Hearing Aid Selection Re-Imagined and Re-Engineered

Finding the right hearing aid can be a daunting task, even for an experienced hearing care professional like myself. Despite massive changes in hearing aid technology over the decades as well as in computer technology itself, the hearing aid selection process has been stuck for two decades.

Value Hearing has just launched a brand new advanced interactive computer-based model, that refines the way hearing aids are being selected.

Hearing Aid Selection to date

ChatGPT from OpenAI, which is a very clever Artificial Intelligence trained on pretty much most of the internet’s information up to 2021, describes the important factors in hearing aid selection as follows:

Hearing care providers, such as audiologists and hearing instrument specialists, consider a variety of factors when selecting a hearing aid for a client. Some of the key factors that they may consider include:

  1. Type and degree of hearing loss: The type and degree of hearing loss will determine which type of hearing aid is most suitable for the client. For example, someone with severe hearing loss may require a different type of hearing aid than someone with mild hearing loss.
  2. Lifestyle: The client's lifestyle and the environments in which they spend the most time will also be considered when choosing a hearing aid. For example, someone who spends a lot of time outdoors or in noisy environments may benefit from a hearing aid with advanced noise-canceling features.
  3. Personal preferences: The hearing care provider will also take into account the client's personal preferences, including the size and style of the hearing aid, as well as any specific features that the client may want or need.
  4. Budget: The client's budget may also be a factor when choosing a hearing aid, as hearing aids can vary significantly in price. The hearing care provider will work with the client to find a hearing aid that meets their needs and fits within their budget.
  5. Physical considerations: The hearing care provider may also consider the client's physical characteristics, such as the size and shape of their ear canal when selecting a hearing aid.

Overall, the hearing care provider will consider a combination of these factors when selecting a hearing aid for a client, with the goal of finding a solution that meets the client's specific hearing needs and preference

I would say in my opinion, that this is a surprisingly accurate summary. I find this kind of technology fascinating and amazing.

From my experience, there are many other factors that may not be accounted for when hearing aids are selected or if they are, they are only factored in very broadly.

These factors could have a big impact on your outcome but are difficult to intuitively take into account with any accuracy. What makes it worse is that each of these factors may differ between hearing aid models, individuals, and situations. These factors also tend to interact with each other in interesting ways, which cannot be accurately guessed.

Below are some of these considerations, which may or may not be factored into the hearing aid recommendation provided to you:

  • Hearing Aid Style - how the hearing aid sits on your head and how that influences the operation of the microphones to help you separate speech from noise
  • Hearing aid venting - is used to ensure your own voice sounds normal to you, while not allowing too much sound to leak out of your ear.
  • One or two hearing aids - most clinicians understand the basic reasoning for one or two hearing aids, but there are interactions that occur with specific hearing aid features and situations which are nearly impossible to consider easily.
  • Hearing Aid Adaptation Level - allows the clinician to ease you into hearing aids by starting with less volume and slowly working our way up to your full prescription.
  • Crowd size and ambient noise level - people tend to start speaking over each other and raise their voices when it becomes difficult to hear. This means that more people in a crowd typically means a louder noise level. Even though this can be calculated, it is very hard to guess at how the crowd size interacts with your hearing and selected hearing aid in a given situation.
  • Lombard Effect - when we can’t hear due to noise, we tend to raise our voices. This will affect how easy to hear the person you are talking to is but varies between situations.
  • Visual cues - We tend to be able to hear better when we can clearly see the speaker's face. Research shows that this varies depending on the situation and your ability to understand speech without looking at someone in the same situation. Clinicians typically understand this, but very few are able to perform the calculations to determine this quickly in their heads when making a recommendation.
  • Speech level and distance to the speaker - the further away someone is from you the softer their voice will tend to reach you.
  • Hearing Aid noise reduction features - how does this affect your ability to understand speech in a variety of situations
  • Hearing Aid Programs - hearing aids tend to have a number of automatic or manually selectable programs (combinations of settings) - it is important to understand how this impacts a client’s goals.
  • Noise Type - Different types of situations have a different spread of noise over different frequencies or pitches. These will affect your ability to hear in these situations depending on all the factors above.

There are many more factors that affect your ability to hear, but accounting for the factors above in detail could increase the accuracy of predicting your outcome with a particular hearing aid significantly.  

It is then no wonder that many hearing care providers then revert to hearing aid trials to put the final choice of the device back on your shoulders. Trials are helpful, but far from perfect as detailed in this article.

