Online Personalization of Hearing Instruments
© Alexander Ypma et al. 2008
Received: 27 December 2007
Accepted: 11 June 2008
Published: 25 June 2008
Online personalization of hearing instruments refers to learning preferred tuning parameter values from user feedback through a control wheel (or remote control), during normal operation of the hearing aid. We perform hearing aid parameter steering by applying a linear map from acoustic features to tuning parameters. We formulate personalization of the steering parameters as the maximization of an expected utility function. A sparse Bayesian approach is then investigated for its suitability to find efficient feature representations. The feasibility of our approach is demonstrated in an application to online personalization of a noise reduction algorithm. A patient trial indicates that the acoustic features chosen for learning noise control are meaningful, that environmental steering of noise reduction makes sense, and that our personalization algorithm learns proper values for tuning parameters.
Modern digital hearing aids contain advanced signal processing algorithms with many tuning parameters. These are set to values that ideally match the needs and preferences of the user. Because of the large dimensionality of the parameter space and unknown determinants of user satisfaction, the tuning procedure becomes a complex task. Some of the tuning parameters are set by the hearing aid dispenser based on the nature of the hearing loss. Other parameters may be tuned on the basis of the models for loudness perception, for example . But, not every individual user preference can be put into the hearing aid beforehand because some particularities of the user may be hard to represent into the algorithm, and the user's typical acoustic environments may be very different from the sounds that are played to the user in a clinical fitting session. Moreover, sound preferences may be changing with continued wear of a hearing aid. Thus, users sometimes return to the clinic soon after the initial fitting for further adjustment . In order to cope with the various problems for tuning parameters prior to device usage, we present in this paper a method to personalize the hearing aid algorithm during usage to actual user preferences.
We consider the personalization problem as linear regression from acoustic features to tuning parameters, and formulate learning in this model as the maximization of an expected utility function. An online learning algorithm is then presented that is able to learn preferred parameter values from control operations of a user during usage. Furthermore, when a patient leaves the clinic with a fitted hearing aid, it is not completely known which features are relevant for explaining the patient's preference. Taking "just every interesting feature" into account may lead to high-dimensional feature vectors, containing irrelevant and redundant features that make online computations expensive and hinder generalization of the model. Irrelevant features do not contribute to predicting the output, whereas redundancy refers to features that are correlated with other features which do not contribute to the output when the correlated features are also present. We therefore study a Bayesian feature selection scheme that can learn a sparse and well-generalizing model for observed preference data. The behavior of the Bayesian feature selection scheme is validated with synthetic data, and we conclude that this scheme is suitable for the analysis of hearing aid preference data. An analysis of preference data from a listening test reveals a relevant set of acoustic features for personalized noise reduction.
Based on these features, a learning noise control algorithm was implemented on an experimental hearing aid. In a patient trial, 10 hearing impaired subjects were asked to use the experimental hearing aid in their daily life for six weeks. The noise reduction preferences showed quite some variation over subjects, and most of the subjects learned a preference that showed a significant dependency on acoustic environment. In a post hoc sound quality analysis, each patient had to choose between the learned hearing aid settings and a (reasonable) default setting of the instrument. In this blind laboratory test, 80% of the subjects preferred the learned settings.
This paper is organized as follows. In Section 2, the model for hearing aid personalization is described, including algorithms for both offline and online training of tuning parameters. In Section 3, the Bayesian feature selection algorithm is quickly reviewed along with two fast heuristic feature selection methods. In addition, the methods are validated experimentally. In Section 4, we analyze a dataset with noise reduction preferences from an offline data collection experiment in order to obtain a reduced set of features for online usage. A clinical trial to validate our online personalization model is presented in Section 5. Section 6 discusses the experimental results, and we conclude in Section 7.
