Evaluation of speech perception deficit compensation in patients with hearing loss.

Objective: To evaluate speech perception deficit compensation and predict potential hearing aids (HA) effectiveness in patients with hearing loss (HL).

Design: The patients underwent pure-tone audiometry and various speech tests in quiet (evaluating the peripheral auditory system and cognitive compensation) and in noise (to quantify central compensation through auditory processing and cognitive abilities).

Study sample: 513 HL patients aged 19-93 years, including 403 HA users.

Results: Speech Perception Deficit Compensation Index (SPDCI) was obtained from the residuals between individual speech perception test results and their predictions based on individual pure tone thresholds (PTT) data, thus characterising solely the patient's hearing abilities, generated using a Bayesian network trained on the cohort-wide partial correlations between PTT and speech test results. The SPDCI quantifies the contribution of central compensation mechanisms (auditory processing performance and cognitive abilities) to the speech perception effectiveness in HL patients. Potential HA effectiveness was evaluated using Bayesian inference of speech test results with HA from individual PTT and speech test results without HA.

Conclusions: The proposed approach is instrumental for the differential diagnosis of HL and impaired speech perception, leading to a better understanding of the potential usefulness of hearing aids and, ultimately, to more informed management of these groups.