The Laryngoscope V C 2012 The American Laryngological, Rhinological and Otological Society, Inc. Hearing Aid Satisfaction and Use in the Advanced Digital Era Ricky Kaplan-Neeman, PhD; Chava Muchnik, PhD; Minka Hildesheimer, PhD; Yael Henkin, PhD Objectives/Hypothesis: To evaluate satisfaction ratings and use patterns of advanced digital hearing aids (HAs) in a group of hearing-impaired adults by means of self-report questionnaires. Study Design: A self report questionnaire study. Methods: One hundred seventy-seven hearing-impaired adults who were fitted with advanced digital HAs at the Speech and Hearing Center at Sheba Medical Center were asked to participate in a structured telephone interview regarding HA sat- isfaction and use by means of the Satisfaction With Amplification in Daily Life (SADL) questionnaire. Patients who were not using their HAs completed a nonuse questionnaire. Results: One hundred thirty-one patients participated in the survey, yielding a response rate of 74%. Eighty-three per- cent used their HAs regularly, whereas 17% were nonusers. Of the users, 92% were satisfied to some degree with their HAs. The global SADL score was 5.12 on a scale of 1 to 7. Background variables that were significantly associated with satisfaction ratings were hours of HA use per day, fitting mode (binaural vs. monaural), age, and degree of hearing loss. Although nonuse was not significantly associated with background variables, the main reasons for nonuse were excessive amplification in back- ground noise and minimal functional benefit. Conclusions: High satisfaction and use rates were characteristic of adults fitted with advanced digital HAs. Patients should be advised that longer use of HAs per day may lead to higher satisfaction and that binaural amplification is advanta- geous, especially while communicating in noise. Finally, expectation from HA functionality in challenging listening situations should be realistic, as additional research and technology development is still needed. Key Words: Digital hearing aids, hearing aid use, satisfaction, questionnaire, Satisfaction With Amplification in Daily Life questionnaire, adults. Level of Evidence: 4 Laryngoscope, 122:2029–2036, 2012 INTRODUCTION The field of hearing rehabilitation by means of hearing aids (HAs) has changed tremendously over the past decade. The introduction of digital signal processing enabled the inclusion of advanced features such as noise reduction algorithms, active feedback cancellation, mul- tichannel compression, and directionality. 1,2 Thus, current HAs offer significantly greater flexibility in shaping the frequency-gain response, better signal-to- noise ratio in everyday listening situations, and superior optimization of microphones. 3 Following the technological breakthroughs, it was reasonable to assume that the benefits derived from HAs would improve and result in increased satisfaction and use rates. Nonetheless, information regarding satis- faction from current advanced digital HAs is scarce. The vast majority of studies reported on heterogynous cohorts that were fitted with analogue, programmable, and first- or second-generation digital circuits. 4–6 Although these studies showed that digital circuits produced higher satis- faction scores to some extent, differences among the levels of circuit sophistication (i.e., analogue, program- mable, or digital) were not significant. Currently, it is agreed that patient satisfaction with HAs should be evaluated by means of self-report meas- ures that provide information about the advantages/ disadvantages of HAs in real life situations as opposed to those obtained in laboratory settings. Patient-driven tools such as the Abbreviated Profile of Hearing aid Ben- efit, 7 the Client Oriented Scale of Improvement, 8 and Satisfaction With Amplification in Daily Life (SADL) 9,10 questionnaires have been predominantly used thus far. For example, the SADL, which outlines satisfaction domains such as acoustic, sound quality, psychological benefit, professional quality of the HA fitting procedure, reliability and cost/value issues, and cosmetic and stig- matizing concerns, was used by Hosford-Dunn and Halpern 4 in a group of 282 HA recipients who were using analogue, programmable, and digital HAs. Their results indicated a global satisfaction score of 5 (on a scale of 1–7). Uriarte et al. 5 also reported a global SADL satisfaction score of 5.3 in 1,014 elderly Australian par- ticipants who were fitted with programmable HAs. Patient-related variables that were significantly From the Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer and Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (R.K.-N., C.M., M.H., Y .H.). Editor’s Note: This Manuscript was accepted for publication April 11, 2012. The authors have no funding, financial relationships, or conflicts of interest to disclose. Send correspondence to Ricky Kaplan-Neeman, PhD, Department of Communication Disorders, Sheba Medical Center, Tel Hashomer, 52621 Israel. E-mail: kaplann@post.tau.ac.il DOI: 10.1002/lary.23404 Laryngoscope 122: September 2012 Kaplan-Neeman et al.: Digital Hearing Aid Satisfaction 2029