2. A Model for Hearing Aid Personalization
2.1. Learning from Explicit Consent
An important issue concerns how and when to collect training data. When a user is not busy manipulating the CW, we have no information about his satisfaction level. After all, the patient might not be wearing the instrument. When a patient starts with a CW manipulation, it seems reasonable to assume that he is not happy with the performance of his instrument. This moment is tagged as a dissent moment. Right after the patient has finished turning the CW, we assume that the patient is satisfied with the new setting. This moment is identified as a consent moment. Dissent and consent moments identify situations for collecting training data that relate to low and high satisfaction levels. In this paper, we will only learn from consent moments.
2.3. Offline Training
and coincides with the MMSE solution. Here, we defined and the -dimensional feature matrix . By choosing a different prior , one may, for example, emphasize sparsity in the utility parameters. In Section 3, we will evaluate a method for offline regression that uses a marginal prior that is more peaked than a Gaussian one, and hence it performs sound feature selection and fitting of utility parameters at the same time. Such an offline feature selection stage is not strictly necessary, but it can make the consecutive online learning stage in the field more (computationally) efficient.
2.4. Online Training
where and are (time-varying) state and observation noise variances. The rate of learning in this algorithm depends on these noise variances. Online estimates of the noise variances can be made by the Jazwinski method  or by using recursive EM. The state noise can become high when a transition to a new dynamic regime is experienced. The observation noise measures the inconsistency in the user response. The more consistently the user operates the control wheel, the less the estimated observation noise and the higher the learning rate will be.
2.5. Leaving the User in Control
By maximizing the expected utility function in (10), we focus purely on user consent; we consider a new user action as "just" the generation of a new target value . We have not (yet) modeled the fact that the user will react on updated settings for , for example, because these settings lead to unwanted distortions or invalid predictions for in acoustic environments for which no consent was given. The assumption is that any induced distortions will lead to additional user feedback, which can be handled in the same manner as before.
Note that by avoiding a sense of being out of control, we effectively make the perceived distortion part of the optimization strategy. In general, a more elaborate model would fully close the loop between hearing aid and user by taking expected future user actions into account. We could then maximize an expected "closed-loop" utility function , where is shorthand for the earlier utility function of (10), utility term expresses other perceived distortions, and utility term reflects the cost of making (too many) future adjustments.
2.6. Example: A Simulated Learning Volume Control
We performed a simulation of a learning volume control (LVC), where we made illustrative online regression of broadband gain (volume = ) at input power level (log of smoothed RMS value of the input signal = ). As input, we used a music excerpt that was preprocessed to give one-dimensional log-RMS feature values. This was fed to a simulated user who was supposed to have a (one-dimensional) preferred steering vector . During the simulation, noisy corrections were fed back from the user to the LVC in order to make the estimate resemble the preferred steering vector . We simulated a user who has time-varying preferences. The preferred value changed throughout the input that was played to the user, according to consecutive preference modes , and . With , we mean the preferred value during mode . A mode refers to a preferred value during a consecutive set of time samples when playing the signal. Further, feature values are negative in this example. Therefore a negative value of leads to an effective amplification, and vice versa for positive .
Moreover, the artificial user experiences a threshold on his annoyance, which will determine if he will make an actual adjustment. When the updated value comes close to the desired value at the corresponding time, the user stops making adjustments. Here we predefined a threshold on the difference to quantify "closeness." In the simulation, the threshold was put to 0.02; this will lead to many user adjustments for the nonlearning volume control situation. Increasing this threshold value will lead to less difference in the amount of user adjustments between learned and nonlearned cases. When the difference between updated and desired values exceeds the threshold, the user will feed back a correction value proportional to the difference , to which Gaussian adjustment noise is added. The variance of the noise changed throughout the simulation according to a set of "consistency modes." Finally, we omitted the discount operation in this example since we merely use this example to illustrate the behavior of inconsistent users with changing preferences.
