8 ms·

My question is how do over the counter hearing aids get adjusted? Currently I go to an audiologist who fine tunes my hearing aids to my specific hearing loss.

My question is how do over the counter hearing aids get adjusted? Currently I go to an audiologist who fine tunes my hearing aids to my specific hearing loss. Will pharmacists do this now? Or are patients still expected to bring over the counter hearing aids to audiologists for those adjustments?

gnicholas 4y ago
Could this be done via smartphone app, where the phone plays a series of sounds and the user responds via the phone's interface? I'm no audiologist, and of course this would depend on the phone's speaker being able to work at a variety of different frequencies.
- crucialfelix 4y ago
  This is currently done by some hearing aid manufacturers. Remote adjustment by Bluetooth pairing with your phone and connecting with an audiologist
- jtwaleson 4y ago
  Check out Mimi. A Berlin based hearing test that runs on your iPhone.
  - gnicholas 4y ago
    Met them at the German Accelerator pitch day in Palo Alto, a few years back!
sdwr 4y ago
Ideally, you should be able to do it yourself on your phone. It's not like it takes special training. Pick what frequencies to boost, try it out, make some different settings for loud parties/quiet conversation/whatever.
- theptip 4y ago
  > It's not like it takes special training. I'm not an expert here but the small amount of digging I've done suggests the opposite. You can permanently damage your hearing if you tune the hearing aid wrong, and it's extremely fiddly (can take many sessions with a professional audiologist) to get things right. I think this is still compatible with some adjustments being done on an app, and definitely with some set of "safe parameters" being available without prescriptions. I just want to push back a bit on the idea that what an audiologist is doing is trivial. I expect most people with severe hearing loss will still want to see a specialist. But _as long as the risks are understood_, more choices are better than fewer.
  - sdwr 4y ago
    Well yeah, "professional audiologists" would love people to believe turning a 2D volume knob is too complicated and dangerous to do alone. Most people don't want to be obsoleted. I use an EQ plugin for Spotify (https://imgur.com/a/NgdTSd1 https://imgur.com/a/NgdTSd1). Something similar, with safety rails for total volume, would be miles better than going in for adjustments for most people. Real-time feedback and control goes a long way to turn a (potentially embarrassing or shameful) disability into something simple, empowering, and even fun.
    - plainhold 4y ago
      People over 60+ accounts for the majority of people with hearing loss. Sadly this part of the population isn't always that tech savvy. It should also be noted that a huge problem in countries in Europe where hearing aids are subsidized by the state is getting people to actually use their subscribed hearing aids. Usually the patients needs information and coaching to be motivated. With that in mind I think alot of over the counter hearing aids will just end up in a shelf somewhere if there isn't any good resource for encouragement and technical help.
      - a9h74j 4y ago
        It seems there are two problems with something in common. Many people don't use their expensive hearing aids after purchase and fitting. And many people might not use inexpensive hearing aids after purchase and whatever fitting. Hmmm.
fasthands9 4y ago
I don't see why you still wouldnt go to an audiologist if you preferred - but I imagine the tech will get good enough that a) perhaps doing it with a phone app would be sufficient b) maybe pharmacies or grocery stores will have techs to help people.
ttpphd 4y ago
Oh hey, I'm an auditory scientist who studies hearing loss, hearing aids, and self-fitting and other "alternative-fit" audio devices. I'm going to copy a bit from my latest paper that touches on this (TL;DR at the bottom). "A central problem of hearing aid fitting is that the space of gain-frequency responses that can be achieved with digital hearing aids is extremely large, but only a subset of those responses could reasonably be audiologically appropriate for any particular ear. Client-based selection of amplification has historically involved some combination of restricting the number of individual gain-frequency responses available (e.g., Humes et al., 2017) and providing efficient methods for navigating the space of gain-frequency responses (e.g., Sabin et al., 2020). The approach of offering a choice between three presets was found to be efficacious in clinical trials of a client-driven delivery model (Humes et al., 2017, 2019). Recent work suggests that as few as four gain-frequency responses can provide audiologically appropriate fits to 60%–75% of adults with mild-to-moderate sensorineural loss (Jensen et al., 2020; Urbanski et al., 2021). Greater coverage can be achieved by expanding the number of gain-frequency responses available to the wearer (Sabin et al., 2021). In a field trial of a self-adjustment tool that provided clients with a large range of gain-frequency responses, participants showed slight preferences for self-adjusted settings over clinician-fit settings, and no group-level differences in clinical measures of amplification benefit were observed (Sabin et al., 2020)." Perry, T. T., & Nelson, P. B. (2022). Self-Adjustment of Hearing Aid Amplification for Lower Speech Levels: Independent Ratings, Paired Comparisons, and Speech Recognition. American Journal of Audiology, 1-17. TL;DR: Some products will come with 4 or 5 presets that you can choose between and then tweak slightly. Some products will come with software (such as a smartphone app) that includes simplified (yet effective!) user interfaces for the wearer to self-adjust the amplification. Some products will ask you to engage in a computerized hearing test to set the device to levels prescribed by an audiogram-based fitting prescription formula. We will see many more audiologists and hearing instrument specialists modifying their service delivery models to invite people to bring their already-purchased OTC hearing aids in and have them programmed by a specialist.
- a9h74j 4y ago
  You have probably considered this, but just to wonder about an option, might a larger (say 15 or 30 total) preset space be searched by a user, UX-wise, via A/B testing or better/worse responses?

