Abram & Steve, thank you very much for the expanded list of hearing aids this year. When last year’s list was limited to thise receiving expert badges, there was no way of knowing if a product in which I was interested just missed the cut or had the lowest scores of the bunch. Add to that the fact that badges are based on overall performance, but someone interested in a specific area like music might find just the right HA for him/her in one of those who missed the cut due to lower overall score. Thanks again.
Thank you Bill. Yes, the Leaderboard seems relatively contentious so far, but we justified creating it for exactly this reason. My advice to people is ignore small differences in SoundScore. Anything less than a difference of 1 will not be noticeable to the end user, by our estimation. That is in fact why we awarded everything within 1 point of the top performing aid with an Expert Choice badge. Anything below 4 hypothetically would be noticeably different from the top performing hearing aids. This is a hypothesis that is rooted in previous science (Andy can elaborate as he’s the architect of the SoundScore), but we also plan to confirm this hypothesis soon. We’re building a tool to deploy that will survey thousands of people who have listened to our files through their headphones regarding listening effort, and are also in talks with one of the top universities in the country to do some real subject testing using our audio files to corroborate.
I feel it’s probably time that I share the FAQs I’d previously written for this page. We’ll definitely be using something similar on the Leaderboard page, but will adapt based on the very helpful feedback we’ve been provided with here today:
Each individual has a unique pattern of hearing loss. Are these audio samples relevant to me?
Sound recordings were collected by our partner HearAdvisor using real hearing aids that were specifically programmed to meet the needs of someone with mild sloping to moderate hearing loss. This type of hearing loss was chosen because it is a very common pattern of age-related hearing loss. However, keep in mind that if you have more or less hearing loss, or a different pattern of hearing loss, HearAdvisor’s audio samples will not be representative of the sound you would hear with hearing aids configured for your own unique hearing loss. Remember, nothing beats a real trial with real hearing hearing aids.
What does a “good” hearing aid sound like?
To hear your best with common age-related hearing loss, it’s important that hearing aids provide adequate high-frequency (high tone) amplification. Emphasizing the high frequencies can alter the sound quality substantially, leading to a less natural sound on first impression. But ultimately, replacing those missing high frequency sounds (that haven’t been heard clearly in so long) is the key to understanding speech better.
So while you’re listening to these sound samples, remember that what sounds best from a sound quality perspective may not align with what provides the greatest benefit to speech clarity. If you’re an experienced hearing aid user, you’ll know well that hearing aids can seem unnatural and overly bright initially, but over time you acclimatize and retrain your brain to hear in a more natural way.
We also encourage your to go beyond the sound samples, and click through to view the HearAdvisor ratings for performance in quiet and noisy settings, as well as ratings for own voice quality, feedback issues, and audio streaming quality. HearAdvisor’s ratings are critical to understanding the benefit side of the equation.
What about “open-fit” vs “closed-fit” hearing aids?
“Open-fit” hearing aids are hearing aids that leave your ear canal open. All of the prescription devices tested to date by HearAdvisor are considered open-fit hearing aids. “Closed-fit” hearing aids are those that seal off your ear canal with either a tight custom mold or rubber / silicone ear tip that lets little to no air in or out. Devices such as the Sony CRE-C10, Jabra Enhance Plus, and Apple AirPods Pro 2 are considered closed-fit devices.
The open-fit configuration has several implications for sound quality, benefit with hearing aids, sound localization, and hearing in noise:
Sound Quality: In the real world, open-fit hearing aids generally provide a more natural sound quality because they do not block the ear canal. By combining natural and amplified sound, open-fit hearing aids create a more balanced listening experience.
The Occlusion Effect: Open-fit hearing aids prevent the occlusion effect, which is the sensation of hearing your own voice as if speaking into a barrel.
Benefit with Hearing Aids: Open-fit hearing aids are particularly beneficial for individuals with mild to moderate high-frequency hearing loss. This is because they can amplify high-frequency sounds while still allowing low-frequency sounds to enter the ear naturally. This configuration helps users maintain a sense of spatial awareness and natural sound quality, making the transition to using hearing aids easier.
Sound Localization: Sound localization is the ability to determine the source and direction of a sound. Open-fit hearing aids allow for a better sense of sound localization compared to traditional behind-the-ear (BTE) hearing aids because they do not block the ear canal. By allowing natural sound to enter the ear, users can better utilize their residual hearing and spatial cues to localize sounds.
