 Hello everyone, my name is Josefine and I am a scientist at Ericsholm Research Center, which is Otikon's research center in Denmark. In this presentation, I would like to give you an overview of how we have developed a framework for our hearing aid users to continuously evaluate on the situations that they find difficult in their everyday life and how we are logging the acoustic environment around them in these situations. And why do we need that? Because overall, we need an overview of the situations that are important to get right. And the way that we typically get feedback from our customers on their experiences is during follow-up visits in the clinic, where people report on the situations that they find difficult, and we are making adjustments to their hearing aids accordingly. But these recollections of these scenarios are typically prone to memory bias and are not always specific enough for us to make targeted adjustments that are relevant. So we need to be able to capture these situations with greater detail and less recall bias so we can have more informed discussions with our clients and make more targeted adjustments of their hearing aids. And one of the most widely used tools for evaluating the benefit of hearing aid processing is the client-oriented scale of improvement or COTI. Together with hearing care professionals, the client lists and ranks up to five different situations that they find difficult and that they want to improve on. And after fitting in an acclimatization period, the client then comes back to the clinic and those key situations are evaluated in terms of how much they have improved after the fitting. And we wanted to develop a digital version of this tool so that people could continuously report on the situations they find difficult while they are actually finding themselves in those situations. But if we wanted to look at every single specific COTI situation, then the list would go on forever and we wouldn't be able to generalize our findings. So what is important to capture when we want to generalize a scenario? We would like to capture the environment that people are finding themselves in so that they might be indoors or they might be out on the playground. And we want to capture the intent that they have in this scenario. So maybe they want to carry out a conversation or maybe they just want to listen to whatever is going on around them without listening to anything specifically. So luckily we did not have to start from scratch because there already exists a framework called CUS or Common Sound Scenarios by Walsers Event where they are narrowing down any intent you might have in any given situation to three overall categories. So either you want to carry out conversation with two or more people or through a device. You want to listen in on something specific like you're at a concert or you are listening in on a lecture or you do not have any specific target that you want to listen to, you just want to monitor your surroundings. And they have listed different scenarios that are examples of these different situations. But we needed to expand the framework a bit and generalize the scenarios that they had exemplified in their framework to match the course situations from our database. So we took 83 course reports from our database where our clients had listed up to five different situations that they found difficult and that they wanted to improve on. And we tried to see how that would fit into the CUS framework in terms of people's intent. And we found a need to expand a few categories. So for example, we were wanted to be able to distinguish between whether people were carrying out a conversation in quiet or noise and or whether they were monitoring nature sounds or alarms in their surroundings. And then we specified overall categories of environments to be able to describe all the 303 CUSy situations in total. Not surprisingly, we found that speech communication was the most challenging situation for our clients by 62% followed by situations where people are actively listening to something. So we have implemented a questionnaire in our OdeCon On App where people can report on these situations continuously after being sent home. The first question that we are asking them in this questionnaire is what environment they're in and secondly, what their intent is in that situation. And then we are asking them to rate how difficult they find this situation and how important the situation is for them and also how often they find themselves in this situation. And then we are asking them how much help they perceive that they are getting from their hearing aid. And then finally, there is an optional field to elaborate on their experiences. And throughout the day and also while they're filling out the questionnaires, we are logging the complexity of the environment around them. So we are logging the sound pressure level, the signal to noise ratio and noise level. And we are also logging if they are making any volume or program changes to get an objective assessment of the environment that they are in. So now we have started our data collection, which consists of the following steps. So first, the client comes into the clinic for an initial fit where they also fill out a CUSy report. And then they download the app to their phone and they are instructed on how to report on the situations that they find challenging. And then they are sent home for a field trial period where we are continuously logging their acoustic environment and capturing their EMAs. They are only receiving a prompt or a notification every morning saying that we would like them to evaluate on their experiences, but otherwise the EMAs are self-initiated. And then four to six weeks after the client comes back to the clinic for a follow-up visit where they are receiving fine-tuning to their hearing aid if they need that. And then we are asking them to fill out a questionnaire where they are to elaborate on their experiences on continuously evaluating on these situations. So we are asking them whether that makes them focus more negatively on the situations or if it's actually empowering them to feel like they have control over the situations. And then we are sending them home again for another field trial period. And after six months they are receiving the questionnaire again to fill out at home and then we are ending the data collection. So what insights do we expect to gain from this experiment? Well, first of all, we hope to get a good overview of what situations are the most important and the most difficult for our users, both from a subjective and an objective point of view. And then we are developing a digital clinical tool for measuring the benefits of hearing aids to be used in normal non-research clinics where the hear-care professional can have a more informed discussion with their client to base their hearing aid fitting on that is less prone to recall bias and that has a greater detail in terms of what exactly the situation was when they were struggling. And they'll be able to do longitudinal analyses of whether there's a change in the client's cozy situations over time. So you should be able to see some results from this experiment in other conferences later this year. For now, I just want to thank you for your time and I'm happy to take your questions.