gms | German Medical Science

Introduction: Ecological Momentary Assessment (EMA) allows an assessment of listening situations in real time as they occur, so the memory bias associated with retrospective questionnaires is reduced. This can be useful for hearing aid fittings – collection of impressions from everyday life can give insights into how to improve the settings such that the hearing aid wearer is satisfied with the fitting. But not all situations can be assessed right in the moment due to e.g., safety reasons or impoliteness. To collect data in such situations, participants are sometimes allowed to answer the questionnaire later. However, it is unknown how much time can pass for an assessment to still be considered “momentary” and how big the impact of memory bias is.

Research question: Does a delay in answering a questionnaire in EMA lead to different answers relative to answering the questionnaire in the moment?

Methods: Ten experienced hearing aid users (9 male, 1 female, mean age 69.5 years, mean PTA4 = 41.5 dB HL) were fitted with Signia Pure 7AX hearing aids using NAL-NL2 and closed domes. The participants received a Samsung Galaxy S20 FE 5G with an EMA app pre-installed. The provided questionnaires include ratings for quality of conversation, speech understanding, importance, mood, stress, listening effort, satisfaction with sound and hearing aids in general, noise level, and disturbance of noise. At the first appointment, the participants were asked to answer an EMA questionnaire in three scenarios: listening to church music, having a walk outside, and having a conversation at the coffee machine. After 60 minutes, the participants were asked to answer the EMA questionnaire for the same three situations again. During the last appointment, they experienced the same situations again and rated them immediately and 30 minutes later. After the first visit, the 14-day field trial commenced. During the field trial, the participants were randomly prompted by the app to answer an EMA questionnaire four times a day. After a 30- or 60-minute delay, the participants were prompted to rate the same situation again. The delay alternated between the first and the second week in a cross-over design.

Results: EMA evaluation in the laboratory situations showed a difference in ratings over time depending on the situation. Two out of ten participants classified the rated listening situation in the initial laboratory test first as focused listening and later as conversation. In the laboratory, the median of average deviation in rating is larger for the 60-minute delay compared to the 30-minute delay. These differences were not observed in the field trial data.

Conclusion: Preliminary results show that ratings for the same situation can differ between two assessments. However, in the field trial, there is no evidence that restricting retrospective responses to 30 minutes is more beneficial compared to limiting it to 60 minutes.