OTC hearing aid ads

Interesting. I’m really glad he’s doing this testing and reviews. One thing that strikes me though about this review and saying these are the best he’s tested so far is the overamplification and lack of noise reduction. Because, that’s what I’ve often heard people complain about when they decide to leave their aids in a drawer rather than wear them. That they make things too loud and don’t help in noise.

Don’t read to much into this, it’s not going to make a difference for the majority of people which is where the market is at, REM isn’t needed for OTC,and it’s not intended to be, also I don’t like Clifford’s videos, he always sounds like some new/used car salesman!

Of course REM isn’t needed for OTC - that’s the whole point of this category of device.

It’s also not actually needed for any HAs, as modern HAs can do the same thing these OTCs do, namely, set themselves automatically based on an audiogram. But the result will not be optimal and a lot of value will be left on the table, a great waste considering the cost of the devices.

The point of REM in the context of evaluating OTC HAs is to asses as objectively as possible whether or not the device is coming close to providing an optimal result for the user. Essentially REM testing the aids here evaluates how aggressive or conservative the OTC aids’ automatic fitting algorithm is versus an optimal fitting.

The question of how optimal the result should be for the much lower price is really the crux of the issue. Comparing various OTC aids to one another using REM is one way of assessing which ones might provide better results instead of accepting the “black box” of automatic fitting as inscrutable.

An ideal evaluation might take the kind of testing shown in the video above further by using numerous ears for each OTC HA instead of just one test subject to eliminate the possibility of unique anatomy preventing a certain HA design from performing well. If sufficient resources were available then independent academic audiology researchers would perform such studies and we could compare devices on that basis. That kind of information would be far superior to the white papers put out by HA makers that always tout X% better performance in this or that scenario for every generation of their own high-end devices… sure! Now, I know I’m mixing apples and oranges here but I digress.

@tenkan said:

I don’t like Clifford’s videos, he always sounds like some new/used car salesman!

I’d never heard of him until this forum. Aside from talking too fast for a hearing-impaired audience (maybe he assumes our hearing’s been well-augmented), I’ve found what he says interesting–one professional’s take on things. But, this one did make me wonder where his funding comes from since he recommended a $1,000 aid that may over or under-amplify and doesn’t reduce noise.

@greg.smith said:

The question of how optimal the result should be for the much lower price is really the crux of the issue.

How optimal isn’t my concern about OTC–it’s are they going to work well enough that people don’t waste their money and get turned off hearing aids (even more than they already are),

@greg.smith said:

If sufficient resources were available then independent academic audiology researchers would perform such studies and we could compare devices on that basis

Yes, this is what we need–except, academe takes forever and a day. These devices will come and go before they even get to the testing room in universities. Testing by an independent source is needed, but not traditional academe–or maybe it could be done through a hearing center associated with a university. Even they’d need to go through human subjects review–but should be pretty quick with something like this. Not much risk to participants.

@cleimer101 said:

If the app is essentially creating an audiogram that the aids will then match, wouldn’t that be considered meeting prescriptive target?

Just my own 2-cents’ worth here, but even if aids are programmed to PERFECTION, using REM, audiogram, yada yada, doesn’t mean you’ll like the sound quality you get wearing them. In that respect, OTC aids (or any programmed aids) are vastly different from prescription eyewear or even OTC reading glasses.

So MUCH of what we hear is our own nuanced preferences. No matter what an audiogram tells my audi to set the aids to, they’re gonna be changed a LOT after 5 min of use right there in the clinic. I am that articulate about what I like and don’t like in how I hear my world.

@greg.smith said:

Of course REM isn’t needed for OTC - that’s the whole point of this category of device

Actually the biggest factor is cost, which can incorporate no longer needing to visit any audiology clinic, which is what DIY is all about. You’ll probably be aware that most clinic’s don’t even bother with REM anyway.

@greg.smith said:

It’s also not actually needed for any HAs, as modern HAs can do the same thing these OTCs do, namely, set themselves automatically based on an audiogram.

Totally agree, and the results can be quite acceptable to a lot people.

@greg.smith said:

More traditional, consumer-oriented sources of HA review information (like Consumer Reports) have tended to be lousy in my view.

Again I agree with this statement, and I’d include the reviews you sometimes see on this forum, hearing is very subjective, federal/government subsidies for independent testing is definitely something that should be looked into.

@tenkan said:

Actually

“Well, actually…”

What I intended to convey is that not needing the assistance of an audiologist (and especially not REM, which is not possible without an audiologist) is the point of an OTC device. That this reduces cost was, I thought, obvious. Maybe I should spell everything out in future though.

@cleimer101 said:

If the app is essentially creating an audiogram that the aids will then match, wouldn’t that be considered meeting prescriptive target?

The big question is, will the aid actually match it?

This concept of prescriptive targets might be worth talking about in detail.

As I understand it, NA-NL2 is currently the most common formula for for fitting HAs. This link has an overview:

What's New About NAL-NL2?5

A concise summary of some of the key changes to the ubiquitous NAL fitting algorithm.

There are other methods, but the general idea is that you can derive the desired amplification in each frequency band from an audiogram. And widely-adopted formulas for doing this exist.

But the question remains, is the device actually capable of delivering that amplification in each frequency band, or is it not calibrated correctly to deliver the desired results from the derived amplification levels given your specific ear anatomy (the shape of which will resonate at certain frequencies, increasing and decreasing volumes in certain bands)?

Any current-generation OTC device will be attempting to match a given audiogram, but many - or even most - may not be capable of (or may programmed in software to stop short of) hitting prescriptive targets the way an audiologist-fitted HA can.

To your question, an apparently underperforming OTC aid might be performing as designed while still amplifying at levels significantly lower than the expected amplification using industry-standard formulas. Is this to please new HA users? For safety? To ensure cheaper devices can’t measure up to “premium” ones? Will it stay that way as the market matures (assuming it does)? Hard to say.

We don’t know if the other hearing aids he tested sell for the same price. We don’t know which ones he’s reviewed or how many–so we don’t really know what the comparison is that he’s making. I went to his audiology practice website thinking maybe I’d find those answers there but didn’t see any OTC reviews. I guess if I really wanted to know I’d have to search through his YouTube videos for each review. Not gonna happen.

He has indeed similarly analyzed numerous OTC-type HAs, videos on which are readily available on his YouTube channel. But as you say, you’re not interested so it’s a moot point.

Yes, I know. Here’s the full explanation, for interest’s sake:

Moot Point vs. Mute Point - Dictionary.com5

You may have heard coworkers or acquaintances refer to an inconsequential or irrelevant point as a moot point, or maybe you’ve heard mute point instead. Fans of the TV show Friends may have heard a third variation: moo point (because, according to...

This is why we need more forum members to review what’s being offered in the OTC market, I’m sure that over the coming months we’ll see a few, don’t forget that the Bose SoundControl has already been reviewed, I’d say their latest respective versions will be quite similar, as they state powered by “Bose” (for whatever that means)

What’s to stop a company from releasing their 10 or fifteen year old prescription aids as OTC for, what, $600.00. These won’t compete with their current models, require no R and D and manufacturing costs are likely minimal. Maybe they’d have to program in self programming capabilities, but probably not. fifteen years ago, HA’s were still very good! This would be a boon to many many people.

@cleimer101 said:

Hearing professionals on the forum @Neville @Um_bongo @Zebras, is that the case?

I’m not an expert, just a user.