how complex a given soundscape is, all those “noise sources moving a LOT of air in different vectors with different room acoustics, sympathetic vibrations, delays, and overtones” are only perceived when they ultimately arrive at two small ear drums in your head. Therefore, capturing any given environment with a stereo pair of mics (that are positioned in such a way as to emulate a person’s ears), captures much of the important detail and complexity of any given environment - particularly when that recodring is played back through stereo inserts/earbuds (as I do in my clinic). It’s not perfect, but it’s a pretty damn good simulacrum for the real thing. The test and test scores are standardised, and are far more sophisticated than a trivial marketing tool.
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Fair enough explanation, @Louie - I’ll retract the marketing gimmick part, but not the issues I have with the physics.
How’s that? 
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Yeah, it’s not obvious to me if QSiN has some kind of setup requirement on the speaker array in a test booth or not. If there’s no requirement and everything can come from just a single speaker, it doesn’t really test the HAs for how they handle surrounding noise at all. For traditional HAs which block out surrounding sounds to focus only in front, a single front speaker emanating all sounds including noise set in front of a patient doesn’t do any good for them because the HAs wouldn’t be able to separate the sounds anyway to help out because there’s no surrounding sounds, there’s only front sounds.
I think at a minimum, there should be a “surround” sound type setup with 5 speakers, a front center, front left, front right, rear left and rear right. Another rear center would also be ideal.
Another thing we don’t know about the QSiN test is whether they can route different noise sources separately into different speakers to simulate the origins of the noise sources, or whether it’s a mono setup and all noises come from 1 channel. If the later, then it’s not going to be as realistic and effective either.
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This test comes BEFORE the fitting of an aid. I don’t use it to assess how people perform with a hearing aid for exactly the reason you both have mentioned. I use it as an unaided test to measure their natural ability to focus on a voice in background noise. The test provides a measure of the client’s required signal-to-noise ratio - I.e how much separation between the vol. of noise and the vol. of speech in order to hear well. We then use that score to recommend an appropriate tech level. If they have a good signal-to-noise ratio I can confidently tell them they don’t need to spend extra thousands for a premium device. Alternatively if they score poorly, I recommend more advanced devices, remote microphones, and I counsel on setting up realistic expectations.
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