Hearing in Noise: Open-fit hearing aids can struggle in noisy environments because they allow background noise to enter the ear along with the amplified signal. To address this issue, many open-fit hearing aids incorporate advanced features like directional microphones and AI noise removal to improve speech understanding in noisy situations. While these technologies can help, users with more severe hearing loss or those who struggle in very noisy environments may find traditional BTE or in-the-ear (ITE) hearing aids with a closed fit more beneficial.
Wireless streaming: Open-fit hearing aids allow sound to escape from the ear canal due to their open design. This can result in a decrease in overall sound quality, particularly at higher volumes or with bass-heavy audio content. Closed-fit hearing aids provide better sound isolation, which can lead to richer and fuller sound quality during streaming. However, keep in mind that situational awareness will suffer with closed-fit hearing aids as they will more effectively block outside sounds.
While open-fit hearing aids offer several advantages over closed-fit hearing aids, they may not be the best choice for everyone, especially those with severe hearing loss or who need better performance in noisy environments. We recommend working closely with an audiologist to determine the most appropriate hearing aid style and features for your individual needs.
Are over-the-counter hearing aids as good as prescription hearing aids?
When listening to the audio samples below, you may be tempted to believe that over-the-counter (OTC) hearing aids, like the Jabra Enhance Plus, are just as good as prescription (Rx) hearing aids. In some cases, OTC hearing aids can offer the same performance as prescription devices, but there are some important caveats to consider:
- Mild-to-moderate hearing loss: OTC hearing aids are specifically geared for users with no greater than mild-to-moderate hearing loss. When optimized for users with mild-to-moderate hearing loss, some OTC devices are capable of performing at or close to the level of Rx devices. However, had HearAdvisor tested devices programmed for a more severe hearing loss, the OTC devices would have been completely ineffective. The Rx devices tested are capable of providing much more amplification in order to meet the needs of users with severe or even profound hearing loss.
- Tuned Fit: HearAdvisor optimized the amplification of OTC and Rx devices in a lab using sophisticated tools to assist with applying appropriate sound levels for the target hearing loss. Most end users are unlikely to achieve such perfectly-beneficial settings on their own with OTC devices. On the other hand, if you seek an audiologist who performs real-ear measurements, it’s likely that you can achieve HearAdvisor’s Tuned Fit settings with Rx devices.
What hearing aid settings were used while recording in HearAdvisor’s lab?
All hearing aids were programmed or adjusted to best meet the audibility needs for a person with mild sloping to moderate hearing loss. Audibility simply means how much speech sound information is made available to the listener. Beyond optimizing tone-by-tone amplification, HearAdvisor also used a series of decision trees, documented in the white paper found on HearAdvisor.com, to select specific listening programs or noise-handling features. The audio samples presented below represent the “Tuned Fit” settings, which is relevant when following the documented decision trees.
Let me present a practical problem if I may. An audiologist has recommended the Phonak Lumity for me due to deteriorating speech-in-noise scores in one of my ears (40% word recognition).
When I read the Hearing Tracker review for the Lumity, it says the following:
“Lumity is the first to run on AutoSense OS 5.0, and delivers new speech enhancement and directional microphone features that aim to deliver better speech clarity - especially in background noise . . .
“You might be interested in the Lumity if you’re looking for:
Better hearing in noise: The Lumity product line is geared toward people who are seeking easier communication in diverse listening environments.”
So far, so good! Perfect match for me, right?
BUT . . .
The Phonak Lumity scored the lowest (2.3) of any current generation hearing aid from the Big 6 on the Speech-in-Noise dimension from the Hear Advisor Sound Performance Lab tests. (Tied with Signia Pure C&G.)
If I were picking a hearing aid based only on its Speech-in-Noise test results, I would be looking at the Starkey Evolv (3.5) or the Oticon Real (3.1). Please help me interpret these test results as they might apply to my specific situation.
Many thanks in advance.
Bill, that is a very fair practical problem, and one of our own making at HearingTracker. The truth is that we are in a complete metamorphosis phase right now. In the past all we had to go off was marketing claims, or whatever people would report in the forums (which as discussed earlier can’t always be easily relied on due to individual differences). We now have access to real scientific data that we can refer to our in product reviews, but have not completely adapted our content arm to utilize the new data. HearingTracker has a whole new data and design system being build behind the scenes and we’ll be transitioning to a 10-point expert review system that incorporates the SoundScore as one dimension. Stay tuned!
Abram, my comment was not intended to be critical of Hearing Tracker at all!
The write up on Hearing Tracker agrees 100% with what my audiologist is saying - and he has 40 years experience in the field and he is very well respected. Frankly most of the reviews of the Lumity are glowing. My dilemma now is whether to follow his advice or to factor in Hear Advisor test results and go in a different direction.