3. Acoustic Feature Selection
We now turn to the problem of finding a relevant (and nonredundant) set of acoustic features in an offline setting. Since user preferences are expected to change mainly over long-term usage, the coefficients are considered stationary for a certain data collection experiment. In this section, three methods for sparse linear regression are reviewed that aim to select the most relevant input features in a set of precollected preference data. The first method, Bayesian backfitting, has a great reputation for accurately pruning large-dimensional feature vectors, but it is computationally demanding . We also present two fast heuristic feature selection methods, namely, forward selection and backward elimination. In this section, both of the Bayesian and heuristic feature selection methods are quickly reviewed, and experimental evaluation results are presented. To emphasize the offline nature, we will index samples with rather than with or in the remainder of this section, or drop the index when the context is clear.
3.1. Bayesian Backfitting Regression
We have implemented the Bayesian backfitting procedure by the variational EM algorithm [5, 8], which is a generalization of the maximum likelihood-based EM method. The complexity of the full variational EM algorithm is linear in the input dimensionality (but scales less favorably with sample size). Variational Bayesian (VB) backfitting is a fully automatic regression and feature selection method, where the only remaining hyperparameters are the initial values for the noise variances and the convergence criteria for the variational EM loop.
3.2. Fast Heuristic Feature Selection
Repeat 10 times.
(b)Heuristically rank the features (see below).
From all 10 values (found at 2c), select the median . Then, for all rankings, count the occurrences of a feature in the top to select the most popular features, and finally optimize their weights on the full dataset.
The difference between the two algorithms lies in the ranking strategy used at step 2b. To identify the most promising feature, FW investigates each (unused) feature, directly calculating training errors using (B.5) of Appendix B. In principle, the procedure can provide a complete ordering of all features. The complexity, however, is dominated by the largest sets; so needlessly generating them is rather inefficient. FW therefore stops the search early when the minimal validation error has not decreased for at least 10 runs. To identify the least promising feature, our BW algorithm investigates each feature still being a part of the set and removes the one that provides the largest reduction (or smallest increase) of the criterion in (B.5). Since BW spends most of the time at the start, when the feature set is still large, not much can be gained using an early stopping criterion. Hence, in contrast to FW, BW always generates a complete ordering of all features. Much of the computational efficiency in the benchmark feature selection methods comes from a custom-designed precomputation of data statistics (see Appendix B).
3.3. Feature Selection Experiments
We compared the Bayesian feature selection method to the benchmark methods with respect to the ability to detect irrelevant and redundant features. For this purpose, we generated artificial regression data according to the procedure outlined in Appendix A. We denote the total number of features in a dataset by , and the number of irrelevant features by . The number of redundant features is , and the number of relevant features is . The aim in the next two experiments is to find a value for (the number of selected features) that is equal to the number of relevant features in the data.
3.3.1. Detecting Irrelevant Features
3.3.2. Detecting Redundant Features
4. Feature Selection in Preference Data
We implemented a hearing aid algorithm on a real-time platform, and turned the maximum amount of noise attenuation in an algorithm for spectral subtraction into an online modifiable parameter. To be precise, when performing speech enhancement based on spectral subtraction (see, e.g., ), one observes noisy speech , and assumes that speech and noise are additive and uncorrelated. Therefore, the power spectrum of the noisy signal is also additive: . In order to enhance the noisy speech, one applies a gain function in frequency bin , to compute the enhanced signal spectrum as . This requires an estimate of the power spectrum of the desired signal since, for example, the power spectral subtraction gain is computed as . If we choose the clean speech spectrum as our desired signal, an attempt is made to remove all the background noise from the signal. This is often unwanted since it leads to audible distortions and loss of environmental awareness. Therefore, one can also choose , where is a parameter that controls the remaining noise floor. The optimal setting of gain depth parameter is expected to be user- and environment-dependent. In the experiments with learning noise control, we therefore let the user personalize an environment-dependent gain depth parameter.
