Oticon Intent Virtual Launch Box Audigy User Guide

Oticon Intent Virtual Launch Box Audigy

Comprehensive

This comprehensive guide provides a person-centered approach to fitting hearing aids for patients who do not require the additional fitting steps taken with the pediatric population or users with tinnitus and/or profound hearing loss. The intention is to provide evidence-based recommendations for Oticon hearing aids, to deliver optimal outcomes in a clinically efficient manner.

Before fitting

1. Communication and quality of life assessmen t
   Consider completing an assessment questionnaire with your patient. Assessment questionnaires such as the Revised Hearing Handicap Inventory (RHHI)1 and the Client Oriented Scale of Improvement (COSI)2,3 are great counseling tools that can help you understand your patient’s hearing needs and how they impact their quality of life. For a measure of individual hearing abilities in a relatively short format, we recommend the Speech, Spatial, and Qualities of Hearing Scale (SSQ12)4.

2. Audible Contrast Threshold (ACTTM)
   It is recommended to complete the Audible Contrast Threshold test before fitting the hearing aids, to determine your patient’s hearing in noise ability. The ACT value is used in the hearing aid fitting to adjust the advanced sound processing (in Oticon Real™ and onwards) to best support your patient when hearing in noise.

3. Uncomfortable Loudness Level (UCL)
   Before fitting the hearing aids, it is recommended to measure the patient’s Uncomfortable Loudness Level, as this will alter the MPO in the fitting prescription. Therefore, ensure UCL information has been saved in the patient’s Noah profile before opening Oticon Genie 2. If using Genie stand- alone, go to PATIENT and open Audiogram to enter the patient’s UCL.

During the fitting

During the fitting session complete the following steps:

1. Through Noah, open Oticon Genie 2. Click on CONNECT in either the WELCOME or SELECTION screen. If using Genie 2 stand-alone, go to PATIENT and open Audiogram to enter the patient’s audiogram and connect the hearing aids.
2. Select Personalization in either the WELCOME or SELECTION screen. Under PATIENT DATA, fill out basic information about your patient such as experience level and native language. Next, under PERSONALIZATION METHOD, select either the Audible Contrast Threshold (ACT) or the Personalization questionnaire.
   • a. By selecting Audible Contrast Threshold (ACT), the obtained ACT value will either be automatically imported from Noah, or you may have to manually enter it in the designated box. Once entered click SAVE.
   • b. If ACT is not available, the Personalization questionnaire can be filled out.

In FITTING, complete the following steps:

1. Select Acoustics:
   First, ensure that the acoustics placed in the patient’s ears match the selected acoustics in Genie 2. It is recommended to use the default acoustic option for best performance.

2. Select Program Manager:
   The recommended fitting rationale for Oticon hearing aids is VAC+. However, a generic fitting rationale can be selected when choosing programs for your patient.

3. Select Feedback Analyzer:
   Ensure the patient is wearing their hearing aids before clicking START. Remember to warn the patient that the sound produced during the measurement may be loud but will only last a few seconds. Running a feedback analysis better ensures the preservation of gain all day when there is dynamic movement around the head or neck.

4. Select REM AutoFit:
   Perform a target match to the chosen fitting rationale using Real Ear Measurement. REM AutoFit or Manual REM can be performed. These measurements will ensure the hearing aid gain and output meet prescribed targets. The fitting rationale chosen in REM AutoFit must match the fitting rationale selected in Step 2 above.

5. Select Fine-tuning:

6. a. Optional: Adjust the Adaptation Manager (1, 2, or 3). Keep in mind that a new user may benefit from starting at a lower gain level
   (1 or 2) and gradually adapting to the prescribed gain (3) over time. Automatic adjustment over time is available under MORE TOOLS and then Automatic Adaptation Manager. For new users, the adjustment period may take up to 4 months.

7. b. Optional: Adjust SUDDEN SOUND STABILIZER. This feature seamlessly monitors the sound environment and instantly adapts amplification to keep both soft and loud sudden sounds available, balanced, and comfortable, without compromising access to speech.