Bill, as an audiologist myself, I am personally a believer in Phonak tech, and generally recommend it to friends and family. As discussed above, there may be some winners and losers with the particular audio presentation setup we have opted for in the lab as it may differ from the specific setups used by the major manf’s (there is a lot of variability in lab setups).
Also, I know that aids with automatic program switching are tested in auto mode. One of the variables we have to deal with in the lab is whether or not a hearing aid has automatic environmental switching based on scene classification. With every decision that’s made with regard to hearing aid setup, we try to take the path that would be taken by the average user. So we assume the average user with an auto switching device would simply set it on auto switching as opposed to manually accessing a noise program, and we assume someone with a hearing aid without auto switching would make the effort to switch into a noise program in noise.
I know for example that Phonak has good hyperdirectionality beamforming tech, but I don’t believe this would be active in their auto mode. Do you know @Steve_Taddei ?
At the end of the day, your hearing loss is unique, and not a perfect match to our target audiogram, so if I was you, I’d give the Lumity a shot, and if in doubt, or just curious, try one of the higher scoring hearing aids too to see if you notice any difference. I would love to know how it goes!
Thanks, Abram! Greatly appreciate your input.
@AbramBaileyAuD wrote:
We are confused by the difference between ReSound and the Jabra too, but the results are real, and we’ve performed retests to ensure consistency. I can say that the initial fit condition is most heavily weighted in our SoundScore to align with the fact that the majority of hearing aid fittings do not include fine tuning to REM targets, and provided amplification is typically closer to what is prescribed by the manufacturer (often referred to as “first fit”). So it is possible that Jabra has a different first fit gain calculation approach than ReSound. There are also small differences in the tech, like GN reserving their 360 all around directionality (directional in one ear and omni in the other) exclusively for ReSound, as I understand it. So, the products are not identical. I’ll let Steve chip in with any further comments when he becomes available later.
This is not accurate. The ReSound Nexia 9s, the Jabra Enhance Pro 20s and the Beltone Serene 17s are identical. The tech, 360 all around directionality, the app versions (and release date) and they even use the same tuning software…it says ReSound on it. I am even currently using the ReSound Smart 3D app with my EP 20s as I like the burgundy color better. All the same thing. This is my understanding.
This however is not the case for the Phillips and the Oticon HAs which are ‘similar’. The same for Rexton and Signia.
and analyse oticon intent 1?
I would suggest tiered ratings. One for mild loss including OTC, another for more severe and profound loss with no OTC. Or at least one for OTC and one for prescribed aids. I realize i have unusually high loss, but again, the info is worthless to me, sorry. And actually I feel including OTC aids with “real” aids is unwise and most will not find the info valuable. Just my personal opinion…
@Steve_Taddei can you think of any reason why Jabra and ReSound would have diverged in testing? Guessing the setup process?
Yes, coming next week!
We had to start somewhere, but the plan has always been to expand to other hearing losses. OTC would definitely not be included beyond mild to moderate given the FDA rules.
Rexton and Signia are identical.
My bad thank you for clarifying!! Great to hear!
This is a good idea, though it can be inferred by the product category (Rx, OTC, PSAP). OTC devices are designed for a perceived mild-to-moderate hearing loss (yes, still vague to most) while Rx can fit most hearing losses.
However, we can make this more clear so it is easier for people who are not familiar with the differences. Furthermore, our testing is focused on a mild-to-moderate hearing loss… we wish we had the time and resources to cover a broader range of hearing losses and we continue to workshop this as a future change. Thank you!
Yes @AbramBaileyAuD, it largely depends on the default settings between Jabra Enhance 300 and Resound Omnia. The scores are quite similar, but Resound’s software recommends a more occluding ear tip while 300 is shipped with an open dome (for me).
With that said, Resound is one device that we have thoroughly looked into and may still not have a great answer for. We love Resound’s products however, scores are lower for many of their products. As Abram mentioned, their directionality approach is unique where one ear is directional and the other is omni. We have isolated the ears for analysis in search of score differences but have not observed a significant change. Again, we are continuing to look into this and one possibility is that the benefits of their specific algorithms are simply not observed given our test setup and analysis. Thank you for your insights @RSW and we can keep you updated on the subject.
I actually just finished testing them TODAY and we will have them analyzed and ready next week so stay tuned! Initial testing looked great so we’ll see.
We turned it around quickly. I stayed up late to get the page up
Spoiler: It did really well.