Many if not all of these factors have lots of research behind them and can be calculated. The calculations for each are often complex and a single change in one aspect would require recalculation of all aspects due to the way they interact fluidly.

Up to now, it would not have been practicable to account for all these aspects with any degree of accuracy. So many clinicians like myself would have a broad idea of how these factors would impact your listening goals, but would not be able to provide a clear indication of the improvement you could expect. Add to this the complexity of your specific hearing loss, and your ability to understand speech in quiet and in noise (if even measured) and this task soon becomes impractical without specialised technology.

There is a wealth of data out there on how different aspects of hearing loss, hearing aids, acoustics, and psychoacoustics interact or work in isolation. I haven’t however seen anywhere where it has all been combined to create a single dynamic mathematical model of these interactions. Such a model might allow you to predict how well a specific client might expect to do, considering their unique listening goals and hearing loss characteristics,  with a particular hearing aid.

The future has arrived

Cognimatch example

I realised that there was a better way to predict client benefit in noise back in 2009 and wrote a few articles around this topic over the years. I started out with a complex Excel sheet listing all available hearing aids and their features, allowing me and my clinicians to calculate the hearing aid’s ability to help in noise relative to your inability to hear in noise. This allowed for some powerful matching resulting in several benefits to the client and clinician over the traditional selection method. It was still quite limited, despite in my and most of my colleagues’ opinion, being miles ahead of the way things were always done.

The latest article about this ever-improving hearing aid selection process can be found here where I describe Cognimatch and the traditional hearing aid selection process in more detail.

Cognimatch is essentially a powerful cloud computing-based method for matching a hearing aid to an individual’s hearing loss with greater accuracy. The goal is to deliver better outcomes and benefits to you while at the same time empowering you to make better decisions regarding your hearing health.

In the last 2 months, CogniMatch has increased in capability tremendously. This was made possible by the fact that I decided to learn Cloud Application development when Covid first hit. I have been building an in-house CRM using these new skills and part of that involved updating Cognimatch with the new capabilities these skills have enabled.

Cognimatch has now transformed into a Dynamic Mathematical Model allowing the clinician, in real-time, to compare various hearing aids to your hearing relative to your specific hearing goals, providing a prediction of the possible outcomes.

I have taken all the research and points not usually considered traditionally as mentioned above and integrated their calculations into the model. Now, we can estimate, in real-time, how well any hearing aid, captured in the system (over 660 and growing), will work for you in very specific circumstances.

The clinician can also dynamically change the situation and/or the parameters of the situation, for instance, the number of people in a group, and the predictions update in real-time.

This modeling is designed to result in even more accurate recommendations, supported by calculations rooted in research. There are several benefits of using such a system for both you and your clinician.

Benefits to you:

  • Better understand your hearing loss and how and why it impacts on your life.
  • Better understand which hearing aid is likely to assist you best before even trialing it
  • Understand how you can influence your hearing ability by working with the hearing aid
  • Be able to compare the predicted performance of different hearing aids to your specific lifestyle situations
  • Better understand what hearing aids can and can’t do for you
  • Be confident that you are making a big decision on research-based facts rather than just on feelings
  • Less back and forth due to choosing the wrong solution or trying to achieve something which is simply not possible based on your unique variables
  • Less likely to end up not using a hearing aid due to unexpectedly poor performance
  • Being able to confidently buy only what you need. Our data shows not everyone needs the most expensive options
  • Understand why a hearing aid might not work for you or where it could work for you
  • And more…

Benefits for the clinician

  • The ability to easily help empower you with information on your hearing and the impact of different hearing aids and environmental factors.
  • Gives them more confidence in their recommendations
  • Sets realistic expectations so they know what can and cannot be achieved
  • Might motivate them to fit the hearing aid as well as possible to achieve maximal benefit.
  • Provides the ability to compare devices they might not be as familiar with in order to provide maximal benefit to you.
  • Allows them to express complex concepts easily and quickly
  • Forms a central focus point for them and the client to work together to find the best solution for you
  • And more…

This is however not the end of the story. There is so much that can be done to refine this methodology even further.

How to see your unique Cognimatch modeling?

Even though I am planning to make Cognimatch available to all hearing care professionals in the future, it is currently ONLY available at Value Hearing.

The easiest way to benefit from Cognimatch is to make a hearing aid assessment appointment at any one of our clinics.

Book your appointment now or call us on 1300 586 104.


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