  * By default, Sudden Sound Stabilizer is set to Medium. The feature is customizable and can easily be adjusted to address varying levels of patient sound sensitivity based on clinical judgment and UCL values.

6. If ACT is not measured: Select MoreSound Intelligence™ to adjust the advanced signal processing and provide the appropriate amount of help for your patient in complex listening environments.

   • a. Turn your screen towards the patient and ask a simple question: “Which situations are Easy or Difficult for you?”

   • b. Use the ENVIRONMENT CLASSIFIER with the patient to choose which situations are difficult or easy. Then, move the boxes
     at the top to the appropriate side.

   • c. When finished categorizing the environments, move on to personalizing Neural Noise Suppression. This feature adjusts the strength of the support provided by the Deep Neural Network 2.0, for both easy and difficult situations.

7. In Oticon Genie 2, it is possible to use data logging for counseling, employing the hearing aid user’s voice activity in different listening environments. To obtain conversation activity data, it is crucial to receive consent in advance. Follow the steps to turn on conversation activity:

   • a. Under MORE TOOLS, click on Data Logging.
   • b. The patient must be informed that data logging tracks the progress of their hearing aid use, including use time, conversation activity, and time spent in different environments, and that conversations are not recorded as part of data logging. The obtained data can be used in a follow-up visit to discuss the patient’s ability to converse and engage in different listening environments.
   • c. I f the patient consents, click on Patient agrees under Conversation activity.

In END FITTING, complete these steps

1. Go to Controls, then BUTTONS AND TAPS, and into CALL CONTROLS to adjust the settings for hands-free call control. This functionality makes it possible to answer and end calls by tapping the hearing aid.*
2. Go to AUDIBLE INDICATORS to demonstrate the available sound indicators for e.g., Program change (in STANDARD) or Answer call (in CALL CONTROLS). Additionally, the Battery low indicator is available as a spoken indicator in select languages.
   • a. If the patient prefers no audible indicators, consider going to VISUAL INDICATORS to make modifications.
3. To end the fitting session, click SAVE AND EXIT.

After Fitting

1. Help your patient connect their hearing aids to any external devices.
2. If your patient uses a smartphone or tablet, recommend that they download the Oticon Companion app. With the app your patient can easily and discreetly control their hearing aids and access Oticon RemoteCare.

At a follow-up visit, either in-person or remotely

1. If the patient has initially given consent, click on Data Logging under MORE TOOLS.
   • a. It is recommended to use the data shown in ENVIRONMENTS as an overview of time spent in different environments, while CONVERSATION ACTIVITY shows the average time the user has actively been speaking over a given time period.
2. Based on the patient’s experiences after the last visit, further adjustments can be made to their help-in-noise settings:
3. Complete an assessment questionnaire with your patient to validate their hearing aid fitting. If a questionnaire was administered before fitting the hearing aid, compare the patient’s answers to determine the benefit of amplification and rehabilitation.
   Only available with devices on the Sirius platform

References:

1. Cassarly, C., Matthews, L J., Simpson, A. N., & Dubno, J. R. (2020). The Revised Hearing Handicap Inventory and Screening Tool Based on Psychometric Reevaluation of the Hearing Handicap Inventories for the Elderly and Adults. Ear and hearing, 41(1), 95–105. doi.org/10.1097/AUD.0000000000000746
2. Laboratory, N. A. (2023). A clinical tool with a focus on a patient’s individual needs is widely adopted when designing rehabilitation programs in appointments. Retrieved from NAL: www.nal.gov.au/nal_products/cosi
3. Dillon, H., James, A., & Ginis, J. (1997). Client-Oriented Scale of Improvement (COSI) and its relationship to several other measures of benefit and satisfaction provided by hearing aids. Journal of the American Academy of Audiology, 8(1), 27–43.’
4. Noble, W., Jensen, N. S., Naylor, G., Bhullar, N., & Akeroyd, M. A. (2013). A short form of the Speech, Spatial and Qualities of Hearing scale suitable for clinical use: is the SSQ12. International journal of audiology, 52(6), 409–412. doi.org/10.3109/14992027.2013.781278

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