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Peer-reviewedCC BYAudiology research

Prescriptive Target Matching Across Hearing Aid Technology Generations: A Real-Ear Insertion Gain Analysis.

  • Megan Kruger1,2
  • Vinaya Manchaiah1,2,3,4,5
  • Steve Taddei6
  • Abram Bailey6,7
  • De Wet Swanepoel1,2,3
7 affiliations
  1. 1Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa.
  2. 2Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine (USA) and the University of Pretoria (South Africa), Aurora, CO 80045, USA.
  3. 3Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA.
  4. 4UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA.
  5. 5Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal 576104, India.
  6. 6Hear Advisor LLC, Rockford, IL 61102, USA.
  7. 7Hearing Tracker Inc., Austin, TX 40702, USA.
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Abstract

Background: Advances in hearing aid technology may improve prescriptive target matching, but whether newer devices better match targets remains unclear. This study compared prescriptive target matching across hearing aid technology generations. Methods: This secondary analysis included 29 flagship prescription hearing aids grouped into older (2021-2022; n = 8), mid (2023; n = 11), and newest (2024-2025; n = 10) technology generations. Root Mean Square Error (RMSE) between measured Real Ear Insertion Gain (REIG) and NAL-NL2 targets was calculated across six frequencies (500-6300 Hz) for soft (55 dB SPL), conversational (65 dB SPL), and loud (75 dB SPL) speech levels under Initial Fit and Tuned Fit conditions. Kruskal-Wallis tests and linear mixed-effects models accounting for manufacturer clustering were used to evaluate prescriptive target matching across technology generations. Results: No significant technology-generation differences were observed at Initial Fit. Following tuning, group comparisons showed differences at conversational (p = 0.006; ε² = 0.321) and loud (p = 0.004; ε² = 0.347) levels, with a directionally consistent but non-significant difference at soft speech (p = 0.055; ε² = 0.146). After accounting for manufacturer clustering, release year remained a significant predictor of closer target matching only at conversational speech (β = -0.15 dB/year, 95% CI [-0.29, -0.01], p = 0.048). Sensitivity analyses supported the robustness of this finding. Conclusions: Newer hearing aids showed closer prescriptive target matching following tuning at conversational speech, although effects at soft and loud speech did not survive adjustment. Technological advances may improve prescriptive target matching at conversational input levels during fitting.

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Cite

BibTeXRIS
BibTeX
@article{kruger2026prescriptive,
  title = {{Prescriptive Target Matching Across Hearing Aid Technology Generations: A Real-Ear Insertion Gain Analysis.}},
  author = {Megan Kruger and Vinaya Manchaiah and Steve Taddei and Abram Bailey and De Wet Swanepoel},
  journal = {Audiology research},
  year = {2026},
  month = sep,
  doi = {10.3390/audiolres16050145},
  url = {https://europepmc.org/article/MED/42930343},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prescriptive Target Matching Across Hearing Aid Technology Generations: A Real-Ear Insertion Gain Analysis.
AU  - Megan Kruger
AU  - Vinaya Manchaiah
AU  - Steve Taddei
AU  - Abram Bailey
AU  - De Wet Swanepoel
PY  - 2026
DA  - 2026/09/25
JO  - Audiology research
DO  - 10.3390/audiolres16050145
UR  - https://europepmc.org/article/MED/42930343
AB  - Background: Advances in hearing aid technology may improve prescriptive target matching, but whether newer devices better match targets remains unclear. This study compared prescriptive target matching across hearing aid technology generations. Methods: This secondary analysis included 29 flagship prescription hearing aids grouped into older (2021-2022; n = 8), mid (2023; n = 11), and newest (2024-2025; n = 10) technology generations. Root Mean Square Error (RMSE) between measured Real Ear Insertion Gain (REIG) and NAL-NL2 targets was calculated across six frequencies (500-6300 Hz) for soft (55 dB SPL), conversational (65 dB SPL), and loud (75 dB SPL) speech levels under Initial Fit and Tuned Fit conditions. Kruskal-Wallis tests and linear mixed-effects models accounting for manufacturer clustering were used to evaluate prescriptive target matching across technology generations. Results: No significant technology-generation differences were observed at Initial Fit. Following tuning, group comparisons showed differences at conversational (p = 0.006; ε² = 0.321) and loud (p = 0.004; ε² = 0.347) levels, with a directionally consistent but non-significant difference at soft speech (p = 0.055; ε² = 0.146). After accounting for manufacturer clustering, release year remained a significant predictor of closer target matching only at conversational speech (β = -0.15 dB/year, 95% CI [-0.29, -0.01], p = 0.048). Sensitivity analyses supported the robustness of this finding. Conclusions: Newer hearing aids showed closer prescriptive target matching following tuning at conversational speech, although effects at soft and loud speech did not survive adjustment. Technological advances may improve prescriptive target matching at conversational input levels during fitting.
SN  - 2039-4330
SN  - 2039-4349
ER  -