Are Marvel 90s worth the price premium over the M50s?


#3

I wear the 70s, although in a custom. Whereas the speech in loud noise is not present, as you say, in the 50s, it is present in the 70s, but you have to manually switch to it. This is not a massive issue because I made it program 3, and made a mental note that if I was in a VERY noise situation that’s where it would be.

However, if you don’t have speech in loud noise, I would say it’s not a huge loss. The difference is that the speech in loud noise really does cut in after 100+ decibels - at least the way mine are programmed. I have only used it once on a train platform in the last couple of years. And as you say the audiologist may be able to alter the thresholds here.

Apart from that, if your lifestyle is reasonably sendentary - mine is approaching horizontal on some days as I reach 50, I don’t think the automatic switching and additional programs - speech in car etc are that badly missed. I have this dilemma every 4 years when I upgrade Phonaks. I actually don’t know if I with have it next time as I suspect Oticon are coming out with something big later on this year and may switch.


#4

I have both a pair of phonak v-50’s and v-90’s set to the same parameters, as close as you can anyway. I cant tell a dimes worh of difference between the two in the same environments


#5

I’ve got the Phonak Q90 and Phonak Q50 and I don’t hear any better with the Q90s. They are set the same (as much as they can be) and I hear the same.


#6

I equate the higher performance levels pushed by audiology retailers. to be like extended warranties or rustproofing to car dealers, almost pure profit.

The cost to Audis are supposedly only a few hundred dollars for the HA itself with the huge markup due to the bundled services. The wholesale cost difference between models must be miniscule.
The services however, testing, adjusting etc are the same so if they cant talk you up, they are leaving a lot of dough onthe table.

The chain I first tested with did say with my mild to moderate hearing impairment I could “get by” with the B50s and then extolled the 90s.

Zip, bang, how soon can you come for a fitting? Felt I was being hustled.

The Brio 3s 2012 chipset is ok but technology is advancing exponentially and to be able to stay state of the art for essentially the same price is a no brainer.


#7

I’ve heard the same hustle. The onIy thing I wonder about in the M50 is speech in loud
noise or the music program. The rest seems redundant. Yet, from what I’ve learned here, it will do just fine. Losing the Compilot is a plus but I wish their phone app was more refined.


#8

I don’t make any more money selling a higher level device than I do an entry level device.

So far, independent research finds that people cannot tell the difference between levels. This is, of course, group data.

On an individual basis, I have had patients do direct comparisons and some of them notice enormous differences between levels and some of them notice little to no difference. I have not yet been able to figure out who is who. Manufacturers like to divide this by “lifestyle” (e.g. quiet life–>low tech, busy life–>high tech), and practioners will do this too in so far as they cannot tell the difference between what the manufacturers tell them and truth. I haven’t really seen that this is a particularly strong correlation. I’ve had patients reject entry level devices as completely unwearable and others who feel that the entry level and the advanced level are identical. The hypotheses I’ve come up with in regards to configuration and type of hearing loss, or types of listening environments, have not yet proven to be predictive.

So when patients ask me what level they need, the real truth is that I have no idea. I can’t say, “Just get the cheap ones, they are all fine” and I can’t say “the more expensive ones are better” because depending on the individual neither of these things may be true. Honestly, it’s the most frustrating part of my job. I want people to get a hearing aid of the appropriate style and power level that is well-fitted. After that, I can’t say I much care what brand or level they get. But not everyone reacts well when you say, “You can get a cheap one or an expensive one. The expensive one might work better or it might not. It’s hard to say.”

Other practitioners may have dramatically different experiences than me.


#9

So, do you notice a significant difference in that program?


#10

So I followed the advice of Dr. Cliff Olson on his You Tube Channel. He gets this question quite often for various hearing aids regarding whether it is worth it to spend the extra money for the higher models (Marvels, Quattros, Evokes, etc.) and his answer is always the same. He says “you are most likely buying the hearing aids for 3-5 years so the difference really doesn’t amount to that much annually and the added benefits are usually beneficial”. And since you indicate in your case you can purchase the M90 model for the same price as the M70, that seems like a very attractive deal to me. I have the Marvel M90R aids and I am a first time user with about 5 weeks of use and I love them. Most of the time I let the AutoSense 3.0 make the necessary adjustments but I have the Speech In Loud Noise program available as one of my manual choices along with the Music and Speech In Car programs. I haven’t yet experienced any cutting in and out while talking with the Music program. I love the hands free phone calls into both ears and I also really love the music streaming from my iPhone. The M90 model has nine programs in AutoSense whereas the M50 has only five. I’m sure whichever way you go you will be happy as these Marvels really are outstanding.


#11

I get what your saying. It’s the marketing from the big six making premium devices
more attractive with automatic settings
to turn on and not need to tweek.

The services you offer go with any device,
M90 or otherwise. Given that most people purchasing are retired I wonder the need for some of the features. But people buy them and are very satisfied with them.


#12

People living in retirement communities can be in dramatically demanding listening environments. Like a gymnasium full of small tables where people are trying to play bridge.

The question of who would benefit from what level of device is theoretically answerable, but audiology is still a relatively young field and the research simply hasn’t been done.

I would put forth the following hypotheses:
-Individuals with largely conductive losses who have been appropriately aided since early childhood, or who had normal hearing in childood, will probably not notice a huge benefit with increased tech level. This does not necessarily hold true for individuals who had considerable middle ear difficulties as a child and who were not aided until later on, given the increased risk of central auditory processing issues. This may also be moderated by other life events that can affect auditory processing such as concussion. Or musical training.
-Individuals with severe-profound (left corner) hearing loss may not notice a difference between tech levels. That is, there may be so much damage present that benefits from high level tech are too small to make a difference. Similarly, individuals with more moderate hearing loss but greater than average auditory processing issues might be in the same boat.
-The more open the fit, the less benefit from directional technologies. (Looks confirmed, open fittings get about one third to half the benefit of directionality that fully occluded fits get, and don’t seem to benefit much at all from noise reduction algorithms.)