Six normal hearing subjects were exposed in a lab trial to an acoustic stimulus that consisted of several speech and noise snapshots picked from a database (each snapshot is typically in the order of 10 seconds), which were combined in several ratios and appended. This led to one long stream of signal/noise episodes with different types of signals and noise in different ratios. The subjects were asked to listen to this stream several times in a row and to adjust the noise reduction parameter as desired. Each time an adjustment was made, the acoustic input vector and the desired noise reduction parameter were stored. At the end of an experiment, a set of input-output pairs was obtained from which a regression model was inferred using offline training.
We postulated that two types of features are relevant for predicting noise reduction preferences. First, a feature that codes for speech intelligibility is likely to explain some of the underlying variance in the regression. We proposed three different "speech intelligibility indices:" speech probability (PS), signal-to-noise ratio (SNR), and weighted signal-to-noise ratio (WSNR). The PS feature measures the probability that speech is present in the current acoustic environment. Speech detection occurs with an attack time of 2.5 seconds and a release time of 10 seconds. These time windows refer to the period during which speech probability increases from 0 to 1 (attack), or decreases from 1 to 0 (release). PS is therefore a smoothed indicator of the probability that speech is present in the current acoustic scene, not related to the time scales (of milliseconds) at which a voice activity detector would operate. The SNR feature is an estimate of the average signal-to-noise ratio in the past couple of seconds. The WSNR feature is a signal-to-noise ratio as well, but instead of performing plain averaging of the signal-to-noise ratios in different frequency bands, we now weight each band with the so-called "band importance function"  for speech. This is a function that puts higher weight to bands where speech has usually more power. The rationale is that speech intelligibility will be more dependent on the SNR in bands where speech is prevalent. Since each of the features PS, SNR and WSNR codes for "speech presence," we expect them to be correlated.
Second, a feature that codes for perceived loudness may explain some of the underlying variance. Increasing the amount of noise reduction may influence the loudness of the sound. We proposed broadband power (Power) as a "loudness index," which is likely to be uncorrelated with the intelligibility indices. The features WSNR, SNR, and Power were computed at time scales of , and seconds, respectively. Since PS was computed at only one set of (attack and release) time scales, this led to features. The number of adjustments for each of the subjects was . This means that we are in the realm of moderate sample size and moderate dimensionality, for which VB is accurate (see Section 3.3).
5. Hearing Aid Personalization in Practice
To investigate the relevance of the online learning model and the previously selected acoustic features, we set up a patient trial. We implemented an experimental learning noise control on a hearing aid, where we used the previously selected features for prediction of the maximum amount of attenuation in a method for spectral subtraction. During the trial, 10 hearing impaired patients were fit with these experimental hearing aids. Subjects were uninformed about the fact that it was a learning control, but only that manipulating the control would influence the amount of noise in the sound. The full trial consisted of a field trial, a first lab test halfway through the field trial, and a second lab test after the field trial. During the first fitting of the hearing instruments (just before the start of the field trial), a speech perception in noise task was given to each subject to determine the speech reception threshold in noise , that is, the SNR needed for an intelligibility score of 50%.
5.1. Lab Test 1
In the first lab test, a predefined set of acoustic stimuli in a signal-to-noise ratio range of [ dB, 10 dB] and a sound power level range of [50 dB, 80 dB] SPL was played to the subjects. SPL refers to sound pressure level (in dB) which is defined as , where is the pressure of the sound that is measured and is the sound pressure that corresponds to the hearing threshold (and no A-weighting was applied to the stimuli). The subjects were randomly divided into two test groups, A and B, in a cross-over design. Both groups started with a first training phase, and they were requested to manipulate the hearing instrument on a set of training stimuli during 10 minutes in order to make the sound more pleasant. This training phase modified the initial (default) setting of 8 dB noise reduction into more preferred one. Then, a test phase contained a placebo part and a test part. Group A started with the placebo part followed by the test part, and group B used the reversed order. In the placebo part, we played another set of sound stimuli during 5 minutes, where we started with default noise reduction settings and again requested to manipulate the instrument. In the test part of the test phase, the same stimulus as in the placebo part was played but training continued from the learned settings from the training session. Analysis of the learned coefficients in the different phases revealed that more learning leads to a higher spread in the coefficients over the subjects.