gnicholas 4y ago

Could this be done via smartphone app, where the phone plays a series of sounds and the user responds via the phone's interface? I'm no audiologist, and of course this would depend on the phone's speaker being able to work at a variety of different frequencies.

crucialfelix 4y ago
This is currently done by some hearing aid manufacturers. Remote adjustment by Bluetooth pairing with your phone and connecting with an audiologist
jtwaleson 4y ago
Check out Mimi. A Berlin based hearing test that runs on your iPhone.
- gnicholas 4y ago
  Met them at the German Accelerator pitch day in Palo Alto, a few years back!

sdwr 4y ago

Ideally, you should be able to do it yourself on your phone. It's not like it takes special training. Pick what frequencies to boost, try it out, make some different settings for loud parties/quiet conversation/whatever.

theptip 4y ago
> It's not like it takes special training. I'm not an expert here but the small amount of digging I've done suggests the opposite. You can permanently damage your hearing if you tune the hearing aid wrong, and it's extremely fiddly (can take many sessions with a professional audiologist) to get things right. I think this is still compatible with some adjustments being done on an app, and definitely with some set of "safe parameters" being available without prescriptions. I just want to push back a bit on the idea that what an audiologist is doing is trivial. I expect most people with severe hearing loss will still want to see a specialist. But _as long as the risks are understood_, more choices are better than fewer.
- sdwr 4y ago
  Well yeah, "professional audiologists" would love people to believe turning a 2D volume knob is too complicated and dangerous to do alone. Most people don't want to be obsoleted. I use an EQ plugin for Spotify (https://imgur.com/a/NgdTSd1 https://imgur.com/a/NgdTSd1). Something similar, with safety rails for total volume, would be miles better than going in for adjustments for most people. Real-time feedback and control goes a long way to turn a (potentially embarrassing or shameful) disability into something simple, empowering, and even fun.
  - plainhold 4y ago
    People over 60+ accounts for the majority of people with hearing loss. Sadly this part of the population isn't always that tech savvy. It should also be noted that a huge problem in countries in Europe where hearing aids are subsidized by the state is getting people to actually use their subscribed hearing aids. Usually the patients needs information and coaching to be motivated. With that in mind I think alot of over the counter hearing aids will just end up in a shelf somewhere if there isn't any good resource for encouragement and technical help.
    - a9h74j 4y ago
      It seems there are two problems with something in common. Many people don't use their expensive hearing aids after purchase and fitting. And many people might not use inexpensive hearing aids after purchase and whatever fitting. Hmmm.

fasthands9 4y ago

I don't see why you still wouldnt go to an audiologist if you preferred - but I imagine the tech will get good enough that a) perhaps doing it with a phone app would be sufficient b) maybe pharmacies or grocery stores will have techs to help people.

ttpphd 4y ago

Oh hey, I'm an auditory scientist who studies hearing loss, hearing aids, and self-fitting and other "alternative-fit" audio devices. I'm going to copy a bit from my latest paper that touches on this (TL;DR at the bottom). "A central problem of hearing aid fitting is that the space of gain-frequency responses that can be achieved with digital hearing aids is extremely large, but only a subset of those responses could reasonably be audiologically appropriate for any particular ear. Client-based selection of amplification has historically involved some combination of restricting the number of individual gain-frequency responses available (e.g., Humes et al., 2017) and providing efficient methods for navigating the space of gain-frequency responses (e.g., Sabin et al., 2020). The approach of offering a choice between three presets was found to be efficacious in clinical trials of a client-driven delivery model (Humes et al., 2017, 2019). Recent work suggests that as few as four gain-frequency responses can provide audiologically appropriate fits to 60%–75% of adults with mild-to-moderate sensorineural loss (Jensen et al., 2020; Urbanski et al., 2021). Greater coverage can be achieved by expanding the number of gain-frequency responses available to the wearer (Sabin et al., 2021). In a field trial of a self-adjustment tool that provided clients with a large range of gain-frequency responses, participants showed slight preferences for self-adjusted settings over clinician-fit settings, and no group-level differences in clinical measures of amplification benefit were observed (Sabin et al., 2020)." Perry, T. T., & Nelson, P. B. (2022). Self-Adjustment of Hearing Aid Amplification for Lower Speech Levels: Independent Ratings, Paired Comparisons, and Speech Recognition. American Journal of Audiology, 1-17. TL;DR: Some products will come with 4 or 5 presets that you can choose between and then tweak slightly. Some products will come with software (such as a smartphone app) that includes simplified (yet effective!) user interfaces for the wearer to self-adjust the amplification. Some products will ask you to engage in a computerized hearing test to set the device to levels prescribed by an audiogram-based fitting prescription formula. We will see many more audiologists and hearing instrument specialists modifying their service delivery models to invite people to bring their already-purchased OTC hearing aids in and have them programmed by a specialist.

a9h74j 4y ago
You have probably considered this, but just to wonder about an option, might a larger (say 15 or 30 total) preset space be searched by a user, UX-wise, via A/B testing or better/worse responses?