*Article* **Ecological Momentary Assessment to Obtain Signal Processing Technology Preference in Cochlear Implant Users**

**Matthias Hey 1,\*, Adam A. Hersbach 2, Thomas Hocke 3, Stefan J. Mauger 4, Britta Böhnke <sup>1</sup> and Alexander Mewes <sup>1</sup>**


**Abstract:** Background: To assess the performance of cochlear implant users, speech comprehension benefits are generally measured in controlled sound room environments of the laboratory. For fieldbased assessment of preference, questionnaires are generally used. Since questionnaires are typically administered at the end of an experimental period, they can be inaccurate due to retrospective recall. An alternative known as ecological momentary assessment (EMA) has begun to be used for clinical research. The objective of this study was to determine the feasibility of using EMA to obtain in-themoment responses from cochlear implant users describing their technology preference in specific acoustic listening situations. Methods: Over a two-week period, eleven adult cochlear implant users compared two listening programs containing different sound processing technologies during everyday take-home use. Their task was to compare and vote for their preferred program. Results: A total of 205 votes were collected from acoustic environments that were classified into six listening scenes. The analysis yielded different patterns of voting among the subjects. Two subjects had a consistent preference for one sound processing technology across all acoustic scenes, three subjects changed their preference based on the acoustic scene, and six subjects had no conclusive preference for either technology. Conclusion: Results show that EMA is suitable for quantifying real-world selfreported preference, showing inter-subject variability in different listening environments. However, there is uncertainty that patients will not provide sufficient spontaneous feedback. One improvement for future research is a participant forced prompt to improve response rates.

**Keywords:** cochlear implant; signal processing; hearing in noise; EMA; ecological momentary assessment; acoustic environment; BEAM; ForwardFocus