5.2. Field Trial
From Figure 12, most subjects exhibit more or less symmetric noise reduction preference. However, subjects 8 and 10 (and to a lesser extent subjects 7 and 12) show a fair amount of asymmetry, and all these four subjects preferred learned settings over default noise reduction in lab trial 2. The need for personalization becomes clear from Figure 12 as well since the learned average parameter preferences cover almost the full range of the noise reduction parameter.
5.3. Lab Test 2
Subjects from group A listened to 5 minutes of acoustic stimuli using hearing instruments containing the noise reduction settings that were learned in the field trial. The sounds were a subset of the sounds in the first lab test which exhibited large transitions in SNR and SPL, but they are reflective of typical hearing conditions. The same sound file was played again with default noise reduction settings of 8 dB in all environments to compare sound quality and speech perception. Group B did the same in opposite order. Subjects did not know when default or learned settings were administered. The subjects were asked which of the two situations led to the most preferred sound experience. Two out of ten subjects did not have a preference, three had a small preference for the learned noise reduction settings, and five had a large preference for learned noise reduction settings (so 80% of the subjects had an overall preference for the learned settings). All subjects in the "majority group" in our trial judged the sound quality of the learned settings as "better" (e.g., "warmer sound" or "less effort to listen to it"), and seven out of eight felt that speech perception was better with learned settings. Nobody reported any artifacts of using the learning algorithm.
When looking more closely into the learned surfaces of all subjects, more than half of the subjects who preferred learned over default settings experienced a significantly sloping surface over the relevant acoustic range. The black dots on the surface of Figure 11 denote the sounds that have been used in the stimulus of the second lab test. From the position of these dots, we observe that during the second lab test, subject 12 experienced a noise reduction that changed considerably with the type of sound. We conjecture that the preference with respect to the default noise reduction setting is partly caused by the personalized environmental steering of the gain depth parameter.
By comparing the results of a final speech perception in noise task to those of the initial speech perception task in the initial fitting, it was concluded that the learned settings have no negative effect on conversational speech perception in noise. In fact, a lower speech reception threshold in noise was found with learned settings. However, a confounding factor is the prolonged use of new hearing instruments which may explain part of the improved intelligibility with learned settings.
In our approach to online personalization, an optional offline feature selection stage is included to enable more efficient learning during hearing aid use. From our feature selection experiments on synthetic data, we conclude that variational backfitting (VB) is a useful method for doing accurate regression and feature selection at the same time, provided that sample sizes are moderate to high and computation time is not an issue. Based on our preference data experiment, we selected the features of Power and WSNR for an experimental online learning algorithm. For one of the users, either the sample size was too low, his preference was too noisy, or the linearity assumption of the model might not hold. In our approach, we expect model mismatch (e.g., departure from linearity of the user's internal preference model) to show up as increased adjustment noise. Hence, a user who will never be fully satisfied with the linear mapping between features and noise reduction parameters because of model mismatch is expected to end up with a low learning rate (in the limit of many ongoing adjustments).
Our online learning algorithm can be looked upon as an interactive regression procedure. In the past, work on interactive curve fitting has been reported (e.g., see ). However, this work has limited value for hearing aid application since it requires an expensive library optimization procedure (like Nelder-Mead optimization) and probing of the user for ranking of parameter settings. In online settings, the user chooses the next listening experiment (the next parameter-feature setting for which a consent is given) rather than the learning algorithm. However, in the same spirit as this method, one may want to interpret a consent moment as a "ranking" of a certain parameter-feature setting at consent over a different setting at the preceding dissent moment. The challenge is then to absorb such rankings in an incremental, computationally efficient, and robust fashion. Indeed, we think that our approach to learning control can be adopted to other protocols (like learning from explicit dissent) and other user interfaces. Our aim is to embed the problem in a general framework for optimal Bayesian incremental fitting [14, 15], where a ranking of parameter values is used to incrementally train a user preference model.