That’s all I can think of off the top of my head.


#13

Well, call me biased in my search for the “Quiet Life”. Sometimes I can’t wait to take them out of my ears. I enjoy the blissful silence I moved to the country for. I may
be in the minority. Sirens and city life diminished my hearing and I don’t miss them.


#14

Only in the quality of the incoming sound. In the speech in loud noise program, it is tinny.


#15

I can’t stand my Speech in Loud Noise program. I find UltraZoom to be a lot better for noise control.


#16

In the speech in loud noise program, it is tinny.

Does that refer to all Phonak or Marvel aids in your opinion or specifically just one brand such as M50, or M90?


#17

Sorry. Don’t know. That is just my experience with my custom Virto V70. Although I do have Venture V90s rics as well…and on reflection, they are less tinny in the speech in loud noise program. But as I say, I don’t know about the marvels.


#18

That can be adjusted out. The program does notch the gain up at high frequencies, presumably to help you catch some of the consonants that might otherwise get lost in noise and perhaps to deal with the change in frequency characteristics of speech that occurs when people raise their voices. But one could drop that high frequency gain back down and try to make comparisons between identical gain settings with wide versus narrow directionality. It’s hard to find these numbers. I can’t, off-hand, find any work that has compared narrow to wide directionality specifically. It seems like they compare narrow to omni, or wide to omni, in different studies which makes direct comparisons more difficult. But it looks like in the lab, wide directionality will give a 2-3 dB SNR advantage (closed fit, only ~1.3 dB advantage for open fit) over omni and narrow might give a 4-5 dB SNR advantage. In the lab is important, because it is always an artificial situation. There has been at least one small study trying to bring a measurement task into a natural setting that has shown that, with an open fit, there is no significant directional benefit. It has not been repeated yet with a closed fit. Plus, while it might be logical that the narrow directionality benefit will be additive in all cases, it could just as well be the case that it really only benefits a closed fit. I don’t think that comparison has been done. Perhaps, though, we could say that narrow directionality (one of the big differences between the 30/50 level and the 70/90 level) might give 1 dB advantage in noise in a natural setting. That seems like a small number, but in the right environment it can be critical. However, there are certainly situations where the signal to noise ratio is so poor, or the individual’s SNR requirements are so high, that this won’t make any difference. So it might provide a critical benefit, but only in the right place for the right person. Further, it has been found that people are pretty poor at managing their manual programs, so you might have a higher chance of taking advantage of that benefit if it is automatic (i.e. 90 level).

How can an individual quantify that benefit? A small boost that might be critical in a particular situation that may be individually unpredictable. It almost has to come down to a gut feel–your back brain data mining your own experiences. (And as soon as your button-pressing finger smooshes some dirt into that back mic, all directional benefit is lost anyway.)

As an aside, one of the limitations of the sort of research that has been done is that to create these artificial speech-in-noise situations they simply raise the volume of the background noise but the recorded voices stay the same. As I mentioned, in real life situations where people are raising their voices the shape of the speech changes. As you can see, this research is complex. The R&D is complex, for anyone who thinks that modern hearing aids are simply 60 cent amplifiers with a billion percent mark-up.


#19

I think your UltraZoom program is the speech in loud noise program I’ve been referring to. You have the Brio 1, yes? Which I think is equivalent to the Q? I believe the UltraZoom (StereoZoom for non-costco lingo, and confusingly the stereozoom auto subprogram was called speech in loud noise) was the narrow directionality program which in the newer models is just called speech in loud noise (I don’t know what it’s called with costco). If you have a manual speech in noise program that is different from your UltraZoom, it’s probably a wide directional program.

Though, that does suggest that you notice a benefit to the narrow directionality. :smiley:


#20

Yes I have the Brio 1s. On the software, in the Speech in Loud Noise program, it says StereoZoom underneath all the WindBlock, SoundRelax sliders so I don’t think it hasn’t UltraZoom in the Speech in Loud program on my Brio 1s. It is called Speech in Loud Noise in the SoundFlow programs.


#21

Neville

22h

I don’t make any more money selling a higher level device than I do an entry level device.

So far, independent research finds that people cannot tell the difference between levels. This is, of course, group data.

(Newbie here so dont know how grab quotes properly.)

Neville

Your comments are candid, informed and informative. Thank you.

I find it strange that your margins are not higher on the premium products you provide. This would require the wholesale cost to be substantially less for the M50s yet I understand that they are merely feature restricted by the software or firmware or will be. Can you elucidate?
(Back in the early 80’s I upgraded my firms Wang CPU from 1 to 10 megabytes for a mere $18K. I was pissed when the Tech merely flipped a switch. Should have put in a dummy board at least.)

Is there a citation for the study you reference?

Many thanx


#22

I’m not the owner, I don’t work on commission and I don’t have sales targets. Whether I fit a high level device or an entry level device has zero effect on my own paycheck, and I do not get any pressure from my boss to do one or the other. I try to keep myself fairly separate from the financials, but there are significant differences in the wholesale pricing of the different levels. Yes, the lower levels are feature restricted, but I don’t know about “merely”. The cost of hearing aids is certainly not based on the cost of the hardware. You’re paying for the R&D of those various features.

Which? I looked through a bunch this morning. The level comparisons? I think Robyn Cox has done a few. Try this: https://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/27556363