In our second lab test, 80% of the subjects preferred learned over default settings. This is consistent with the findings by Zakis  who performed (semi-) online personalization of compressor gains using a standard least-squares method. Subjects had to confirm adjustments to a hearing aid as explicit training data, and after at least 50 "votes" an update to the gains was computed and applied. In two trials, subjects were asked to compare two settings of the aid during their daily life, where one setting was "some good initial setting" and the other was the "learned setting." The majority of the subjects preferred learned settings (70% of the subjects in the first trial, 80% in the second).
In recent work , Zakis et al. extended their personalization method to include noise suppression. Using the same semi-on-line learning protocol as before, a linear regression from sound pressure level and modulation depth to gain was performed. This was done for three different frequency (compression) bands separately by letting the control wheel operate in three different modes, in a cyclical manner. Modulation depth is used as an SNR estimate in each band, and by letting the gain in a band be steered with SNR, a trainable noise suppression can be obtained. Zakis et al. concluded that the provision of trained noise suppression did not have a significant additional effect on the preference for trained settings.
Although their work clearly demonstrates the potential of online hearing aid personalization, there are some issues that may prevent a successful practical application. First, their noise suppression personalization comes about by making per-band gains depend on per-band SNR. This requires a "looping mode implementation" of their learning control, where different bands are trained one after the other. This limits the amount of spectral resolution of the trainable noise suppression gain curve. In our approach, a 17-band gain curve is determined by a noise reduction method based on spectral subtraction, and we merely personalize an "aggressiveness" handle as a function of input power and weighted SNR. Apparently, a perceptual benefit may be obtained from such a learning noise control.
Furthermore, the explicit voting action and the looping mode of the gain control in  can make acceptance in the real world more difficult. We designed our learning control in such a way that it can be trained by using the hearing aid in the same way as a conventional hearing aid with control wheel. Further, in  environmental features have to be logged for at least 50 user actions, and additional updating requires a history of 50 to 256 votes, which limits the practicality of the method. Many users operate a control wheel for only a couple of times per day; so real-world learning with these settings may require considerable time before convergence is reached. In our approach, we learn incrementally from every user action, allowing fast convergence to preferred settings and low computational complexity. This is important for motivating subjects to operate the wheel for a brief period of time and then "set it and forget it" for the remainder of the usage. The faster reaction time of our algorithm comes at the expense of more uncertainty during each update, and by using a consistency tracker we avoid large updates when the user response contains a lot of uncertainty.
Interestingly, Zakis et al. found several large asymmetries between trained left and right steering coefficients, which they attribute to symmetric gain adjustments with highly asymmetric SPL estimates. We also found some asymmetric preferences in noise reduction. It is an open question whether these asymmetries are an artifact of the asymmetries in left and right sound fields or they reflect an actual preference for asymmetric settings with the user.
We described a new approach to online personalization of hearing instruments. Based on a linear mapping from acoustic features to user preferences, we investigated efficient feature selection methods and formulated the learning problem as the online maximization of the expected user utility. We then implemented an algorithm for online personalization on an experimental hearing aid, where we made use of the features that were selected in an earlier listening test. In a patient trial, we asked 10 hearing impaired subjects to use the experimental hearing aid in their daily life for six weeks. We then asked each patient to choose between the learned hearing aid settings and a (reasonable) default setting of the instrument. In this blind laboratory test, 80% of the subjects chose the learned settings, and nobody reported any artifacts of using the learning algorithm.
The authors would like to thank Tjeerd Dijkstra for preparation of the sound stimuli, and they are grateful to him, Almer van den Berg, Jos Leenen and Rob de Vries for useful discussions. They would also like to thank Judith Verberne for assistance with the patient trials. All collaborators are affiliated with GN ReSound Group.
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